DA Form 5457 at a glance
What it is: DA Form 5457 is the Potable Water Container Inspection; for use of this form see TB MED 577, and the proponent of this form is the Office of The Surgeon General.
Who signs: The form has PRINTED/TYPED NAME AND GRADE OF PVNTMED INSPECTOR and SIGNATURE.
A filled-in DA Form 5457 example: a water trailer passes Section I
How to fill out DA Form 5457, box by box
Report date, to and from
The form has a REPORT DATE.
The form has TO and FROM.
Inspection rating, serial number and map coordinate location
The form has INSPECTION RATING, SERIAL NUMBER and MAP COORDINATE LOCATION.
Owning unit, maintenance NCO and unit representative
The form has OWNING UNIT, MAINTENANCE NCO and UNIT REPRESENTATIVE.
Inspection unit, date/time group and inspected by
The form has INSPECTION UNIT, DATE/TIME GROUP and INSPECTED BY.
For deployments lasting less than 30 days, FSTs will conduct routine inspections.
During deployments, supporting PM assets should inspect fielded containers according to table 16[2]
Section I. Water trailer inspection criteria
SECTION I. WATER TRAILER INSPECTION CRITERIA.
Section I, 1. CONTAINER EXTERIOR: a. Marked "POTABLE WATER ONLY", b. Clean/Good Repair.
Section I, 2. MANHOLE COVERS: a. Rubber Gasket Intact, b. Locking Mechanism Functions, c. No Rust/Insulation Intact, d. Pressure Relief Valve Operates.
Section I, 3. DISPENSING SPIGOTS: a. All Spigots Function, b. "T" Handle Operates Easily, c. Protective Box Intact, d. Locking Devices Function.
Section I, 4. DRAIN: a. Plug Installed Hand-Tight, b. Cracks Do Not Expose Fiberglass, c. Plug/Hole Threads Undamaged, d. Threads Not Rusted.
Section I, 5. CONTAINER INTERIOR: STAINLESS STEEL AND ALUMINUM: a. Clean/Good Repair, b. No Rust, c. Not Painted/Coated, d. No Cracks/Dents Exposing Polyurethane.
Section I, 6. CONTAINER INTERIOR: FIBERGLASS: a. Clean/Good Repair, b. and c. Cracks/Chips Less Than 10% Fiberglass Exposed, d. Paint Surface Not Flaking.
Section II. Water tank truck inspection criteria
SECTION II. WATER TANK TRUCK INSPECTION CRITERIA.
Section II, 1. CONTAINER EXTERIOR: a. Marked "POTABLE WATER ONLY", b. Clean/Good Repair.
Section II, 2. MANHOLE COVERS AND FILLING PORTS: a. Rubber Gaskets Intact, b. Locking Mechanisms Function, c. No Rust/Insulation Intact.
Section II, 3. DISPENSING VALVES: a. Valves Operate Easily, b. Hose Coupling Threads Undamaged, c. Dust Caps Attached to Valve Ports.
Section II, 4. TANK INTERIOR: a. Clean/Good Repair, b. No Rust, c. Steel/Aluminum Not Painted.
Section III. Fabric tank/drum inspection criteria
SECTION III. FABRIC TANK/DRUM INSPECTION CRITERIA.
Section III, with YES and NO, 1. CONTAINER EXTERIOR: a. Marked "POTABLE WATER ONLY", b. Clean/Good Repair, c. Plugs/Patches Secure.
Section III, 2. VALVE ASSEMBLY: a. Check-Valve Adapter Undamaged, b. Coupler Valve Operates Easily, c. Dust Cap Attached to Coupler.
Section IV. Container location (field use) inspection criteria
SECTION IV. CONTAINER LOCATION (FIELD USE) INSPECTION CRITERIA.
Section IV, 1. SITE CONDITIONS: a. Manholes/Parts Closed, b. Soakage Pits Constructed Beneath Spigots.
Section IV, 2. WATER CONDITIONS: a. Chlorine Residual Adequate ( ppm), b. Procured From:
Comments and recommendations
The form has COMMENTS AND RECOMMENDATIONS.
Inspectors should note unresolved or new vulnerabilities in the inspection sheet comments area.[2]
Common questions about DA Form 5457
Where do I file it?
PM inspectors/testers retain the original report, leave one copy with the inspected unit, and send copies to the command surgeon, the headquarters of the unit that was inspected.[2]
Sources
[1] DA Form 5457 (NOV 2005), Potable Water Container Inspection, U.S. Army (the Official source link on this page).
[2] armypubs.army.mil, line_comments_doc_note_vulnerabilities. Accessed October 20, 2026.