TIA OHIO DEPARTMENT OF AGRICULTURE AMUSEMENT RIDE SAFETY DIVISION 8995 E. MAIN STREET REYNOLDSBURG, OHIO 43068 Phone 614-728-6280 Fax 614?728-6416 REY-INSPECTION DATE 949* I "7 COMPANY aha/cm ?~13 (if Amcaiee COMPANY CODE A RM .1. LOCATION U) [em CODE: Satisfactory (U) Unsatisfactory (N) Not Applicable (R) Remarks LOCATION INSTALLATION 1. No visible adjacent hazards and/ or interference . In level position where applicable .. .Blocked jacked . . . Anchored, braced guyed . Motors, belts cables guarded . Stairs walkways-no Obvious hazards . . Fencing, railings and gates in place . Fuels stored in proper location area free of Spills 9. No Visible unsecured items 10. No visible unguarded pinch points or hazardous projections 11. Operating at designated speed (RPM) STRUCTURAL 12. Visual appearance indicates proper assembly, II 13. Visibly free of cracks or excessive wear I I I 14. No missing bolts, or bolts of improper grade 15. Pins retainers in place . I I II ., 16. Alignment, including sheaves cables are satisfactory? 17. Cables, chains, belts, gearing and bearings indicate no excessive wear l8. Motors, clutches controls functioning when viewed 19. Brakes stops functional 20. Hydraulic system shows no excessive wear 21. Air system functional TUB VEHICLE 22. Latches Operate 23. Ride vehicle/tub attached to ride structure 24. Restraints in place and ?nictional .. 25. Skin visually free of unrepaired cracks damage 26. Seat coverings acceptable and secure 27. Back up latches present functional 28. Wheels tires-no excessive wear 29. Signage/identi?cation in place ELECTRICAL 30. Ride transformer generators guarded, ground rod connected 31. Electronic testing device indicates no stray voltage to fence/platform 32. Insulation on wires cables shows no excessive wear 33. No loose cables detected at plugs or boxes 34. Electrical boxes have covers, latches signs 35. Switches controls operational 36. No unattached, unconnected or unguarded lighting detected 37. Electrical supply source MISCELLANEOUS 38. OTHER . I . 39. Owner/Agent has read and understood the codes and stand .1 My signature certi?es that I have read the Owner/A gent Notice and a 5M STANDARD INSPECTION {<10an p?0,1st BQTHER Plate No. ?530 3" Sticker 30 537 Fin. an I MFG Km (9 Serial KMe?crs? F1213 ?st-006 Theme Name NOTICE The owner of amusement ride(s) is required to abide by all applicable codes, standards and rules and provide necessary equipment and documents which include but are not limited to: l. Signage OAC 901:9-1-07 2. Electrical Grounding/Requirements OAC 901:9?1?06 (C) (E) 3. Fire Extinguishers OAC (H) 4. Maintenance Repair and Inspection Documentation ORC 1711.55 (A), OAC OAC 5. Operator Training Documentation OAC 901 (B) (I) 6. Proper Anchoring OAC (A) The Amusement ride cannot operate until the items listed are in full compliance. Disclaimer: This is a visual inspection meant to regulate compliance with applicable law as of this day and time Of inspection. The electrical portion of this inspection is not intended to be an electrical safety inspection pursuant to RC. Chapter 3783. The owner remains responsible under Ohio Law for maintaining the safety of the ride and ride environment. Portable Generator El Utility Power OWN PRINT SIGNATURE UWNERIAGEDIT I THE FOLLOWING ALTERATIONS, CHANGES OR REPAIRS HEREINAFTER SET FORTH MUST BE MADE IN ORDER TO BRING THIS EQUIPMENT INTO CONFORMITY LINE ITEM REQUIREMENTS DATE COMPLIANCE DUE I were. or (3.1. rniec/ I CERTIFY ALL REQUIREMENTS OF THIS ORDER HAVE BEEN FULLY COMPLIED WITH ON 20 PRINT SIGNATURE SIGNATURE TITLE WHEN REQUIREMENTS ARE COMPLETED, CERTIFY COMPLIANCE AND MAIL PINK COPY TO THE ABOVE ADDRESS. FAILURE TO COMPLY MAY RESULT IN THE REVOCATION OF YOUR PERMIT TO OPERATE FINES UP TO $5000. AIATIO ?Inn? H1112 "?1nl?1f?1/I\ nlx?b' 1112? min . Amusements of America in Daily Inspection and Maintenance 11 Day Report Ride Name: Fireball Location: (ERIN Serial No.: KMG-98-FRB-24-006 Dates: ?l?taeg?ugl i INSTRUCTIONS: S=Satisfactory. U=Unsa?sfactory. Any items that are are to be explained on the Work Order. I No Points of Inspection D18 DEV Dgy 03y Dtaty i Pre Outriggers and braces torqued to 1700 Nm Pre ?g?g?gr?iax speed of 8 RPM and 120 degree angular 5 1. Gondolalarm joints torqued to 240 Nm 9 2. Arm/drum joints torqued to 240 Nm 9 3. Check attachment brackets on seat a 4. Joint pendulum with slewing gear torqued to 240 Nm 5 5. Joint drum with slewing gear torqued to 400 Nm 9 6. All fences and gates are properly installed 6 7. Condition of floor boards (sharp edges, secure) 5 8. Grease floor hinge points (8 planes) Item 06 5 9- Grease hinge points on ?oor cylinders (8 places) Item 08 5 10. Grease swing bearings (8 places) Item 09 ?9 11. Grease rotating bearing (4 places) Item 13 5 12. Plugs and wires secure at arms, joints and control box 9 13. Ground fault switch operating 9 14. 24 volt emergency system functioning 5 15. Shoulder hamessas working property and in good condition ?5 16- All seat indicator lights operating property 5 17. Ride will not start with a seat fault light on 5 18. Hydraulic system for leaks and worn hoses 19. Oil level above minimum level (3 20. Check return pressme for ?lter replacement 5 21. Middle floor cylinders moving freely, condition of hinges 5 22. Check that all signage is posted and correct 9 23. Check operational controls CL 24- Run 3 complete n'de sequences using all controls 3' 25. Inspection performed by (initial only) . an? FOR YOUR SAFETY: ?Lodtour' ride before performing maintenance or r?pairs and clear ride of all tools, personnel and obstructions before operating. Foreman?s Signature - i oerlify that i have checked the daily inspection points listed and the ride is ready to operate. REPORT ANY PROBLEM FOUND IMMEDIATELY TO RIDE SUPERVISOR BEFORE CONTINUING INSPECTION OR REPAIR. 3-27-06 THIS PERMIT SHALL BE KEPT AT THE SAME LOCATION AS THE AMUSEMENT RIDE AND SHALL BE MADE AVAILABLE FOR INSPECTION BY ANY PERSON. $1 50.00 STATE OF OHIO $150.00 JOHN KASICH, Governor Department of Agriculture. OHIO RIDE PERMIT To Operate: COMMON NAME OF RIDE MANUFACTURER 5+ SERIAL OR ID NO. .- Issued To: NON-TRANSFERABLE 15"" 4 - i I FIRM NAME I IMO I595: .1 5 11.5?; 5+ 5 5 STREET ADDRESS CITY STATE SC ZIP 99532? DATED THIS 25% DAY OF 20 L57 LICENSEE: INSPECTOR $150.00 $150.00 AGR 1002 3048 (REV. 10/14) Amusements of America at Daily Inspection and Maintenance 11 Day Report Ride Name: Fireball Location: Serial No.: KMG-98-FRB-24-006 Dates: INSTRUCTIONS: S=Satisfactory, U=Unsatisfactory. Any items that are UNSATISFACTORY are to be explained on the Work Order. No Points of Inspection D1ay Dgy [138? Pre Outriggers and braces torqued to 1700 Nm "7 I Pre $232312?? speed of 8 RPM and 120 degree angular 5 1. Gondola/arm joints torqued to 240 Nm 5 5 2. joints torqued Check attachment brackets on seat 5 5 /7 5? 4. Joint pendulum with slewing gear torqued Joint with slewing gear torqued All fences and gates are properly installed ?9 4 5 6 7. Condition of ?oor boards (sharp edges, secure) 5 6 5' 7 8. Grease floor hinge points (8 places) Item 06 9 5 5 5- 9. Grease hinge points on ?oor cylinders (8 places) Item 08 5 5 5 5 5 10. Grease swing bearings (8 places) Item 09 5 5 5 11. Grease rotating bearing (4 places) Item 13 3 5 5 5 5 12. Plugs and wires secure at arms, joints and control box 5 5 6 13. Ground fault switch operating volt emergency system functioning 3 ?5 (I. 15. Shoulder harnesses working properly and in good condition 3 5 5 5 3. 16. All seat indicator lights operating properly 5" 5 17. Ride will not start with a seat fault light on 5 5 9 5 18. Hydraulic system for leaks and worn hoses 5 5 5 #1 9. Oil level above minimum level 5 5 5 20. Check return pressure for ?lter replacement 9 5' 21 . Middle floor cylinders moving freely, condition of hinges 9 5' 3 5? 5 22. Check that all signage is posted and correct 6 5? 5 23- Check operational controls 5 5 5 24. Run 3 complete ride sequences using all controls 6 3 5 I 5 25. Inspection performed by (initial only) I?x? W) (Mi? IA) FOR YOUR SAFETY: ?Lockout ride before perfonning maintenance or repairs and clear title of an tools, personnel and ohstuc?ons before opetating. 3 For - I certify that I have chedted the daily inspection points listed and the ride is ready to operate. REPORT ANY PROBLEM FOUND IMMEDIATELY TO RIDE SUPERVISOR BEFORE CONTINUING INSPECTION OR REPAIR. 3?27?06 r? EB. I Amusements of America Daily Inspection and Maintenance 11 Day Report Ride Name: Fireball Location: 1M Griffith tun alfx Serial No.: Dates: guns sluitu Q..-1el1 INSTRUCTIONS: S=Satisfactory, U=Unsatisfactory. Any items that are to)be eibtainect . on the Work Order. No Points of Inspection ny Dgy 02y Ugly Dgy [13y D1E?lly Pre Outriggers and braces torqued to 1700 Nm 6 . I Pre $133:ng r:iax speed of 8 RPM and 120 degree angular 9 1. Gondola/arm joints torqued Arm/drum joints torqued Check attachment brackets on seat Joint pendulum with slewing gear torqued Joint drum with slewing gear torqued All fences and gates are properly installed Condition of floor boards (sharp edges, secureGrease floor hinge points (8 places) Item Grease hinge points on ?oor cylinders (8 places) Item 10. Grease swing beatings (8 places) Item 11. Grease rotating bearing (4 places) Item 13 5 5 3 5 5 12. Plugs and wires secure at arms, joints and control box 13- Ground fault switch operating volt emergency system functioning 5' 5 5 5 9 I 15_ Shoulder harnesses working properly and in good condition 16. All seat indicator lights operating properly 5 5 6 5 5 17. Ride will not start with a seat fault light 18- Hydraulic system for leaks and worn hoses 19. Oil level above minimum level .20. Check return pressure for ?lter replacement 5 5 5' 5 EL 21. Middle floor cylinders moving freely, condition of hinges 22- Check that all signage is posted and correct 23. Check operational controls complete ride sequences using all controls j" s? 6 5? 25. Inspection performed by (initial only51%? 5M 9 FOR YOUR SAFETY: "Lockout? ride before perfon'ning maintenance or repairs'and clear Tide of all tools, personnel'an? Foreinan's Signature - Ice inspection points listed and the ride is ready to operate. REPORT ANY PROBLEM FOUND IMMEDIATELY TO RIDE SUPERVISOR BEFORE CONTINUING INSPECTION OR REPAIR abet-actions before operating. 3?27-06 RIDE MAINTENANCE LOG RIDE NAME: Rabat) L3H DATE I WORK PERFORMED LOCATION WORK BY an?? ganjl'?n I 06 Kepimg/j Fray)? I/m/u? dogs?j, 7kg? vaLm/yQ/dp Rmo. Comen?ah/ A 1 a {214: ?ip/mi] Cyling/w (7n me/y/y derZ/ ?ag, EMPLOYEE NAME Dinah?) The above named person has successfully completed the training, as required for compliance with ASTM F24 Committee standards. The trainers who conduct the training also meet the requirements of ASTM F24 Committee standards and are certi?ed by this company to conduct training, supervise and observe the inspection and operation and maintenance of the devices/attractions listed below. ?are/l 7 SIGNATURE OF PERVISOR Safety! Operations! Inspection Emergency Assigned Maintenance RIDE NAME Procedures Duties Procedures ?mm? x/ A I certify that I have been trained in the above listed areas (as indicated by a check mark) on the rides listed above. gum/L A09 1% 4ng SIGNATURE OF 144.64%th EMPLOYEE NAME The above named person has successfully completed the training, as required for compliance with ASTM F24 Committee standards. The trainers who conduct the training also meet the requ irements of ASTM F24 Committee standards and are certi?ed by this company to conduct training, supervise and observe the inspection and operation and maintenance of the devices/attractions listed below. Aggy/7 DAT Safety! Operations! Inspection Emergency Assigned Maintenance RIDE NAME Procedures Duties Procedures (Pint! 1/ 0 certify that have been trained in the above listed areas (as indicated by a check mark) on the rides listed above. OF EMPLOYEE AMUSEMENTS OF AMERICA CERTIFICATION RE: OPERATOR TRAINING NAME OF RIDE: MFG SERIAL NUMBER OF RIDE: KM Ir" om. REF.: N.J.A.C. 9.8 and 9.9 For the above referenced ride, 1 hereby certify that: 1) I have read and understand the manufacturer?s recommendations for operation, as found in the operation manual(s); 2) I know the safety-based limitations, including height, weight, or other rider requirements, regarding who may ride; 3) I am well versed on what can reasonably be expected to go wrong, how to recognize it, and how to get the ride and riders into a position that minimizes the risk of injury; 4) I know how to perform the pre?startup operational ride check as required by the operations manual(s); 5) i know how to verify that the daily maintenance checklist has been completed prior to Operating the ride; 6) i know how to use all normal and emergency operating controls; 7) i know how to operate any restraint system, lap bar locking system, or seatbelts, and the proper way to contain and restrain a rider; 8) I know the whereabouts of safety equipment, including ?re extinguishers, main electrical disconnect, lock?out point(s), and means of communication for emergency assistance. 9) i am capable of communicating with the public in the English language to convey safe riding policies and react to patron emergencies; 10) have received a demonstration of the ride operation and have satisfactorily operated the ride under the supervision of my trainer; and 11) I have received adequate training to Operate the ride. OPERATOR OPERATOR SIGNATUREIs) DATE A NAME OF THE TRAINER: ?l3? TITLE: Wk 0% SIGNATURE: - Date: 8?73- ?hug Construc?cn Materials Non Destmc?ve Semen Envimnrnental Acct. No: AMOOT Report Date: 1 012512016 SCI SOIL CONSULTANTS, INC. ENGINEERS AND GEOLOGISTS SINCE 1951 P.O. Drawer see - CHARLESTON, so 29492 (843) 723-4539 Fax {343) 723-3648 com Project No: 161473 Date Sampled: 10f25l2016 Sampled By: Gale Mole Project: 2016 Amusement Ride Inspections - Ladson, 80 By Order Of: Client Location: Fireball (KMG) SIN 98-FRB-24-006 Order Number: Client: AMUSEMENTS OF AMERICA REPORT: Visual Weld Examination LAB NO: 44572-5 ?r TEST RESULTS Report No: 44572?5 Page 1 of 1 On this date I did a visual inspecti SCl's visual inspection procedure on of the ride's structural components. No defects were found. For the inspection, SGN-VT-BOD Rev. 4 was used. Acceptance of the welds was done using AWS 01.1 Structural Welding Code Table 6.1. Remarks: Accept Orig: AMUSEMENTS OF AMERICA Ann: Mr. Billy ?Bobs" E?Mail: Carnival B@aol.com (t-ec copy} Respectfully Submitted, SOIL CONSULTANTS, INC. Mole CWI 93061051 we. .1. om exp. 6m2017 Gale Mole Mgr, Lvi 1012812016 THIS REPORT APPLIES ONLY TO THE STANDARDS OR PROCEDURES AND TO THE SAMPLEEIS) TESTED ANDIOR OBSERVED AND ARE NOT NECESSARILY INDICATIVE OF THE QUAUTIES OF APPARENTLY IDENTICAI. OR SIMILAR PRODUCTS OR PROCEDURES NOR DO THEY REPRESENT AN ONGOING QUALITY ASSURANCE PROGRAM UNLESS SO NOTED. THESE REPORTS ARE FOR THE EXCLUSIVE USE OF THE ADDRESSED CLIENT ANDARE NOT TO BE REPRODUCED WITHOUT WRITTEN PERMISSION. SCI SOIL CONSULTANTS, INC. Consuuotion Materials AND GEOLOGESTS No? new SINCE 1951 swam? PO. Drawer see - CHARLESTON. so 29492 - (843) 723-4539 - Fax (343) 723-3648 Emmnmenw Acct. No: AMOOT Project No: 181473 Date Sampied: 10125I2016 Report Date: 100512016 Sampted By: Mole, Gale Project: 2016 Amusement Ride Inspections - Ladson, SC By Order Of: Client Location: KMG Fireball Order Number: Client: AMUSEMENTS OF AMERICA REPORT: Uitrasonic Examination LAB NO: 44572-4 Test Method: See Below TEST RESULTS Report No: 44512-4 Page 1 of 1 Inspection Peiformed: Annual Inspection: of a KMG Fireball SIN - Ultrasonic Inspection of Ride's 24 Gondola Pins for Defects No: Gondola Arm Pins (24) Item No: NIA Date Received: 1025116 Date Examined: 10i25f16 Type of Math Carbon Steel Temp of Mat'I: Surface Condition: CleanlSmooth Heat No; NIA Heat Treat MIA Acceptance Std: Mfg. Safety Builetin Exam Std: ASTM E114 NDT Procedure No: Equipment: USM {30+ Transducer: 2.25 Test Block: Step Wedge Method Used: Pulse Echo Scanning Method: Manual Sensitivity Levei: 55 to 65 st Couplant: Sonotech Sonotrace 30 Part No: Gondola Pins Total Length Examined: 100% Type of Work: New No Items Accepted: 24 Pins No Items Rejected: 0 or SW1E Result Defect Remarks All 24 Gondola Accept No Defective Pins Found Pins Tested Remarks: Inspection was at Coastal Carolina Fair in Ladson, SC and covers only areas of ride listed. Examiners: Gale F. Mote, NDT Manager,Level tlI Orig: AMUSEMENTS OF AMERICA Respectfully Submitted, Aim: Mr. Billy ?Bobs? Costagiiola E-Meil: CamIVaIB@aol.com (1?ecoopy) SOIL Gale Mole CWI 93061051 QCI EXP. 6f1f2017 Gale Maia Mgr, was/201s THIS REPORT APPLIES ONLY TO THE STANDARDS 0R PROCEDURES INDICATED AND TO THE SAMPLES) TESTED ANDIOR OBSERVED AND ARE NOT NECESSARILY OF THE OUALITIES OF APPARENTLY IDENTICAL OR SIMILAR PRODUCTS OR PROCEDURES. NOR DO THEY REPRESENT AN ONGOING QUALITY ASSURANCE PROGRAM UNLESS SO NOTED, THESE REPORTS ARE FOR THE EXCLUSIVE USE OF THE ADDRESSED CLIENT AND ARE NOT TO BE REFRODUCED WITHOUT WRITTEN PERMISSION.