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Environmental Health Department <br />2^2^1.Name of Event: <br />2, <br />3. <br />4. <br />5. <br />TSTotal Attendance: Average Age-6. <br />UTILITIES <br />1. <br />2. <br />3.Yes <br />4. <br />b roSq L <br />Number of dumpsters: 5. <br />6. <br />APPLICATION <br />1. <br />2. <br />Date:Event Coordinator: <br />s <br />Date(s) of Event: <br />Location <br />Event Coordinator (Name): <br />Mailing Address: <br />Number of Food Booths: <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 $179 <br />c) Temporary Food Vendors Applications for each booth <br />d) Temporary Event Site Plan <br />e) Food Vendor List <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 APP <br />07/01/2025 <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 />B'ves <br /> Yes <br />^3^03/2^2^ <br />If the event is selected for inspection, the Event Coordinator will be billed for inspection time: <br />• $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 /> No <br />&NO <br /> No <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: WT-S7 v'frLLty <br />Method of disposal of liquid waste for food booths: <br />GENERAL EVENT FILE INFORMATION <br />P6)&(g-e>A <br />I'LCi'LC Time of Event: || A-H _____ <br />6 A-.5 D Telephone: (6 /^ <br />7^) <br />Approximate attendance at peaKTIme: