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STOCKTON FIRE DEPARTMENT <br /> 4=:r/� � � r_1'rY Car <br /> FIRE PREVENTION DIVISION(209) 937-8271 • FAX (209)937-e893 M. irCK-GMN <br /> RESPONSIBLE VENDOR FORM FOR <br /> OUTDOOR COOKING BOOTHS <br /> t <br /> Name of Vendor: <br /> } t �, JL_� [6L c_kr S L 3 <br /> N•a ling Address =s_���r r f <br /> Teiesahone Number. ! — tr � LI <br /> Type a!Outcoor Cooking Booth:10x I'D <br /> Da:e(s) of Function: r 1 1 2 1 ad <br /> Location of Function: t~Ck t -\ r <br /> (Print Name) hereby represent and warrant that I am the <br /> a.rt"torized agent of C , (Print Name of vendor), <br /> with tree authority to act on its behalf. <br /> On behalf of said vendor, I have read and understood the Fire Departments <br /> Regulations for Outdoor Cooking Booths ('Regulations'), and 1 agree to comply with the <br /> Reguiatfons 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 hlslher sole discretion. <br /> REA , NDERSTOOD,AND AGREED: <br /> 1 <br /> �!' ,l l oats <br /> Name���tle <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 /> Page10 <br />