subject_line
New Jersey Department of Community Affairs
Division of Codes and Standards
Carnival Amusement Ride Safety Unit
INSPECTION REQUEST FOR CARNIVAL AMUSEMENT RIDES
Company Name:
Company Number:
Site Phone
On Site Contact Person:
Office Phone
Ride NJ Serial #(s)
*
Permit #
*
Type of Inspection
*
Annually
Acceptance
Violation Compliance
Reassembly
Have any of the rides listed been relocated? (
Traveling show owners or if requesting acceptance inspection select N/A
)
*
Yes
No
N/A
+
-
If YES, provide NJID of ride(s) relocated
Date Requested for Inspection
*
+
Town
Location Requested for Inspection
*
County
Atlantic
Bergen
Burlington
Camden
Cape May
Cumberland
Essex
Gloucester
Hudson
Hunterdon
Mercer
Middlesex
Monmouth
Morris
Ocean
Passaic
Salem
Somerset
Sussex
Union
Warren
Comment:
Additional Ride Requests
*
Yes
No