Form K-ISH500 "Amusement Ride Daily Inspection Checklist" - Kansas

What Is Form K-ISH500?

This is a legal form that was released by the Kansas Department of Labor - a government authority operating within Kansas. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on June 1, 2017;
  • The latest edition provided by the Kansas Department of Labor;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form K-ISH500 by clicking the link below or browse more documents and templates provided by the Kansas Department of Labor.

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Download Form K-ISH500 "Amusement Ride Daily Inspection Checklist" - Kansas

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KANSAS DEPARTMENT OF LABOR
Page 1 of 2
www.dol.ks.gov
AMUSEMENT RIDE DAILY INSPECTION CHECKLIST
K-ISH 500 (6-17)
Note: Each ride may have an inspection checklist provided by the manufacturer of the ride. Additionally,
professional organizations such as ACCT, AIMS, ASTM and NAARSO may have daily inspection checklists for
purchase. Such checklists will also be accepted.
Date if inspection: __________________________
Name of ride:______________________________________________Serial number: _____________________
Model number: ________________________________ Permit number: _________________________________
Date permit expires: _____________________
Classification of ride: _____Class A _____ Class B
Type of location: _____ Temporary
_____ Permanent
Name of Operator performing daily inspection: _____________________________________________________
KEY:
N/A = Not applicable
Y = YES
N = NO
____I have completed a daily inspection in accordance with the manufacturer’s recommendations and a copy of the
manufacturer’s daily inspection recommendations for this ride is currently maintained at the location of the ride;
____ All inspection tools and test equipment used for this inspection were calibrated and in working order at the
time of the inspection;
____ I have reviewed the ride Operating Document, as defined in ASTM F770-17, which is available to the
operator(s) and attendant(s), and which includes: the manufacturer’s recommended operation policies and
procedures, including the recommended location of the ride and the operator(s), attendant(s) and rider(s);
a description of the ride operation including the function and operation of its major components and a
description of a series of steps to be followed in definite order to complete safe operation of the ride;
description of the motion(s) of the ride during operation; specific duties of each assigned operator(s) and
attendant(s); recommended safety procedures and instructions to be given to patrons, and information
about safety equipment pertaining to patrons and ride or device operators and attendants; passenger
capacity by weight and by number; ride speed; ride duration; direction of travel; recommended passenger
loading procedures including recommended seating and balance of passenger loading or unloading;
environmental restrictions; recommended passenger restrictions; electrical and mechanical power requirements
fastener schedule; instructions on specific procedures to follow in the event of unusual conditions or an
interruption of operation; an evacuation plan; and additional instructions from the owner or operator;
____ The water quality was tested in accordance with the manufacturer’s recommendations and the test results
are within the manufacturer’s recommendations;
____ Nondestructive testing has been performed in accordance with the manufacturer’s recommendations. A
copy of nondestructive testing results is maintained at the location of the ride.
OR
____ Nondestructive testing is not recommended by the manufacturer. (In cases where nondestructive testing
is not recommended, the operator must provide a statement from the manufacturer that no NDT is
recommended on the ride in accordance with ASTM F 1193-06 section 12.4.1.8.)
____Prior to allowing patrons to use the ride: all rider-carrying devices including restraint devices and latches were
inspected and found to be in proper working order as recommended by the manufacturer;
____Prior to allowing patrons to use the ride: all entrances, exits, stairways and ramps were visually inspected and
found to be in proper working order as recommended by the manufacturer;
KANSAS DEPARTMENT OF LABOR
Page 1 of 2
www.dol.ks.gov
AMUSEMENT RIDE DAILY INSPECTION CHECKLIST
K-ISH 500 (6-17)
Note: Each ride may have an inspection checklist provided by the manufacturer of the ride. Additionally,
professional organizations such as ACCT, AIMS, ASTM and NAARSO may have daily inspection checklists for
purchase. Such checklists will also be accepted.
Date if inspection: __________________________
Name of ride:______________________________________________Serial number: _____________________
Model number: ________________________________ Permit number: _________________________________
Date permit expires: _____________________
Classification of ride: _____Class A _____ Class B
Type of location: _____ Temporary
_____ Permanent
Name of Operator performing daily inspection: _____________________________________________________
KEY:
N/A = Not applicable
Y = YES
N = NO
____I have completed a daily inspection in accordance with the manufacturer’s recommendations and a copy of the
manufacturer’s daily inspection recommendations for this ride is currently maintained at the location of the ride;
____ All inspection tools and test equipment used for this inspection were calibrated and in working order at the
time of the inspection;
____ I have reviewed the ride Operating Document, as defined in ASTM F770-17, which is available to the
operator(s) and attendant(s), and which includes: the manufacturer’s recommended operation policies and
procedures, including the recommended location of the ride and the operator(s), attendant(s) and rider(s);
a description of the ride operation including the function and operation of its major components and a
description of a series of steps to be followed in definite order to complete safe operation of the ride;
description of the motion(s) of the ride during operation; specific duties of each assigned operator(s) and
attendant(s); recommended safety procedures and instructions to be given to patrons, and information
about safety equipment pertaining to patrons and ride or device operators and attendants; passenger
capacity by weight and by number; ride speed; ride duration; direction of travel; recommended passenger
loading procedures including recommended seating and balance of passenger loading or unloading;
environmental restrictions; recommended passenger restrictions; electrical and mechanical power requirements
fastener schedule; instructions on specific procedures to follow in the event of unusual conditions or an
interruption of operation; an evacuation plan; and additional instructions from the owner or operator;
____ The water quality was tested in accordance with the manufacturer’s recommendations and the test results
are within the manufacturer’s recommendations;
____ Nondestructive testing has been performed in accordance with the manufacturer’s recommendations. A
copy of nondestructive testing results is maintained at the location of the ride.
OR
____ Nondestructive testing is not recommended by the manufacturer. (In cases where nondestructive testing
is not recommended, the operator must provide a statement from the manufacturer that no NDT is
recommended on the ride in accordance with ASTM F 1193-06 section 12.4.1.8.)
____Prior to allowing patrons to use the ride: all rider-carrying devices including restraint devices and latches were
inspected and found to be in proper working order as recommended by the manufacturer;
____Prior to allowing patrons to use the ride: all entrances, exits, stairways and ramps were visually inspected and
found to be in proper working order as recommended by the manufacturer;
Page 2 of 2
Kansas Department of Labor
Amusement Ride Daily Inspection Checklist
K-ISH 502 (6-17)
KEY:
N/A = Not applicable
Y = YES
N = NO
____Prior to allowing patrons to use the ride: a functional test of all communication equipment necessary for
the operation of the ride was conducted and found to be in proper working order as recommended by the
manufacturer;
____Prior to allowing patrons to use the ride: all automatic and manual safety devices were inspected and
tested and found to be in proper working order as recommended by the manufacturer;
____Prior to allowing patrons to use the ride: all brakes, service brakes, emergency brakes, parking brakes
and back stops were inspected and tested and found to be in proper working order as recommended by
the manufacturer;
____Prior to allowing patrons to use the ride: all fencing, guarding and barricades were inspected and tested
and found to be in proper working order as recommended by the manufacturer;
____Prior to allowing patrons to use the ride, a visual inspection of the ride was conducted and no defects or
problems were seen;
____Prior to allowing patrons to use the ride, a visual inspection of signs and other visual communication
devices was conducted and no defects or problems were seen;
____Prior to allowing patrons to use the ride, the ride was operated through one complete operating cycle to
ensure proper functioning;
____Prior to allowing patrons to use the ride, all maintenance and repair instructions recommended by the
manufacturer were satisfactorily performed as recommended by the manufacturer. (Note that maintenance
and repair logs for each ride are required to be maintained.)
____Each ride operator has satisfactorily completed training for the ride, including instruction on operating
procedures for the ride, the specific duties of the operator, general safety procedures and emergency
procedures, demonstration of physical operation of the ride and supervised operation of the operator’s
physical operation of the ride, and a certificate of satisfactory completion of training for each operator
so trained is available at the location of the ride.
Additional comments by inspector:
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
By my signature below, I certify and declare that the information provided in this Daily Inspection Checklist is
true and accurate to the best of my knowledge, and that I am trained and authorized to perform this inspection
on behalf of the owner of the amusement ride.
Printed name:__________________________________ Signature: _________________________________
Date:________________________
Page of 2