LL 1 [3 INITIAL SUPPLEMENTAL REJNSPECTION OHIO DEPARTMENT OF AGRICULTURE AMUSEMENT RIDE SAFETY DIVISION 8995 E. MAIN STREET REYNOLDSBURG, OHIO 43068 Phone 614-728-6230 Fax 614-728-6416 DATE 6 COMPANY 05139 1 E. LOCATION /v7 CODE: (V) Satisfactory (U) Unsatisfactory (N) Not Applicable (R) Remarks LOCATION INSTALLATION . No visible adjacent hazards andfor interference .. . In level position where applicable .. . Biocked jacked .. . Anchored, braced guyed .. . Motors, belts cables guarded .. . Stairs wallcways no obvious hazards .. . Fencing, railings and gates in place .. . Fuels stored area free of spills .. . No visible unsecured items .. . No visible unguarded pinch points or hazardous projections .. 11. Operating at designated speed (RPM) .. STRUCTURAL 12. Visual appearance indicates proper assembly .. 13. Visibiy free of cracks or excessive wear .. 14. No missing bolts, or bolts of improper grade .. I5. Pins retainers in piece .. 1.6. Alignment, including sheaves cables, satisfactory .. 17. Cables, chains, belts, gearing and bearings indicate no excessive wear. I8. Motors, clutches controls functioning when viewed .. I9. Braltes stops functional .. 20. Hydraulic system shows no excessive wear .. 21. Air system functional .. TUB VEHICLE 22. Latches operate .. 23, Ride vehiclefitub attached to ride structure .. 24. Restraints in place and functional .. 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. Signagefidentification 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, iatches signs . .. .. 35. Switches controls operational .. 36. No unattached, unconnected or unguarded lighting detected .. 37. Electrical supply source .. racers C5 :23 PLATE ADULT STICKER THEME NAME 30Portable Generator Utility Power My signature cemfies that I have read the Owner/Agent Notice on the reverse side and agree to fully campfy with all statutory requirements listed thereon. INSPECTOR SIGNATURE FOLLOWING ALTERATIONS. CHANGES OR REPAIRS HEREINAFTER SET FORTH MUST BE MADE IN ORDER TO BRENG THIS EQUIPMENT XNTO CONFORMITY NUMBER UIREMENTS ON . 20 SIGNATURE TITLE I CERTIFY ALL REQUIREMENTS OF THIS ORDER HAVE DATE COMPLIANCE fit-' FULLY COMPLIED WITH REQUIREMENTS ARE COMPLETED, CERTIFY COMPLIANCE TO THE ABOVE ADDRESS. AXLURE TO COMPLY MAY RESULT IN THE REVOCATION OF YOUR PERMIT TO OPERATE FINES UP TO $5000. Ci' It. -Eva fie INITIAL I %'irir"sPEcr1oN OI-HG DEPARTMENT OF AGRICULTURE AMUSEMENT RIDE SAFETY DIVISION 8995 E. MAIN STREET REYNOLDSBURG, 01-110 43068 Phone 614-728-6280 Fax 614-728-6416 .. I 5 ye; Ara" . (xi) Satisfactory (U) Unsatisfactory (N) Not Applicable LOCATIGN a. INSTALLATION 1. No visible adjacent hazards andfor interferenc .. . In level position where applicabie .. - Blocked jacked .. . Anchored, braced guyed .. . Motors, belts cables guarded .. . Stairs walkways no obvious haza.rds .. . Fencing, railings and gates in place .. . Fuels stored area free of spilis .. . No visible unsecured items .. . No visible unguarded pinch points or hazardous projections .. . Operating at designated speed (RPM) .. STRUCTURAL 12. Visual appearance indicates proper assembly .. 13. Visibiy free of cracks or excessive wear .. 14. No missing bolts, or bolts of improper grade .. 15. Pins retainers in place .. 26. Alignment, inciuding sheaves cables, satisfactory .. 17. Cables, chains, belts, gearing and bearings indicate no excessive wear. 18. 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 functional .. 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. Signagefidentification in place .. ELECTRICAL 30. 31. 32. 33. 34. 35. 36. 37. DATE COMPANY LOCATION CODE: Ride transformer generators guarded, ground rod connected .. Electronic testing device indicates no stray voltage to Insulation on wires cables shows no excessive wear .. No loose cables detected at plugs or boxes .. Electrical boxes have covers, latches signs .. Switches controls operational .. No unattached. unconnected or unguarded lighting detected .. Electricai supply source .. requirements listed ether KIDDIE ADULT OTHER Ci 2 PLATE fig va- RIDE - t" MFG - s'rzcI