Laserfiche WebLink
S A N !O A Q U I N Environmental Health Department <br /> --COUNTY -- <br /> TEMPORARY EVENT APPLICATION <br /> To be completed and signed by Event Coordinator, then returned to <br /> no eater than the <br /> Environ weeks m ntal Health event Department with all <br /> of the Food Vendor's Applications <br /> GENERAL EVENT FILE INFORMATION <br /> 1. Name of Event: <br /> 2. Date(s)of Event: 2 -20 `l ZOZCP Time of Event: <br /> 3. Location: - C <br /> CC 0 <br /> 4. Event Coordinator(Name): Telephone: 0 ) <br /> Vim' J <br /> Mailing Address: Du <br /> 5. Number of Food Booths: <br /> 6. Approximate attendance at peak time: _16�_Total Attendance: Average Age: '1 <br /> UTILITIES <br /> 1. Is potable water supplied and available for each food vendor: Yes ❑ No <br /> 2. Is electricity supplied and available for each food vendor: es ❑ No <br /> 3. Are janitorial facilities available: _ Yes ❑ No <br /> 4. Number of toilets provided: PrA,q) Y <br /> 5. Name of sanitary garbage disposal company: " Number of dumpsters: <br /> 6. Method of disposal of liquid waste for food booths: <br /> APPLICATION <br /> 1. Submit the following to the Environmental Health Department two weeks prior to the event: <br /> La) Temporary Event Application <br /> �) Application Review Fee o 179 <br /> �) Temporary Food Vendor A ations for each booth <br /> mod) Temporary Event Site Plan <br /> /) Food Vendor list <br /> 2. If thent is selected for inspection, the Event Coordinator will be billed for inspection time: <br /> / 0 $179 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$805.50 <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: �� Date: )l <br /> �T <br /> 1868 E. Hazelton Avenue J Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.orglehd <br /> EHO IU2 Page 1 of 11 TEMP EVENT APP <br /> 0710112025 <br /> Z:)CJIV� � <br />