Get Work Zone Accident Report (form 25d-123) - Dot State Ak

Filling out the Work Zone Accident Report (Form 25D-123) is crucial for documenting accidents that occur within work zones. This guide will provide you with clear and supportive instructions on how to accurately complete the form online.

Follow the steps to fill out the Work Zone Accident Report online.

1. Click 'Get Form' button to access the form and open it in the editor.
2. Begin by filling in the project name in the designated field. This information identifies the location related to the incident.
3. Enter the project number, which serves as a unique identifier for the project in question.
4. Provide the roadway name where the accident took place, ensuring that this is accurate for record-keeping.
5. In the 'Investigated by' section, list the name of the Department of Transportation and Public Facilities employee who conducted the investigation.
6. Fill in the name of the person reporting the accident in the 'Reported by' field.
7. Indicate the date and time of arrival at the accident site to establish when the report was submitted.
8. Provide the milepost where the accident occurred for precise location details.
9. Enter the date of the accident occurring.
10. Specify the time of the accident to ensure comprehensive detail.
11. Indicate the number of vehicles involved in the accident.
12. Describe the roadway conditions at the time of the accident.
13. Document the weather conditions present during the incident.
14. Assess the severity of injuries resulting from the accident.
15. Provide a narrative of the accident to offer further context and details regarding the events.
16. If applicable, indicate whether contractor's vehicles or equipment were involved by selecting Yes or No.
17. Repeat the last step for state vehicles or equipment.
18. Confirm if the accident occurred within the project's limits by marking Yes or No.
19. Indicate if the accident took place within the active work zone.
20. Determine whether the accident was related to construction activity by selecting Yes or No.
21. State whether police were on-site and, if yes, be prepared to attach their report.
22. Document the police case number if applicable.
23. Include an accident diagram by either pasting an electronic sketch or attaching a hard copy sketch, using the prescribed symbols.
24. Once all fields are completed, review your entries for accuracy. You can then save changes, download, print, or share the completed form.

Complete your Work Zone Accident Report online today to ensure timely and efficient processing.