Laserfiche WebLink
Environmental Health Department <br />Name of Event: <br />2. <br />3.[i/e. <br />4. <br />5. <br />lb6.Total Attendance: Average Age: <br />2. <br />3. <br />/4. <br />t5. <br />6. <br />APPLICATION <br />1. <br />2. <br />Date: <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 $152 <br />c) Temporary Food Vendors Applications for each booth <br />d) Temporary Event Site Plan <br />e) Food Vendor List <br /> No <br /> No <br /> No <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 />-7/ 2J/Z/ <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 lot 11 TEMP EVENT APP <br />06/19/19 <br />Time of Event: F/ <br />c . c A K <br />” W- <br />If the event is selected for inspection, the Event Coordinator will be billed for inspection time: <br />• $152 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 $684.00 <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 />GENERAL EVENT FILE INFORMATION <br />1. <br />UTILITIES <br />1. <br />_________Number of dumpsters: <br />'Fix <br />SANJOAQUIN <br />------COUNT Y------- <br />Greatness grows here. <br />Event Coordinator: <br />-Telephone: 0^) 9 - 3 <3 2 <br />Is potable water supplied and available for each food vendor: Yes <br />Is electricity supplied and available for each food vendor: Yes <br />Are janitorial facilities available: Yes <br />Number of toilets provided: <br />Name of sanitary garbage disposal company: (I C <br />Method of disposal of liquid waste for food booths: I/- - <br />Date(s) of Event: , <br />Location: 3 <br />Event Coordinator (Name): J'jneW <br />Mailing Address: 5~Hfcfr AA» f -K-> L <br />Number of Food Booths:2___________ <br />Approximate attendance at peak time: 2-^0