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STOCKTON FIRE DEPARTMENT <br /> FIRE PREVENTION DIVISION <br /> (209) 937-8271 - FAX (209) 937-8893 <br /> RESPONSIBLE VENDOR FORM FOR <br /> OUTDOOR COOKING BOOTHS <br /> Name of Vendor: - f <br /> 1)-d I <br /> oM <br /> Mailing Address- <br /> q3 <br /> Telephone Number- <br /> 6 - <br /> Type of Outdoor Cooking Booth. <br /> Date(s) of Function: <br /> Location of Function: <br /> (Print.Name) hereby represent and warrant that I am the <br /> authorized agent of-._42-7,L <br /> -_(Print Name of Vendor), <br /> with the authority to act on its behla . <br /> On behalf of said vendor, I have read and understood the Fire Department's <br /> Regulations for Outdoor Cooking Booths ("Regulations"), and I agree to comply with the <br /> Regulations at the location and on the date(s) specified above. <br /> I understand and agree that the City of Stockton Fire Marshal (and/or representative <br /> thereof) may inspect said vendor's cooking booth at any time to enforce the <br /> Regulations. <br /> I further understand and agree that said vendor shall be held liable for any and all fees <br /> and costs related to violations of the Regulations, as determined by the Fire Marshal, in <br /> the exercise of his/her sole discretion. <br /> READ, UNDERSTOOD, AND AGREED: <br /> Sign-at Date.- Y <br /> Name and Title <br /> Please return this completed form to: Stockton Fire Department <br /> Fire Prevention Division <br /> 345 N. El Dorado Street <br /> Stockton, CA 95202 <br /> Page*10 <br />