Dosh activity notification form 2025

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The document is an Activity Notification Form from the California Department of Industrial Relations, specifically for holders of annual permits related to scaffolding, falsework, and trenches/excavations. It requires notification to the Division of Occupational Safety and Health (DOSH) before commencing work, detailing project specifics such as location, type of activity, and safety measures. The form must be completed by a knowledgeable person and can be faxed to the nearest DOSH office.

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Versions	Form popularity	Fillable & printable
2006	4.8 Satisfied (281 Votes)
1994	4.4 Satisfied (231 Votes)

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What is the purpose of the Activity Notification Form?

The form is used by holders of annual permits to notify the Department of Industrial Relations (DOSH) before commencing work on scaffolding, falsework, or trenches/excavations.

How should I submit the completed notification form?

The completed form can be faxed to the nearest DOSH office. Do not mail duplicate notifications after faxing.

What information is required on the form?

You need to provide details such as company name, annual permit number, specific activity location, number of employees, starting and anticipated completion dates, and whether high voltage lines are in proximity.

Is a professional engineer required for certain activities?

Yes, if your project involves scaffolding over 60 feet or metal structures over 125 feet, you must have designs by a California Registered Civil Engineer.