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New Jersey Department of Community Affairs
Division of Codes and Standards
Carnival Amusement Ride Safety Unit
INSPECTION REQUEST FOR SKI LIFTS
Company Name:
Company Number:
Site Phone
On Site Contact Person:
Office Phone
Lift/Device Name
*
Registration #
*
Type of Inspection
*
Annually
Acceptance
Violation Compliance
Reassembly
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 Lift Requests
*
Yes
No