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S A N ]UA Q U I N 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 /> GENERAL EVENT FILE INFORMATION <br /> 1. Name of Event: Christmas Festival <br /> 2. Date(s) of Event: December 14-15, 2024 Time of Event: Sat 11 am-8pm, Sun 11 am-8pm <br /> 3. Location: St. Mark Coptic Orthodox Church: 315 Orange Avenue, Ripon, CA 95366 <br /> 4. Event Coordinator(Name):Salty Elsakr Telephone: (209 613-7828 <br /> Mailing Address: 201 Blossom View Place, Modesto, CA 95356 selsakr@gmail.com <br /> 5. Number of Food Booths: One food, one desert, 1 grilling station, drink station. <br /> 6. Approximate attendance at peak time. 30-40 Total Attendance: 200-250 Average Age: 30-35 <br /> UTILITIES <br /> 1. Is potable water supplied and available for each food vendor. ® Yes ❑ No <br /> 2. Is electricity supplied and available for each food vendor: ® Yes ❑ No <br /> 3. Are janitorial facilities available: ® Yes ❑ No <br /> 4. Number of toilets provided: 5 <br /> 5. Name of sanitary garbage disposal company: Gilton Waste Management Number of dumpsters: 2 <br /> 6. Method of disposal of liquid waste for food booths: Bucket <br /> APPLICATION <br /> 1. Submit the following to the Environmental Health Department two weeks prior to the event: <br /> a) Temporary Event Application <br /> b) Application Review Fee of$162 <br /> c) Temporary Food Vendors Applications for each booth <br /> d) Temporary Event Site Plan <br /> e) Food Vendor List <br /> 2. If the event is selected for inspection, the Event Coordinator will be billed for inspection time: <br /> • $172 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$774.00 <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: pate_ 12/9/2024 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/ehd <br /> EHD 16-02 Page 1 of 11 TEMP EVENT APP <br /> 07101/2024 <br />