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PQ, 2^0022^ Environmental 1. 2. 3. 4. 5. Average Age: C/OTotal Attendance: '6. 1. 2. 3. 4. 1Number of dumpsters:5. 6. APPLICATION 1. 2. Date: Event Coordinator: Submit the following to the Environmental Health Department two weeks prior to the event: a) Temporary Event Application b) Application Review Fee of $179 c) Temporary Food Vendors Applications for each booth d) Temporary Event Site Plan e) Food Vendor List No No No If the event is selected for inspection, the Event Coordinator will be billed for inspection time: • $179 per hour (weekdays 8:00 am to 5:00 pm) • After regular business hours (weekday, weekends and holidays) the inspection is charged at a minimum three-hour overtime rate of $805.50 This application is to be completed and signed by the Event Coordinator, then returned to the Environmental Health Department with all Food Vendor’s Applications no later than two weeks prior to the event. I understand that as a temporary event coordinator, I am responsible for meeting California State standards and the Environmental Health Department policies and procedures. UTILITIES Is potable water supplied and available for each food vendor: "S Yes Is electricity supplied and available for each food vendor: 0 Yes Are janitorial facilities available: Q Yes Number of toilets provided: Name of sanitary garbage disposal company: Method of disposal of liquid waste for food booths: SANdOAQUIN -------COUNTY------- Greatness grows here. TEMPORARY EVENT APPLICATION™0®^ To be completed and signed by Event Coordinator, then returned to the Environmental Health Department with all of the Food Vendor’s Applications no later than two weeks prior to event partment WB© APR 15 2026 GENERAL EVENT FILE INFORMATION Name of Event: Date(s) of Event: Time of Event: rr\ —ip p/Y] Location: mi Lw/f'vvp Event Coordinator (Name): 1 ^Telephone: ( ) Mailing Address: ^3^ 7^3/£ , C# Number of Food Boothsf Approximate attendance at peak time: j