Title Page
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Audit Title
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Extra Work Ticket #
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Client / Site
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Conducted on
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Prepared by
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Location of Extra Work
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Personnel
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Please describe extra work performed
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Please explain who directed this work to be completed, and by what means (verbal, email etc.)
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Please describe the time frame required to complete this work
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Please attach photographs here
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Were carpenters used to complete this fix?
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Please specify who completed this task
Employee
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Name
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Were laborers used to complete this fix?
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Please specify who completed this task
Employee
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Name
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Were finishers used to complete this fix?
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Please specify who completed this task
Employee
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Name
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Were operators needed to complete this fix?
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Please specify who completed this task
Employee
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Name
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Were Ironworkers used to complete this fix?
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Please specify who completed this task
Employee
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Name
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Were Engineers used to complete this fix?
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Please specify who completed this task
Employee
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Name
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Please enter materials needed to complete this fix
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Please enter date work began
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Please enter date work was completed
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Will there be additional work required to complete this task? If so, please describe
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Does this fix require architect or structural engineer approval?
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Please specify by whom and enter reference information (ASI, RFI, SSK etc.)
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Signature of Author
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Signature and Title of Recipient
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Additional Comments
