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Environmental Health Department <br />8 AM-10 PM <br />Telephone: ( +1 (413) 388-7895 ) <br />Average Age: 35Total Attendance: <br />1. <br />2. <br />Date: Event Coordinator: <br />1. <br />2. <br />3. <br />4. <br />5. <br />6. <br />Yes <br />Yes <br />Yes <br />"I <br />f <BC' S <br /> No <br /> No <br /> No <br />SAN JOAQUIN <br />-COUNTY— <br />Greatness grows here <br />Number of dumpsters: <br />. Vendor will take back <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 />oNumber of toilets provided: <br />Name of sanitary garbage disposal company:--------------------- <br />Method of disposal of liquid waste for food booths: ---------- <br />1868 E2 Hazelton Avenue | Stockton, California 95205] T, 209 468-3420 | F 209 464-0138 | www.sjgo^org/ehd^ <br />06/19/19 <br />UTILITIES <br />1. <br />2. <br />3. <br />4. <br />5. <br />6. <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 />APPLICATION <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 $152 <br />c) Temporary Food Vendors Applications for each booth <br />d) Temporary Event Site Plan <br />e) Food Vendor List <br />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 a <br />minimum three-hour overtime rate of $684.00 <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 />f^erstand 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 />Name of Event: Poorba's Disco Dandiya and Durga Puja 2025--------------- <br />Date(s) of Event: 09/26/2025, 09/27/2025, 09/28/2025 Time of Event: <br />Location: Mountain House Central Community Park <br />Event Coordinator (Name): Poorba Inc. (Deepak Manda I.) <br />Mailing Address: 490 N Ventura St. Mountain House <br />Number of Booths : <br />Approximate attendance at peak time: