Form DWR922A "Contractor's Accident Summary" - California

What Is Form DWR922A?

This is a legal form that was released by the California Department of Water Resources - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on August 1, 2019;
  • The latest edition provided by the California Department of Water Resources;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form DWR922A by clicking the link below or browse more documents and templates provided by the California Department of Water Resources.

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Download Form DWR922A "Contractor's Accident Summary" - California

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State of California
DEPARTMENT OF WATER RESOURCES
California Natural Resources Agency
CONTRACTOR'S ACCIDENT SUMMARY
Month
Injuries x 200,000
Days Lost x 200,000
Frequency:
Severity:
20
Total Man Hours
Total Man Hours
Number of
Man Hours
Disabling Injuries
Day Lost Time
Frequency
Severity to
Project Offices
Employees
to Date
Date
Month
To Date
Month
To Date
Month
To Date
Totals
Summary: National Average for Construction*
Year
for DWR Construction
Year
for Sacramento Projects
Year
for Lancaster Projects
Year
for
*The National Average for Construction for frequency as published by the Bureau of Labor
Sheet
of
Statistics (BLS). BLS has stopped publishing the severity rate.
DWR 922a (Rev. 8/19)
State of California
DEPARTMENT OF WATER RESOURCES
California Natural Resources Agency
CONTRACTOR'S ACCIDENT SUMMARY
Month
Injuries x 200,000
Days Lost x 200,000
Frequency:
Severity:
20
Total Man Hours
Total Man Hours
Number of
Man Hours
Disabling Injuries
Day Lost Time
Frequency
Severity to
Project Offices
Employees
to Date
Date
Month
To Date
Month
To Date
Month
To Date
Totals
Summary: National Average for Construction*
Year
for DWR Construction
Year
for Sacramento Projects
Year
for Lancaster Projects
Year
for
*The National Average for Construction for frequency as published by the Bureau of Labor
Sheet
of
Statistics (BLS). BLS has stopped publishing the severity rate.
DWR 922a (Rev. 8/19)