DA Form 5382 "Hazard/Deficiency Inspection Record"

What Is DA Form 5382?

This is a military form that was released by the U.S. Department of the Army (DA) on January 1, 2009. The form, often mistakenly referred to as the DD Form 5382, is a military form used by and within the U.S. Army. As of today, no separate instructions for the form are provided by the DA.

Form Details:

  • A 1-page document available for download in PDF;
  • The latest version available from the Army Publishing Directorate;
  • Editable, free, and easy to use;

Download an up-to-date fillable DA Form 5382 down below in PDF format or browse hundreds of other DA Forms stored in our online database.

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Download DA Form 5382 "Hazard/Deficiency Inspection Record"

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HAZARD/DEFICIENCY INSPECTION RECORD
SUSPENSE DATE
For use of this form, see AR 420-1, the proponent agency is ACSIM.
TO:
FROM: (Fire Chief)
LOCATION OF FIRE SAFETY VIOLATION
DATE AND TIME OF VIOLATION
HAZARDS/DEFICIENCIES NOTED
CORRECTIVE ACTION TAKEN (Return to Fire Chief)
DATE
REPORT DONE BY:
DATE
INSTALLATION FIRE CHIEF SIGNATURE:
DATE
INSTALLATION FIRE MARSHALL SIGNATURE:
DATE
ORGANIZATION OR ACTIVITY FIRE MARSHALL SIGNATURE:
FOLLOW UP INSPECTION
SATISFACTORY
UNSATISFACTORY
DATE
INSPECTED BY:
DA FORM 5382, JAN 2009
PREVIOUS EDITIONS ARE OBSOLETE.
APD LC v1.00ES
HAZARD/DEFICIENCY INSPECTION RECORD
SUSPENSE DATE
For use of this form, see AR 420-1, the proponent agency is ACSIM.
TO:
FROM: (Fire Chief)
LOCATION OF FIRE SAFETY VIOLATION
DATE AND TIME OF VIOLATION
HAZARDS/DEFICIENCIES NOTED
CORRECTIVE ACTION TAKEN (Return to Fire Chief)
DATE
REPORT DONE BY:
DATE
INSTALLATION FIRE CHIEF SIGNATURE:
DATE
INSTALLATION FIRE MARSHALL SIGNATURE:
DATE
ORGANIZATION OR ACTIVITY FIRE MARSHALL SIGNATURE:
FOLLOW UP INSPECTION
SATISFACTORY
UNSATISFACTORY
DATE
INSPECTED BY:
DA FORM 5382, JAN 2009
PREVIOUS EDITIONS ARE OBSOLETE.
APD LC v1.00ES