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 10:29 AM

Hugo Ortiz jr.

Lionel Blackwell

None

ethnicity

gender

ssn

badge

Hispanic

Male

2626

No

Job Classification

Union Member?

Apprentice?

Period

Plumber Helper

Yes

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

12/11/2017

04/11/2018

8.00

11.70

Pay Type

Pay Day

deductions

OSHA

Paycheck

Wednesday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Tape Measure

Channel Locks

Knife

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

None

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature