Worker Interview - DSA

Worker Interview

General Information

Project Name: Yates High School - HISD

Prime Contractor: Turner Construction Company

Subcontrctor: LD Bundren Painting, Inc.

Interview Detail

Date

Worker Name

Auditor Name

Remarks

10/06/2017 12:00 AM

Ciilo villeda

Victor Bowen

Biweekly pay

ethnicity

gender

ssn

badge

Hispanic

Male

1234

No

Job Classification

Union Member?

Apprentice?

Period

Painter

No

Unkown

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

07/04/2017

10/05/2017

8.00

14.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Hand Tools

Roller

Paint brush

0

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

No

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

0

0

2.00

0

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature