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Is potable potable water supplied and available for each food vendor: sp Yes El No <br />_ <br />Is electricity supplied and available for each food vendor: ' Yes 0 No <br />Are janitorial facilities available: Yll Yes El No <br />Number of toilets provided: <br />UTILITIES <br /> <br /> <br /> <br /> <br />Pie0'5D 011 <br />SAR.d0AQUIN <br />COU NY— <br />Greatness grows <br />Environmental Health Department <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 />GENERAL EVENT FILE INFORMATION _ <br /> <br />1. Name of Event: ',_.\-1)- Caknil' itt% I. <br /> <br />3. <br />Time of Event: NIAV31 (irl2 '°'14) it& ifriv-Z- / <br /> <br />2. Date(s) of Event: MCI .3t — 2-- <br />Location: IG S-S S' - AliFt i Wtigill -, <br />Event Coordinator (Name): Latta C42,00 Telephone: (Xli )1-6)-Ifekt <br />Mailing Address: <br />Number of Food Booths: <br />Approximate attendance at peak time: 5 WO Total Attendance: 3-5 Average Age: <br />,ct-u4, as- ikcat10.0 <br />Name of sanitary garbage disposal company: vage kkaof • /4144- Number of dumpsters: <br />Method of disposal of liquid waste for food booths: clrev k,\J a-e(ha V.$r <br />APPLICATION <br /> <br />1. Submit the following to the 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 event. <br />I understand that.as—a—temporary event coordinator, I am responsible for meeting California State <br />standards and tile Environmenial HeOth Department policies and procedures. <br />------ <br />Event Coordinator/ Date: 5120i <br />1868 E. Hazelton Av <br />EHD 16-02 <br />06/29/2023 <br />ock omia 95205 T 209 468-3420 I F 209 464-0138 vvvvvv.s.!gov.orgieht.-. Page 1 of 11 TEMP EVENT APP