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

11/15/2017 12:00 AM

Norma Carolina gomez

Victor Bowen

0

ethnicity

gender

ssn

badge

Hispanic

Female

6163

Yes

Job Classification

Union Member?

Apprentice?

Period

Painter-Helper

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

11/08/2017

11/14/2017

8.00

14.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Thursday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Roller

Paint brush

Hand Tools

0

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

No

No

No

32.00

Other Work?

Other Training?

Experience

Certifications

0

0

1.00

0

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature