"Request for Initial State Inspection" - Rhode Island

Request for Initial State Inspection is a legal document that was released by the Rhode Island Department of Labor and Training - a government authority operating within Rhode Island.

Form Details:

  • Released on October 1, 2015;
  • The latest edition currently provided by the Rhode Island Department of Labor and Training;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the Rhode Island Department of Labor and Training.

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_____________________________________________________
_____________________________________________________
Rhode Island Department of Labor & Training
Division of Workforce Regulation and Safety
Occupational Safety - Elevator Unit
1511 Pontiac Avenue, P.O. Box 20157 Cranston, RI 02920-0942
Phone: (401) 462-8570 Fax: (401) 462-8576
Request for Initial State Inspection
I ________________________________, representing _________________________
(Company Name)
hereby request an inspection of the following device:
State ID Number: ______________________________________________________
Type of Device: ______________________________________________________
Location of Device: _____________________________________________________
Email: ____________________________ Telephone Number: ___________________
This unit has been pre-tested and all work associated with the installation,
modernization or construction is complete. This includes general contractors work
associated with the above listed device.
Signature: _______________________________
Date: ___________________
Any work not completed, personnel required for testing associated systems not present, or
equipment malfunctions that cannot be repaired within a reasonable time, will cause the
inspection to be terminated and will NOT be rescheduled for a minimum of thirty (30) days.
There will be a charge for any and all re-inspections in accordance with the fee schedule
contained within RIGL 23-33-12.
Please submit this form to request for initial inspection to Sean Egan.
Sean.Egan@dlt.ri.gov
Email:
or Fax:(401) 462-8576
DLT is an equal opportunity employer/program - auxiliary aids and services available upon request. TTY via RI Relay:711
MDF Rev. 10/15
_____________________________________________________
_____________________________________________________
Rhode Island Department of Labor & Training
Division of Workforce Regulation and Safety
Occupational Safety - Elevator Unit
1511 Pontiac Avenue, P.O. Box 20157 Cranston, RI 02920-0942
Phone: (401) 462-8570 Fax: (401) 462-8576
Request for Initial State Inspection
I ________________________________, representing _________________________
(Company Name)
hereby request an inspection of the following device:
State ID Number: ______________________________________________________
Type of Device: ______________________________________________________
Location of Device: _____________________________________________________
Email: ____________________________ Telephone Number: ___________________
This unit has been pre-tested and all work associated with the installation,
modernization or construction is complete. This includes general contractors work
associated with the above listed device.
Signature: _______________________________
Date: ___________________
Any work not completed, personnel required for testing associated systems not present, or
equipment malfunctions that cannot be repaired within a reasonable time, will cause the
inspection to be terminated and will NOT be rescheduled for a minimum of thirty (30) days.
There will be a charge for any and all re-inspections in accordance with the fee schedule
contained within RIGL 23-33-12.
Please submit this form to request for initial inspection to Sean Egan.
Sean.Egan@dlt.ri.gov
Email:
or Fax:(401) 462-8576
DLT is an equal opportunity employer/program - auxiliary aids and services available upon request. TTY via RI Relay:711
MDF Rev. 10/15