Ammunition malfunctions can lead to serious accidents and operational failures, impacting both safety and efficiency within the armed services. Recognizing the critical nature of these incidents, the DA 4379 form serves as a thorough report dedicated to cataloging the specific details of ammunition malfunctions. This document is an essential piece of administrative protocol, mandated for use by the Department of the Army Regulation 75-1, with the Deputy Chief of Staff for Logistics (DCSLOG) as the overseeing body. The form meticulously captures various elements tied to a malfunction event, including identifying the malfunctioning item and its components, providing a detailed malfunction description, and noting the site of malfunction alongside the unit controlling and using the ammunition. It goes further to document the date and time of occurrence, any casualties (ranging from fatalities to non-hospitalized injuries), and the extent of damage caused, including whether the weapon was damaged and if repairs can be managed at the unit level. Additionally, it covers detonation details, the quantity of ammunition remaining, and whether certain exhibits are available for further examination. The form also inquires about the firing conditions at the time of malfunction, including the weapon used, target, range, and environmental conditions like weather and terrain, which could influence a malfunction's outcome. The storage conditions of the malfunction lot and packaging details are required entries, ensuring a comprehensive analysis of factors leading to the incident. This form not only aids in immediate response and preventive measures but also contributes to long-term ammunition safety and quality control within military operations.
Question | Answer |
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Form Name | Da Form 4379 |
Form Length | 1 pages |
Fillable? | No |
Fillable fields | 0 |
Avg. time to fill out | 15 sec |
Other names | OBSTRUCTIONS, da form 4379, FUZE, 1961 |
AMMUNITION MALFUNCTION REPORT
For use of this form, see AR
1.REPORT NO.
Requirements Control Symbol - CSGLD 1961
2. MALFUNCTIONING ITEM |
3. ITEM COMPONENTS |
4.MALFUNCTION DESCRIPTION
5. |
SITE OF MALFUNCTION |
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6. |
UNIT CONTROLLING SITE |
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7. |
UNIT USING AMMUNITION |
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8a. |
DATE MALFUNCTION |
8b. TIME |
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OCCURRED |
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9a. |
CASUALTIES (No. Killed) |
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9b. |
CASUALTIES (Hospitalized) |
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9c. |
CASUALTIES (Other Injuries) |
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9d. |
DESCRIPTION |
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10. |
DAMAGE |
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10c. |
DESCRIPTION |
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a. |
WEAPON DAMAGED? |
Yes |
No |
N/A |
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b.DAMAGE REPAIRABLE
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AT UNIT LEVEL? |
Yes |
No |
N/A |
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11. |
DETONATION |
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c. |
M FROM WEAPON |
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d. M FROM NEAREST PERSON |
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a. None |
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b. In Weapon |
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12. |
Quantity Remaining |
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13. |
EXHIBITS AVAILABLE |
(Hold Exhibits Pending Disposition Instructions |
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per AR |
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a. |
FIRING SITE |
b. |
LOCAL STORAGE |
c. SUSPENDED? |
a. Fragments |
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b. Intact Components |
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YES |
NO |
c. Weapon |
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d. None |
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14.Firing Conditions for Malfunction Lot
a. |
WEAPON |
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b. |
TARGET |
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c. |
RANGE |
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AZIMUTH |
e. |
ELEVATION |
f. |
ZONE |
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g. FUZE SETTING |
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M |
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h. |
FIRED HOW MANY ROUNDS PER MINUTE |
i. |
FOR HOW MANY MINUTES BEFORE |
j. |
TOTAL FIRED FROM WEAPON ON DAY OF |
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FROM WEAPON |
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MALFUNCTION |
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MALFUNCTION |
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k. |
TOTAL MALFUNCTIONED |
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l. |
TOTAL FIRED |
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m. |
MALFUNCTION RATE |
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% |
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15. |
Terrain |
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a. |
FIRING SITE |
b. |
DOWN RANGE |
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c. POSSIBLE OBSTRUCTIONS |
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d. CLEAR VIEW OF FLIGHT PATH |
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M |
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16.Weather Conditions
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VISIBILITY |
b. |
PRECIPITATION |
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TEMPER- |
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d. |
PRIOR 24 HOURS |
e. |
RELATIVE |
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ATURE |
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HUMIDITY |
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F |
HIGH |
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LOW |
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F |
F |
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17. |
Malfunction Lot Storage Conditions |
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18. |
Packaging of Malfunction Lot |
YES |
NO |
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a. |
Firing Site: |
Open |
Enclosed |
b. Local Storage: |
Open |
Enclosed |
a. |
Original Package? |
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c. |
UNPACKED HOW |
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d. MAGAZINE TYPE |
e. |
STORED HOW |
b. |
Original Seal? |
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MANY HRS. BEFORE |
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MANY MONTHS |
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c. |
Package Adequate? |
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MALFUNCTION |
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d. |
Package Damaged? |
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19.ADDITIONAL DATA (If more space is needed, use continuation sheet or back of form)
20a. |
FOR ADDITIONAL DATA, CONTACT |
21a. |
PERSON COMPLETING REPORT |
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b. |
TELEPHONE NO. (Include Area Code) |
b. |
TELEPHONE NO. (Include Area Code) |
c. |
DATE |
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DA FORM 4379, APR 01 |
DA FORM 4379, JAN 89 MAY BE USED |
USAPA V1.00 |