In environments where the safety of individuals and the integrity of structures are paramount, meticulous attention to fire risk management is crucial. The DA Form 5381, known as the Building - Fire Risk Management Survey, emerges as a vital instrument in this arena. Originating under the directive of AR 420-1, with the Assistant Chief of Staff for Installation Management (ACSIM) as its proponent agency, this form encapsulates a comprehensive checklist for evaluating potential fire hazards within a building or specified area. From ensuring the proper functioning and servicing of fire extinguishers to evaluating the procedures for handling flammable materials, the form covers a wide array of safety considerations. Details such as building occupancy, organizational responsibility, and the date of inspection are methodically recorded, alongside an inspection checklist that probes into housekeeping practices, electrical safety, heating equipment, and even the specific constructions of the building that could bear on its susceptibility to fire. Also integral to the survey are assessments of life safety codes, storage of hazardous materials, and the presence of special hazards, making the DA Form 5381 an indispensable tool for fire safety officers, facility managers, and safety personnel dedicated to mitigating fire risks in their environments.
| Question | Answer |
|---|---|
| Form Name | Form 5381 |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | da form 5381, da form fire, da form building, hud 5381 form |
BUILDING - FIRE RISK MANAGEMENT SURVEY
For use of this form, see AR
USE REVERSE SIDE FOR REMARKS
1.BUILDING NUMBER OR AREA
2.OCCUPANCY
3.ORGANIZATION
4.DATE
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SECTION A - INSPECTION CHECK LIST (Common and or Special Fire Hazards) |
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A. HOUSEKEEPING: |
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D. PETROL, OIL, LUBRICANTS: |
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G. FIRE DETECTION: |
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J. FIRE EXTINGUISHERS: |
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Girders |
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General Order |
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Pipe Leaks |
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Detectors |
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Service Date |
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Trusses |
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Rubbish |
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Refueling |
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Batteries |
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Location |
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Stairs |
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Cleanliness |
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Defueling |
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Wiring |
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Hydrostatic Test Date |
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Fire Escape |
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Vegetation Growth |
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Grounding |
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Control Box |
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Pressure Gauge |
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Improper Storage |
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Bonding |
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Fuses |
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Horn |
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M. STORAGE: |
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Overall Poor |
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Electrical |
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Nozzle |
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Procedures |
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Outdoor Housekeeping |
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Compatibility |
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H. FIRE SUPPRESSION SYSTEMS |
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Control Valve |
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Fire Lanes |
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Manhole Cover |
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Sprinkler Riser |
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Safety Pin |
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Wall to Storage Spacing |
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B. SMOKING: |
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Distance to Building |
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Compressor |
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K. FLAMMABLE STORAGE: |
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Storage Height |
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Unauthorized Area |
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Drains |
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Post Indicator Valve |
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Flammable Gases |
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N. HAZARDOUS MATERIALS: |
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Smoking Permit |
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Nozzles |
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Flammable Liquids |
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Containers |
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Disposal of Materials |
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E. HEATING: |
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Branch Lines |
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Electrical Fixtures |
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Compatibility |
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Receptacles |
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Fuel Pipe |
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Sprinkler Heads |
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Diking |
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Storage Method |
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No Smoking Signs |
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Fuel Lines |
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Inspector's Test Valve |
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Barrier Protection |
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Improper Facility |
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Improper Lighter |
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Filters |
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Agent |
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Venting |
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Items Not Labeled |
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Matches |
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Damper |
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Fusible Links |
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Labeling |
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Warnings Signs |
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Cooking Equipment |
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Nozzles |
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Containers |
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Ventilation |
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Deep Fat Fryers |
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Fire Hydrant |
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Cabinet |
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Ovens |
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Leakage |
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C. ELECTRICAL: |
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Burners |
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I. LIFE SAFETY CODE: |
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Overstock |
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Multiple Outlets |
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Exhaust Hoods |
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Occupancy Load |
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Extension Cords |
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Housekeeping |
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Means of Egress |
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L. BUILDING CONSTRUCTION: |
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Frayed Wiring |
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Chimney |
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Exit Requirement |
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Doors |
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Hazardous Locations |
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Thermostat |
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Emergency Lighting |
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Windows |
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O. SPECIAL HAZARDS: |
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Improper Wiring |
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F. FIRE DOORS: |
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Exit Impediments |
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Hardward |
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Welding & Cutting |
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Fuses & Panel Boxes |
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Fusible Link |
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Exit Lights |
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Fire Walls |
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Finishing Processes |
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Conduit & Raceways |
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Door Guides |
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Exit Signs |
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Door Frame |
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Hot Work Permit |
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Conductors |
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Operational |
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Interior Finish |
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Floors, Bearing |
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Spontaneous Heating |
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Outlet Boxes |
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Rated |
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Smoke Barriers |
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Roofs |
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Interior Finish |
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Switches & Fixtures |
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Damaged |
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Ramps |
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Columns |
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Hardware |
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Beams |
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6.a. NAME OF INSPECTOR (Print or Type)
7.a. NAME OF ORGANIZATION FIRE MARSHALL (Print or Type)
6.b. SIGNATURE
7.b. SIGNATURE
DA FORM 5381, JAN 2009 |
PREVIOUS EDITION ARE OBSOLETE. |
APD PE v1.00ES |