Worker Interview - DSA

Worker Interview

General Information

Project Name: Dowling Middle School (Lawson) - HISD

Prime Contractor: Turner Construction Company

Subcontrctor: LD Bundren Painting, Inc.

Interview Detail

Date

Worker Name

Auditor Name

Remarks

04/12/2018 02:18 PM

Luis Palacios

Victor Bowen

None

ethnicity

gender

ssn

badge

Hispanic

Male

4693

No

Job Classification

Union Member?

Apprentice?

Period

Painter

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

08/26/2017

04/11/2018

8.00

18.00

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

Yes-30

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Paint brush

Roller

Hand Tools

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

40.00

Other Work?

Other Training?

Experience

Certifications

None

None

5.00

Scissor

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature