DA Form 5381 Building - Fire Risk Management Survey

DA Form 5381 or the "Building - Fire Risk Management Survey" is a Department of the Army-issued form used by and within the United States Military.

The form - often incorrectly referred to as the DD form 5381 - was last revised on January 1, 2009. Download an up-to-date fillable DA Form 5381 down below in PDF-format or look it up on the Army Publishing Directorate website.

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BUILDING - FIRE RISK MANAGEMENT SURVEY
USE REVERSE SIDE FOR REMARKS
For use of this form, see AR 420-1; the proponent agency is ACSIM.
1. BUILDING NUMBER OR AREA
2. OCCUPANCY
3. ORGANIZATION
4. DATE
5.
SECTION A - INSPECTION CHECK LIST (Common and or Special Fire Hazards)
A. HOUSEKEEPING:
D. PETROL, OIL, LUBRICANTS:
G. FIRE DETECTION:
J. FIRE EXTINGUISHERS:
Girders
General Order
Pipe Leaks
Detectors
Service Date
Trusses
Rubbish
Refueling
Batteries
Location
Stairs
Cleanliness
Defueling
Wiring
Hydrostatic Test Date
Fire Escape
Vegetation Growth
Grounding
Control Box
Pressure Gauge
M. STORAGE:
Improper Storage
Bonding
Fuses
Horn
Overall Poor
Electrical
Nozzle
Procedures
H. FIRE SUPPRESSION SYSTEMS
Outdoor Housekeeping
Compatibility
Control Valve
Fire Lanes
Manhole Cover
Sprinkler Riser
Safety Pin
Wall to Storage Spacing
B. SMOKING:
K. FLAMMABLE STORAGE:
Distance to Building
Compressor
Storage Height
N. HAZARDOUS MATERIALS:
Unauthorized Area
Drains
Post Indicator Valve
Flammable Gases
Smoking Permit
Nozzles
2-inch Drain
Flammable Liquids
Containers
E. HEATING:
Branch Lines
Electrical Fixtures
Compatibility
Disposal of Materials
Receptacles
Fuel Pipe
Sprinkler Heads
Diking
Storage Method
No Smoking Signs
Fuel Lines
Inspector's Test Valve
Barrier Protection
Improper Facility
Improper Lighter
Filters
Agent
Venting
Items Not Labeled
Matches
Damper
Fusible Links
Labeling
Warnings Signs
Cooking Equipment
Nozzles
Containers
Ventilation
Deep Fat Fryers
Fire Hydrant
Cabinet
Ovens
Leakage
C. ELECTRICAL:
I. LIFE SAFETY CODE:
Burners
Overstock
Multiple Outlets
Exhaust Hoods
Occupancy Load
L. BUILDING CONSTRUCTION:
Extension Cords
Housekeeping
Means of Egress
Frayed Wiring
Chimney
Exit Requirement
Doors
O. SPECIAL HAZARDS:
Hazardous Locations
Thermostat
Emergency Lighting
Windows
F. FIRE DOORS:
Improper Wiring
Exit Impediments
Hardward
Welding & Cutting
Fuses & Panel Boxes
Fusible Link
Exit Lights
Fire Walls
Finishing Processes
Conduit & Raceways
Door Guides
Exit Signs
Door Frame
Hot Work Permit
Conductors
Operational
Interior Finish
Floors, Bearing
Spontaneous Heating
Outlet Boxes
Rated
Smoke Barriers
Roofs
Interior Finish
Switches & Fixtures
Damaged
Ramps
Columns
Hardware
Beams
6.a. NAME OF INSPECTOR (Print or Type)
7.a. NAME OF ORGANIZATION FIRE MARSHALL (Print or Type)
6.b. SIGNATURE
7.b. SIGNATURE
DA FORM 5381, JAN 2009
PREVIOUS EDITION ARE OBSOLETE.
APD LC v1.00ES
BUILDING - FIRE RISK MANAGEMENT SURVEY
USE REVERSE SIDE FOR REMARKS
For use of this form, see AR 420-1; the proponent agency is ACSIM.
1. BUILDING NUMBER OR AREA
2. OCCUPANCY
3. ORGANIZATION
4. DATE
5.
SECTION A - INSPECTION CHECK LIST (Common and or Special Fire Hazards)
A. HOUSEKEEPING:
D. PETROL, OIL, LUBRICANTS:
G. FIRE DETECTION:
J. FIRE EXTINGUISHERS:
Girders
General Order
Pipe Leaks
Detectors
Service Date
Trusses
Rubbish
Refueling
Batteries
Location
Stairs
Cleanliness
Defueling
Wiring
Hydrostatic Test Date
Fire Escape
Vegetation Growth
Grounding
Control Box
Pressure Gauge
M. STORAGE:
Improper Storage
Bonding
Fuses
Horn
Overall Poor
Electrical
Nozzle
Procedures
H. FIRE SUPPRESSION SYSTEMS
Outdoor Housekeeping
Compatibility
Control Valve
Fire Lanes
Manhole Cover
Sprinkler Riser
Safety Pin
Wall to Storage Spacing
B. SMOKING:
K. FLAMMABLE STORAGE:
Distance to Building
Compressor
Storage Height
N. HAZARDOUS MATERIALS:
Unauthorized Area
Drains
Post Indicator Valve
Flammable Gases
Smoking Permit
Nozzles
2-inch Drain
Flammable Liquids
Containers
E. HEATING:
Branch Lines
Electrical Fixtures
Compatibility
Disposal of Materials
Receptacles
Fuel Pipe
Sprinkler Heads
Diking
Storage Method
No Smoking Signs
Fuel Lines
Inspector's Test Valve
Barrier Protection
Improper Facility
Improper Lighter
Filters
Agent
Venting
Items Not Labeled
Matches
Damper
Fusible Links
Labeling
Warnings Signs
Cooking Equipment
Nozzles
Containers
Ventilation
Deep Fat Fryers
Fire Hydrant
Cabinet
Ovens
Leakage
C. ELECTRICAL:
I. LIFE SAFETY CODE:
Burners
Overstock
Multiple Outlets
Exhaust Hoods
Occupancy Load
L. BUILDING CONSTRUCTION:
Extension Cords
Housekeeping
Means of Egress
Frayed Wiring
Chimney
Exit Requirement
Doors
O. SPECIAL HAZARDS:
Hazardous Locations
Thermostat
Emergency Lighting
Windows
F. FIRE DOORS:
Improper Wiring
Exit Impediments
Hardward
Welding & Cutting
Fuses & Panel Boxes
Fusible Link
Exit Lights
Fire Walls
Finishing Processes
Conduit & Raceways
Door Guides
Exit Signs
Door Frame
Hot Work Permit
Conductors
Operational
Interior Finish
Floors, Bearing
Spontaneous Heating
Outlet Boxes
Rated
Smoke Barriers
Roofs
Interior Finish
Switches & Fixtures
Damaged
Ramps
Columns
Hardware
Beams
6.a. NAME OF INSPECTOR (Print or Type)
7.a. NAME OF ORGANIZATION FIRE MARSHALL (Print or Type)
6.b. SIGNATURE
7.b. SIGNATURE
DA FORM 5381, JAN 2009
PREVIOUS EDITION ARE OBSOLETE.
APD LC v1.00ES

Download DA Form 5381 Building - Fire Risk Management Survey

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