The DA Form 7632, also known as the Certificate of Risk Acceptance, plays a critical role in the management and acknowledgment of risks within a specific operational context, as detailed by DA PAM 385-30. This form facilitates a structured process for the official recording and acceptance of risks, particularly focusing on the specifics such as the initial probability and severity of identified risks, potential impacts on personnel including fatalities, injuries, and estimated losses, as well as detailed hazard categorization. In addition, it encompasses the comprehensive assessment of regulatory or policy noncompliance issues, the ramifications these hazards may have on missions, and the personnel and equipment involved. Furthermore, the DA Form 7632 outlines both permanent and interim risk mitigation strategies, evaluating their residual risk levels, the effectiveness and costs of corrective actions, and the practicalities of their implementation. Notably, the form concludes with a section dedicated to the formal acceptance of the risk, requiring authoritative signatures, signifying a thorough understanding and deliberate decision-making regarding the continuation of operations despite the recognized threats. This document underscores a pivotal governance tool within the Department of the Army, ensuring that risks are not merely identified but are comprehensively evaluated, addressed, and officially documented, promoting a culture of safety and accountability within military operations.
| Question | Answer |
|---|---|
| Form Name | Da Form 7632 |
| Form Length | 4 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 1 min |
| Other names | get form 7632, form da 7632, how to form da 7632, form 7632 |
|
CERTIFICATE OF RISK ACCEPTANCE |
|
ISSUE DATE |
||||||
|
For use of this form, see DA PAM |
|
EXPIRATION DATE |
||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
RISK SITE INFORMATION |
|
|
|
|||
1. LOCATION REQUIRING CERTIFICATE OF ACCEPTANCE |
|
2. ORGANIZATION ORIGINATING CERTIFICATE |
|||||||
(Name and Address) |
|
|
|
(Name and Address) |
|
|
|
||
|
|
|
|
|
|
|
|
|
|
|
|
|
RISK INFORMATION |
|
|
|
|||
3. ORIGINAL PROBABILITY |
|
4. ORIGINAL SEVERITY |
|
|
5. LEVEL OF ORIGINAL RISK |
||||
|
|
|
|
|
|
|
|
|
|
6. ESTIMATE IMPACT ON PERSONNEL |
a. FATALITIES |
|
b. INJURIES |
|
|
c. ESTIMATED LOSS |
|||
|
|
|
|
|
|
|
|
||
|
|
|
|
|
|
|
|
||
|
|
|
HAZARD INFORMATION |
|
|
|
|||
7. HAZARD CATEGORY |
|
|
|
8. SPECIFIC HAZARD |
|||||
|
|
|
|||||||
|
See supplemental explosives worksheets for additional information on the hazard. |
||||||||
|
|
|
|
|
|
|
|
|
|
9. CAUSE |
|
|
|
|
|
|
|
|
|
|
|
|
|||||||
|
|
||||||||
10. |
NUMBER/TITLE OF REGULATORY - POLICY |
|
11. REFERENCE REQUIREMENT |
||||||
|
|
|
|
|
|
|
|
||
|
|
|
MISSION IMPACT |
|
|
|
|||
12. |
CONSEQUENCES OF HAZARD ON: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
a. MISSION |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
b. PERSONNEL |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
c. EQUIPMENT |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
13. |
IMPACT OF NOT ACCEPTING RISK ON MISSION |
|
|
|
|
|
|||
|
|
|
|
|
|
|
|
|
|
|
|
PERMANENT RISK MITIGATION INFORMATION |
|||||||
14. |
PERMANENT MITIGATION ACTION |
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||
15. |
RESIDUAL PROBABILITY |
|
16. RESIDUAL SEVERITY |
17. LEVEL OF RESIDUAL RISK |
|||||
|
|
|
|
|
|||||
18. |
RISK REDUCTION FACTOR |
|
19. COST OF CORRECTION |
20. COST EFFECTIVE |
|||||
|
|
|
|
|
|
|
|||
21. |
CORRECTION RESTRICTS |
|
22. IMPLEMENTATION |
|
|
23. NO EFFECTIVE |
|||
MISSION TOO GREATLY |
|
TIME TOO GREAT |
|
|
CORRECTIVE ACTION |
||||
|
|
|
|
|
|
|
|
|
|
24. |
EXPLANATION FOR ABOVE |
|
|
|
|
|
|
|
|
|
|
|
|
||||||
|
|
|
INTERIM RISK MITIGATION INFORMATION |
||||||
25. |
INTERIM MITIGATION ACTION |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
26. |
RESIDUAL PROBABILITY |
|
27. RESIDUAL SEVERITY |
28. LEVEL OF RESIDUAL RISK |
|||||
|
|
|
|
|
|
|
|
|
|
29. |
RISK REDUCTION FACTOR |
|
30. COST OF CORRECTION |
31. COST EFFECTIVE |
|||||
|
|
|
|
|
|
|
|
|
|
DA FORM 7632, AUG 2007 |
SUPERSEDES DA FORM |
APD PE v1.01 |
|
Page 1 of 4 |
|||
|
|
CERTIFICATE OF RISK ACCEPTANCE
ISSUE DATE
EXPIRATION DATE
RISK SITE INFORMATION
32.LOCATION REQUIRING CERTIFICATE OF ACCEPTANCE
(Name and Address)
33.ORGANIZATION ORIGINATING CERTIFICATE
(Name and Address)
RISK ACCEPTANCE INFORMATION
34. RESIDUAL PROBABILITY
35. RESIDUAL SEVERITY
36. LEVEL OF RESIDUAL RISK
37. ANALYST
38. TITLE
39. OFFICE SYMBOLS
RECOMMENDATION OF ACCEPTANCE
I have reviewed the risk assessment for the risk I am recommending be accepted. I understand the hazard, the risk, the cause and the consequences of the risk on the mission, personnel, and the environment. I have evaluated the recommended corrective actions and the mission requirements. After careful consideration, I am recommending that the risk and possible consequences should be accepted due to the constraints it imposes on the mission's execution and/or unavailability of a timely,
ORGANIZATION
PRINTED NAME
SIGNATURE
DATE
(YYYYMMDD)
CONCUR
(YES/NO)
RISK ACCEPTANCE
I have reviewed the risk assessment for the risk I am accepting. I understand the hazard, the risk, the cause and the consequences of the risk on the mission, personnel, and the environment. I have evaluated the recommended corrective actions and the mission requirements. After careful consideration, I am accepting the risk and its consequences due to the constraints it imposes on the mission's execution and/or unavailability of a timely, cost effective, corrective action.
40.SIGNATURE
41.TITLE
DA FORM 7632, AUG 2007
42.DATE (YYYYMMDD)
APD PE v1.01
Page 2 of 4
AMMUNITION AND EXPLOSIVES SUPPLEMENTAL WORKSHEET
43. ANALYST
44.DATE (YYYYMMDD)
45. DESCRIPTION OF EXPLOSIVES STANDARD NOT BEING MET
INFORMATION ON THE POTENTIAL EXPLOSION SITE
46. |
PES IDENTIFICATION |
47. |
PES NAME |
|
|
|
|
48. |
PES FUNCTION |
|
|
|
|
|
|
49. |
NET EXPLOSIVE WEIGHT |
50. |
MAJOR HAZARD |
|
|
|
|
51. |
REQUIRED BLAST DISTANCE |
52. |
REQUIRED FRAGMENT DISTANCE |
|
|
|
|
53. |
COST OF FACILITY AND EQUIPMENT (In thousands) |
54. |
PERSONNEL AT SITE |
|
|
|
|
INFORMATION ON THE EXPOSED SITES
55.
FACILITY NUMBER
DESCRIPTION
DISTANCE
REQUIRED |
ACTUAL |
PERSONNEL
EXPOSED
DOLLAR VALUE
(In thousands)
SAFETY
DISTANCE VIOLATION
TOTAL
56.
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
TOTAL |
|
|
|
|
|
|
57. GRAND TOTAL |
|
|
|
|
|
|
DA FORM 7632, AUG 2007 |
|
|
|
|
APD PE v1.01 |
|
|
|
|
|
|
|
Page 3 of 4 |
|
|
|
CHEMICAL AGENT SUPPLEMENTAL WORKSHEET |
|
|
|
|
|
|
|
|
|
58. |
ANALYST |
|
|
|
59. DATE (YYYYMMDD) |
|
|
|
|
|
|
60. |
DESCRIPTION OF CHEMICAL AGENT STANDARD NOT BEING MET |
|
|
||
|
|
|
|
|
|
|
INFORMATION ON THE POTENTIAL CHEMICAL AGENT EXPOSURE/EXPLOSION SITE |
||||
61. |
FACILITY IDENTIFICATION |
|
62. FACILITY NAME |
|
|
|
|
|
|
|
|
63. |
FACILITY FUNCTION |
|
|
|
|
|
|
|
|
||
64. TYPE CHEMICAL AGENT |
65. WPL |
66. STEL |
67. IDLH |
||
|
|
|
|
|
|
68. |
|
69. GPL |
|
|
|
|
|
|
|
|
|
70. |
NET EXPLOSIVE WEIGHT |
|
71. MAJOR HAZARD |
|
|
|
|
|
|
|
|
72. |
REQUIRED BLAST DISTANCE |
|
73 REQUIRED FRAGMENT DISTANCE |
||
|
|
|
|
|
|
INFORMATION ON THE EXPOSED SITES
74.
|
FACILITY |
DESCRIPTION |
DISTANCE |
PERSONNEL |
DOLLAR VALUE |
SAFETY |
||
|
NUMBER |
REQUIRED |
ACTUAL |
EXPOSED |
(In thousands) |
DISTANCE VIOLATION |
||
|
|
|||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
TOTAL |
|
|||
|
75. |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
TOTAL |
|
|
|
|
|
|
76. GRAND TOTAL |
|
|
|
|
|
|
DA FORM 7632, AUG 2007 |
|
|
|
|
APD PE v1.01 |
|
|
|
|
|
|
|
Page 4 of 4 |
|