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,..R <br /> t <br /> z �' u)M' S A N J OA Q U I N Environmental Health Department <br /> : ? tA COUNTY <br /> ' Greatness grows here. <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 /> GENERAL EVENT FILE INFORMATION <br /> 1. Name of Event: WEST VALLEY MALL SPRING CARNIVAL <br /> 2. Date(s)of Event: APR IL 10-19, 2026 Time of Event: NOON-11 PM <br /> 3. Location: WEST VALLEY MALL <br /> 4. Event Coordinator(Name): BUTLER AMUSEMENTS, INC. Telephone: �09) 903-4800 <br /> Mailing Address: 1006 TRAVIS BLVD. FAIRFIELD, CA. 94533 <br /> 5. Number of Food Booths: ONE 1 <br /> 6. Approximate attendance at peak time: NA Total Attendance: NA Average Age: NA <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: ® Yes ❑ No <br /> 3. Are janitorial facilities available: ® Yes ❑ No <br /> 4. Number of toilets provided: 12 <br /> 5. Name of sanitary garbage disposal company: BUTLER AMUSEMENT ILIA ar of dumpsters: 1 <br /> 6. Method of disposal of liquid waste for food booths: APPROVED DRAIN OR BLADDERS <br /> APPLICATION <br /> 1. 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 /> 2. 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 /> Event Coordinator: SALLY MCCLAIN Date: 3/5/2026 <br /> 1868 E. Hazelton Avenue 1 Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/ehd <br /> EHD 16-02 Page 1 of 11 TEMP EVENT APP <br /> D714112425 <br /> 'W10 52 395` <br />