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8 WO PM' qwM <br />loo Average Age: 25Total Attendance: <br />3 <br />Method of disposal of liquid waste for food booths: *no dispbtt.1 <br />APPLICATION <br />1. <br />2. <br />then returned to the <br />Event Coordinator: <br />5. <br />6. <br /> Yes <br /> Yes <br /> Yes <br />Temporary Event Application <br />Application Review Fee of $179 <br />Temporary Food Vendors Applications for each booth <br />Temporary Event Site Plan <br />Food Vendor List <br />Environmental Health Department <br />This application is to be completed and signed by the Event Coordinator, C.c.. uie <br />Environmental Health Department with all Food Vendor’s Applications no later than two weeks prior to the <br />[^No <br />S^lo <br />0No <br />SAN JOAQUIN <br />------COUNTY- <br />Greotness grows here. <br />UTILITIES <br />1. <br />2. <br />3. <br />4. <br />5. <br />6. <br />GENERAL EVENT FILE INFORMATION <br />1. <br />2. <br />3. <br />4. <br />ehd?6^2 HaZelt°n AV6nUe 1 Stockton’ California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />07/01/2025 Pagel of 11 TEMP EVENT APP <br />^0072.2 <br />________C»nuo Qo Mdijo____________ <br />02, Time of Event: <br />| ParK- j 320 W- Oonty St, nWwn_______ <br />MdrUMVUfl Telenhone:rfilln KlS-SW <br />123 w. VOSomiK) AVt.________ <br />Number of Food Booths: (fl <br />Approximate attendance at peak time: /0o <br />APR | 7 <br />TEMPORARY EVENT APPLICATIONa ro. ^ . <br />To be completed and signed by Event Coordinator, then returned to the Environmental Health Department v^fktlH <br />of the Food Vendor’s Applications no later than two weeks prior to event <br />Name of Event: <br />Date(s) of Event: <br />Location: UbrArjj W <br />Event Coordinator (Name):__ <br />Mailing Address: <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: MMtWL Jilid klwto Number of dumpsters: 2 <br />Date: 4/|6 <br />Submit the following to the Environmental Health Department two weeks prior to the event: <br />a) <br />b) <br />c) <br />d) <br />e) <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 />application is to be completed and signed by the Event Coordinator, <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 />flidki Mdnuifrtoua