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SAN JOAQUIN <br />COUNTY <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 />1. Name of Event: 209BEATDOWN <br />Date(s) of Event: October 12,2024 Time of Event: 4:00 PM <br />Location: 525 N. CENTER STREE <br />Event Coordinator (Name): RAYFORD HUDSON Telephone: ( 2Cq 992-9665 <br />Mailing Address: 10403 EL PASO WAY, STOCKTON CA - 95209 <br />Number of Food Booths: 1 <br />Approximate attendance at peak time: 800 Total Attendance: 900 Average Age: 35 <br />UTILITIES <br />Is potable water supplied and available for each food vendor: Ni Yes LI No <br />Is electricity supplied and available for each food vendor: ['Yes LII No <br />Are janitorial facilities available: Ni Yes El No <br />Number of toilets provided: 20+ <br />Name of sanitary garbage disposal company: WASTE MANAGEMENT Number of dumpsters: 3 <br />Method of disposal of liquid waste for food booths: CITY <br />APPLICATION <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 $152 <br />Temporary Food Vendors Applications for each booth <br />Temporary Event Site Plan <br />Food Vendor List <br />2. If the event is selected for inspection, the Event Coordinator will be billed for inspection time: <br />$152 per hour (weekdays 8:00 am to 5:00 pm) <br />After regular business hours (weekday, weekends and holidays) the inspection is charged at the <br />hourly rate, calculated at one and one half times ($228 per hour) <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: RAYFORD HUDSON IV Date: 09/28/2024 <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sjcehd.com <br />EHD 16-02 Page 1 of 11 TEMP EVENT APP <br />07/3/17