Worker Interview - DSA

Worker Interview

General Information

Project Name: Madison High School - HISD

Prime Contractor: Satterfield & Pontikes Construction, Inc

Subcontrctor: CFI Mechanical Inc

Interview Detail

Date

Worker Name

Auditor Name

Remarks

04/12/2018 10:25 AM

Ramon Espinosa

Lionel Blackwell

None

ethnicity

gender

ssn

badge

Hispanic

Male

4745

No

Job Classification

Union Member?

Apprentice?

Period

Plumber

Yes

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

06/01/2017

04/11/2018

8.00

21.80

Pay Type

Pay Day

deductions

OSHA

Paycheck

Wednesday

Yes

Yes-30

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Channel Locks

Tape Measure

Drills

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

None

None

4.00

Scissor lift

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature