Da Form 5161 1 R – Fill Out and Use This PDF

The DA Form 5161-1 R, also known as the Food Establishment Sanitation Inspection Remarks Form, is a critical document used to record observations and findings during a sanitation inspection. It serves as a detailed addendum to the DA Form 5161-R, providing specific insights into the establishment's refrigeration, warewashing data, and other pertinent temperature and sanitation details. For those involved in managing food establishments within the Department of the Army, ensuring this form is accurately filled out is crucial for maintaining health and safety standards. Click the button below to learn more about how to properly fill out this form.

Get Form Now Download PDF

What Is the DA Form 5161 1 R?

The DA Form 5161 1 R is the Food Establishment Sanitation Inspection Remarks Form. Army food service inspectors use it to record detailed data during routine sanitation checks at Department of the Army food facilities.

The form captures four categories of data. First, it records refrigerator and freezer temperatures. Second, it documents hot holding temperatures and individual food item temperatures. Third, it captures manual warewashing data including wash and rinse temperatures. Fourth, it records mechanical dishwasher data including final rinse temperature and sanitizer concentration in parts per million (ppm).

TB MED 530, issued by the Office of The Surgeon General (OTSG), mandates use of this form. Inspectors attach the completed DA Form 5161 1 R to the DA Form 5161-R as a permanent part of the inspection record. Together, these two documents provide a complete record of each facility's compliance with Army sanitation standards.

Question	Answer
Form Name	Da Form 5161 1 R
Form Length	1 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	15 sec
Other names	A5161_1_R tb med 530 army form

How to Edit Da Form 5161 1 R Online for Free

How to Fill Out the DA Form 5161 1 R

Complete the DA Form 5161 1 R during or immediately after a food establishment inspection. The form has four main data sections. Fill out each section completely before attaching it to the DA Form 5161-R.

Section 1: Header Information

Write the facility name and inspection date at the top of the form. Include the name and rank of the inspector. These fields link the remarks record to the primary DA Form 5161-R inspection report.

Section 2: Temperature Readings

Use a calibrated thermometer to measure and record the following temperatures in degrees Fahrenheit. Refrigerators must read 41 degrees or below. Freezers must read 0 degrees or below. Hot holding equipment must maintain 135 degrees or above. Record each individual food item temperature in the designated column.

Section 3: Warewashing Data

Record wash and rinse temperatures for all dishwashing equipment. For manual warewashing, document the temperature of each tank separately. For mechanical dishwashers, record the final rinse temperature and sanitizer concentration level in parts per million (ppm). The sanitizer concentration for chlorine solutions must stay between 50 and 100 ppm.

Section 4: Remarks

Note any deficiencies found during the inspection. Identify the specific TB MED 530 section for each deficiency. Record corrective actions taken on-site and any follow-up actions required.

Who Uses the DA Form 5161 1 R

Army preventive medicine officers and food service managers complete this form. It covers all Department of the Army food operations including dining facilities, field kitchens, and contract food service sites. Completion is mandatory for all inspections per TB MED 530.

Frequently Asked Questions

Is the DA Form 5161 1 R required for every inspection?

Yes. TB MED 530 requires this form for all Army food establishment inspections. It must be attached to the DA Form 5161-R and kept as a permanent record.

How often must Army food facilities be inspected?

Army policy requires at least one sanitation inspection per month for most food facilities. High-risk facilities may need more frequent visits.

What other Army forms are related to this one?

Food service managers use several related forms. The DA Form 87 Certificate of Training documents staff food safety training records. The Army Risk Assessment Form supports hazard identification during inspections. Personnel evaluations reference the DA Form 67-9-1 OER Support Form.