DA Form 5382 Hazard/Deficiency Inspection Record

DA Form 5382 or the "Hazard/deficiency Inspection Record" 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 5382 - was last revised on January 1, 2009. Download an up-to-date fillable DA Form 5382 down below in PDF-format or look it up on the Army Publishing Directorate website.

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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

Download DA Form 5382 Hazard/Deficiency Inspection Record

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