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- \ • 2-M <br />• <br />L1/2-4/22(- - <br />SAN JOAQUIN <br />COU NY— <br />Greotnt-ss grows here. <br />S 201--3 <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 />Name of Event: MOUNTAIN HOUSE CFM <br />Date(s) of Event: YEAR ROUND SUNDAYS Time of Event: 9 AM - 1 PM <br />Location: 251 E MAIN STREET, MOUNTAIN HOUSE, CA 953 <br />Event Coordinator (Name): BILL HARLOW Telephone: ( ) <br />Mailing Address: PO BOX 9898, SOUTH LAKE TAHOE, CA. 961! <br />Number of Food Booths: 25 <br />Approximate attendance at peak time: 400 - <br />Total Attendance: 1'000 Average Age: 30 <br />UTILITIES <br />Is potable water supplied and available for each food vendor: Yes III No <br />Is electricity supplied and available for each food vendor: LII Yes Z No <br />Are janitorial facilities available: Yes XI No <br />Number of toilets provided: 1 <br />Name of sanitary garbage disposal company: REPUBLIC Number of dumpsters: 1 <br />Method of disposal of liquid waste for food booths: VENDORS TAKE HOME <br />APPLICATION <br /> <br />1. Submit the following to the Environmental! <br />Temporary Event Application <br />Application Review Fee of $162 <br />Temporary Food Vendors Applici <br />Temporary Event Site Plan <br />Food Vendor List <br /> <br />2. If the event is selected for inspection, the EN <br />$162 per hour (weekdays 8:00 an <br />After regular business hours (wee <br />minimum three-hour overtime rate <br />This application is to be completed and . <br />Environmental Health Department with all Fooi <br />event. <br />I understand that as a temporary event co <br />standards and the Environmental Health Depa : <br />Event Coordinator: <br /> <br />1868 E. Hazelton Avenue I Stockton, California 95: <br />EHD 16-02 <br />06/29/2023