Worker Interview - DSA

Worker Interview

General Information

Project Name: Yates High School - HISD

Prime Contractor: Turner Construction Company

Subcontrctor: Karsten Interior Services, LP

Interview Detail

Date

Worker Name

Auditor Name

Remarks

01/04/2018 02:03 PM

Obdolio Campos

Jorje Munoz

None

ethnicity

gender

ssn

badge

Hispanic

Male

1234

Yes

Job Classification

Union Member?

Apprentice?

Period

Laborer-Skilled

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

09/15/2017

01/03/2018

8.00

12.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

Yes

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Broom

Shovel

Trash bin

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

No

No

No

32.00

Other Work?

Other Training?

Experience

Certifications

None

None

0.00

None

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature