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OS-301ln_ <br /> SAN JOAQUIN <br /> <br />Environmental Health Department <br />—COUNTY <br />/ Greatness grows here. <br /> <br />TEMPORARY EVENT APPLICATION jt/A1 21 2024 Epv <br />To be completed and signed by Event Coordinator, then returned to the Environmental Health U4P/V106,14Lith all <br />of the Food Vendor's Applications no later than two weeks prior to event RAI/r/W411. ke40. V/% <br />GENERAL EVENT FILE INFORMATION <br />Name of Event:\Wai \\/14 D-2,1 car.$jj j, <br />Date(s) of Event: g .?) Time of Event: <br />Location: 211 0 (S-4' , 4\1 <br />Event Coordinator (Name)thereAD. cg_JUI.Vie-ICS Telephone: ( ath Vci 3 <br />Mailing Address:64 ).)1 LIMMA0 -_Ck-OCA2k1N) Cot 0‘ <br />Number of Food Booths:A <br />Approximate attendance at peak time: Total Attendance: SOT Average Age: 0 5 - 6 17 <br />UTILITIES <br /> Is potable water supplied and available for each food vendor: S Yes No <br /> Is electricity supplied and available for each food vendor: Yes No <br /> Are janitorial facilities available: Yes E No <br /> Number of toilets provided:* 6 <br /> Name of sanitary garbage disposal company: $\140,.W, • \ ,kia,c) Number of dumpsters: <br /> Method of disposal of liquid waste for food booths: <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 <br />event. <br />I understand that as a temporary event coordinator, I am responsible for meeting California State <br />standards and the Environmental Health Department policies and procedures. <br />Event Coordinator: ttig/I 011,0(01/ Date: <br /> <br />,,Pody <br /> <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sjgov.org/ehd <br />EHD 16-02 Page 1 of 11 TEMP EVENT APP <br />06/29/2023 <br />7/10 0 /985 3