Laserfiche WebLink
9r <br />JUL 0 2 2024 <br />/ 'tv <br />2. <br />3. <br />4. <br />5. <br />Total Attendance: 6. <br />2. <br />3. <br />4. <br />5. <br />6. <br />APPLICATION <br />1. <br />2. <br />Date: <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 $162 <br />c) Temporary Food Vendors Applications for each booth <br />d) Temporary Event Site Plan <br />e) Food Vendor List <br />0 Yes <br />0 Yes <br />0 Yes <br />Environmental Health Department <br />[RECEOVEB <br />7 <br />Mailing Address: '.Zj 7.2 -4'X7/zF <br />Number of Food Booths:/^/y <br />Approximate attendance at peak time: ZZ’C' <br />SAN JOAQUIN <br />-----COUNTY------ <br />Greatness qrows here. <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: <br />Name of sanitary garbage disposal companyC^z/y / <br />Method of disposal of liquid waste for food booths: <br />t>u { e <5 <br />GENERAL EVENT FILE INFORMATION <br />1. <br />UTILITIES <br />1. <br />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: <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />EHD 16-02 Page 1 of 11 TEMP EVENT APR <br />06/29/2023 <br /> No <br /> No <br /> No <br />~ on $ <br />Z^ZZ9 / Number of dumpsters: tZ ~3 <br />TEMPORARY EVENT APPLICATION ENVIRONMENTAL HEALTH <br />To be completed and signed by Event Coordinator, then returned to the Environmental Health <br />of the Food Vendor’s Applications no later than two weeks prior to event <br />P(2_oSm -| \ocj <br />Name of EventF/z^^z ,/Z^ A -.52 ~ '^rt 'tvi- <br />Date(s) of Event: Time of Event: ) <br />Location: ///^/ ZZ/fapL 3/v$- X z77 XS'JZY______________—/ —— / -) <br />Event Coordinator (Name):'7/TXgy Z/z>a^ ZZ oZ Telephone: (Z/Y) <br />-jr-j <br />Average Age: 29-