Dosh activity notification form 2025

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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.
The completed form can be faxed to the nearest DOSH office. Do not mail duplicate notifications after faxing.
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.
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.
Ground protection methods for excavations deeper than 20 feet must be designed by a Registered Professional Engineer.
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