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Mobile Food Establishments & Food Caterers Operating at Special Events (If not operating within permit guidelines, you must apply for a Temporary Permit) (Web Form)

2. Mobile Food Establishments & Food Caterers Operating at Special Events
   Maricopa County Environmental Services Department <br>Environmental Health Division<br>Permitting Services Program <br>Phone: (602)506-6872<br>specialevents@maricopa.gov

   Maricopa County Environmental Services Department
   Environmental Health Division
   Permitting Services Program
   Phone: (602)506-6872
   specialevents@maricopa.gov

4. If not operating within permit guidelines, you must apply for a Temporary Permit.

6. Business Information

8. Permit # *

10. Business Name*

12. Contact Name*

13. Contact Phone*

15. Email Address*

17. Event Information

19. Event Name

21. Event Address*

23. Coordinator Name*

24. Coordinator Phone*

26. Coordinator Email Address*

28. Event Start Date*
    Event Start Date

29. Event End Date*
    Event End Date

33. Food Caterers Booth Information
    All Food Caterers must provide information on each booth that is set up at the Special Event.

    All Food Caterers must provide information on each booth that is set up at the Special Event.

35. Booth 1 - Booth Name

36. Booth 1 - Menu

38. Booth 2 - Booth Name

39. Booth 2 - Menu

41. Booth 3 - Booth Name

42. Booth 3 - Menu

44. Booth 4 - Booth Name

45. Booth 4 - Menu

47. Booth 5 - Booth Name

48. Booth 5 - Menu

50. Booth 6 - Booth Name

51. Booth 6 - Menu

53. Booth 7 - Booth Name

54. Booth 7 - Menu

56. Booth 8 - Booth Name

57. Booth 8 - Menu

59. If you have additional booths, please attach a separate sheet

61. Disclaimer
    Information entered on this form will be retained by Maricopa Environmental Services Department and is a record as defined by Arizona law. This form will be provided without redaction in response to a public record request unless any of the information is exempt from release under Arizona law.

    Information entered on this form will be retained by Maricopa Environmental Services Department and is a record as defined by Arizona law. This form will be provided without redaction in response to a public record request unless any of the information is exempt from release under Arizona law.

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62. 1. Receive an email copy of this form.
63. Email address

    This field is not part of the form submission.

64. Submit Submit and Print

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