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# DLA Official Forms

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Form Information
| Form Number:       | DLA7016                                                                                                                                                                                                                                                   |
|--------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Form Title:        | DLA Annual Safety and Occupational Health (SOH) Industrial Workplace Inspection Checklist                                                                                                                                                                 |
| Form Version:      | Jun 2018                                                                                                                                                                                                                                                  |
| Status:            | Active                                                                                                                                                                                                                                                    |
| Functional Area:   | Chief of Staff                                                                                                                                                                                                                                            |
| Opr:               | CoS                                                                                                                                                                                                                                                       |
| Safeguards:        | none                                                                                                                                                                                                                                                      |
| Electronic:        | Yes                                                                                                                                                                                                                                                       |
| Form Link:         | Documents/FormsSite/forms/DL7016.pdf                                                                                                                                                                                                                      |
| Type:              | Primary                                                                                                                                                                                                                                                   |
| Prescribed:        | DLAI 6055.01                                                                                                                                                                                                                                              |
| Description:       | To provide a consistent approach for reviewing safety programs and identifying workplace hazards for safety professionals conducting annual safety and health inspections across the Agency. For use by SOH Professionals - i.e., 0018, 0019, 0690, etc.. |
| Records Retention: | 6000.3 Safety and Health Case Files. Destroy 5 years after all aspects of the case are closed.                                                                                                                                                            |
| Form Audience:     |                                                                                                                                                                                                                                                           |

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