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Environmental Health Department <br />1. <br />2. <br />3. <br />4. <br />5. <br />Total Attendance: ’5006. <br />UTILITIES <br />1. <br />2. <br />3. <br />4. <br />4Number of dumpsters:5. <br />6. <br />APPLICATION <br />1. <br />2. <br />Date: 9/09/2025Event Coordinator: <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 /> 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 />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />EHD 16-02 Pagel of 11 TEMP EVENT APP <br />SAN JOAQUIN <br />-COU NTY— <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 />Approximate attendance at peak time: 50Q <br />GENERAL EVENT FILE INFORMATION <br />Name of Event: Saint Anne's Harvest Fest <br />Date(s) of Event: October 4th & October Sth 2025 Tjme Of Event: 1Q/4: 1pm-9pm 10/5: 9am-4pm <br />LocatjOn: 215 W Walnut Street Lodi CA 95240 <br />Event Coordinator (Name): Hilda Sousa <br />Mailing Address: 200 S Pleasant Ave Lodi CA 95242 <br />Number of Food Booths: 6 <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 company: Waste Management <br />Method of disposal of liquid waste for food booths: 9rey water disPosed of down the drain. Grease will be <br />collected and dropped off at county recycling facility <br />Avpranp Ada- 25-50 adults Average Age. 5_12 Rids <br />Telephone: (g^Q 396-0012