Form FDACS-03439 "Fair Rides Request for Annual Permit Inspection or Re-inspection" - Florida

What Is Form FDACS-03439?

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

Form Details:

  • Released on September 1, 2020;
  • The latest edition provided by the Florida Department of Agriculture and Consumer Services;
  • 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 fillable version of Form FDACS-03439 by clicking the link below or browse more documents and templates provided by the Florida Department of Agriculture and Consumer Services.

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Download Form FDACS-03439 "Fair Rides Request for Annual Permit Inspection or Re-inspection" - Florida

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Florida Department of Agriculture and Consumer Services
Division of Consumer Services/Bureau of Fair Rides Inspection
FAIR RIDES REQUEST FOR ANNUAL PERMIT INSPECTION OR RE-INSPECTION
Sections 616.242(5), (7)(b), Florida Statutes, Rule 5J-18.0012, Florida Administrative Code
NICOLE “NIKKI” FRIED
Phone: 1-800-435-7352; Fax: 850-410-3797
COMMISSIONER
FairRides@FDACS.gov
Section 1 - Company Information:
Permit Inspection
Re-Inspection
Name of Company
Name of Owner or Manager
Telephone #
Mailing Address
Email
Fax #
Facility Address
Facility Contact Name
Facility Contact Number
Section 2 - Inspection Information:
Inspection Date Requested
Inspection Time Requested
Section 3 - Ride Information (continued on next page):
Ride Name
USAID #
Manufacturer Name
Serial #
1.
2.
3.
4.
5.
6.
7.
FDACS-03439 09/20
Page 1 of 2
Florida Department of Agriculture and Consumer Services
Division of Consumer Services/Bureau of Fair Rides Inspection
FAIR RIDES REQUEST FOR ANNUAL PERMIT INSPECTION OR RE-INSPECTION
Sections 616.242(5), (7)(b), Florida Statutes, Rule 5J-18.0012, Florida Administrative Code
NICOLE “NIKKI” FRIED
Phone: 1-800-435-7352; Fax: 850-410-3797
COMMISSIONER
FairRides@FDACS.gov
Section 1 - Company Information:
Permit Inspection
Re-Inspection
Name of Company
Name of Owner or Manager
Telephone #
Mailing Address
Email
Fax #
Facility Address
Facility Contact Name
Facility Contact Number
Section 2 - Inspection Information:
Inspection Date Requested
Inspection Time Requested
Section 3 - Ride Information (continued on next page):
Ride Name
USAID #
Manufacturer Name
Serial #
1.
2.
3.
4.
5.
6.
7.
FDACS-03439 09/20
Page 1 of 2
Continuation of Section 3 - Ride Information (Additional pages may be attached using the same format if extra space is needed.)
Ride Name
USAID #
Manufacturer Name
Serial #
8.
9.
10.
11
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
I request inspection / re-inspection of amusement rides listed above.
Owner/Manager
Date
FDACS-03439 09/20
Page 2 of 2
Page of 2