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Environmental Health Department <br />2. <br />3. <br />4. <br />5. <br />Average Age: ?>oTotal Attendance: 1,5006. <br />2 <br />3. <br />4. <br />5. <br />Method of disposal of liquid waste for food booths: barr-eA6. <br />APPLICATION <br />1. <br />2. <br />Event Coordinator: Date: <br />1868 E. Hazelton Avenui <br />EHD 16-02 '■ <br />07/01/2024 <br />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 $172 <br />c) Temporary Food Vendors Applications for each booth <br />d) Temporary Event Site Plan <br />e) Food Vendor List <br /> Yes <br /> Yes <br /> Yes <br />S'No <br />®No <br />® No <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 />SAN JOAQUIN <br />-----COUNTY- <br />Greatness grows here. <br />itockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />Pagel of 11 TEMP EVENT APP <br />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 />GENERAL EVENT FILE INFORMATION <br />1. <br />UTILITIES <br />1. <br />Name of Event: Or\r\S~Vvr\o<s \r\ -Vine, PcxrY <br />Date(s) of Event: 2-OZ-5 Time of Event:_ VU- OQ prrx — <br />Location: dzo u3- Center SVj Cfi O5S5U <br />Event Coordinator (Name):_ Joann Telephone: ( ) <br />Mailing Address: 2,^ E.. oserrnA-e Ave, < CA <br />Number of Food Booths: 12-_________ <br />Approximate attendance at peak time: 1,500 <br />Is potable water supplied and available for each food vendor: <br />Is electricity supplied and available for each food vendor: <br />Are janitorial facilities available: <br />Number of toilets provided 12 <br />Name of sanitary garbage disposal company: Number of dumpsters: ^4