Laserfiche WebLink
SAN,,JOAQUIN 1,41 <br />.s.ar Greatness grows here. <br />Environmental Health Department <br />COUNTY-- <br />TEMPORARY EVENT APPLICATION <br />To be completed and signed by Event Coordinator, then returned to the Environmental Health Department with all <br />of the Food Vendor's Applications no later than two weeks prior to event <br /> <br />GENERAL EVENT FILE INFORMATION , <br />Name of Event: -A-0 aci-cm,. f>k-ar-- riPT 0(1(1 ( <br />Date(s) of Event: SRO1ay4/302... 0--, „,)._,,G. (4--- Time of Event: 16) - ‘; <br />Location: c,;-,.i 4 COAde-S-- -\-0 Cli-UVI I (CA- <br />Event Coordinator (Name): Am-hoolc----) ft3by Telephone: ( ) <br />Mailing Address i t) bOK ID) cf ,-- - <br />Number of Food Booths: ,S <br />Approximate attendance at peak time: /ób Total Attendance: /5-0 d Average Age: /41-77 <br />UTILITIES <br /> Is potable water supplied and available for each food vendor: 2/Yes El No <br /> Is electricity supplied and available for each food vendor: :Yes III No <br /> Are janitorial facilities available: E2'es El No <br /> Number of toilets provided: ID <br /> Name of sanitary garbage disposal company: litil racbit'ut— Number of dumpsters: <br /> Method of disposal of liquid waste for food booths: <br />APPLICATION <br /> <br />1. Submit the following to'tfie Environmental Health Department two weeks prior to the event: <br />Temporary Event Application <br />Application Review Fee of $162 <br />Temporary Food Vendors Applications for each booth <br />Temporary Event Site Plan <br />Food Vendor List <br /> <br />2. If the event is selected for inspection, the Event Coordinator will be billed for inspection time: <br />$162 per hour (weekdays 8:00 am to 5:00 pm) <br />After regular business hours (weekday, weekends and holidays) the inspection is charged at a <br />minimum three-hour overtime rate of $729.00 <br />This application is to be completed and signed by the Event Coordinator, then returned to the <br />Environmental Health Department with all Food Vendor's Applications no later than two weeks prior to the <br />event. <br />I understand that as a temporary event coordinator, I am responsible for meeting California State <br />standards and the Envir nmental Health Department policies and procedures. <br />Event Coordinator: -7esZ( Date: <br /> <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sigov.orgiehd <br />EHD 16-02 Page 1 of 11 TEMP EVENT APP <br />06/29/2023 S 0 2 5qV