Laserfiche WebLink
SAN JOAQUIN <br /> Environmental Health t, a artment <br /> —COUNTY-- <br /> MAY 2? 20 <br /> eNV1R pN <br /> TEMPORARY EVENT APPLICATION p�RMsNrA�H <br /> �Rk E4CTy <br /> To be completed and signed by Event Coordinator, then returned to the Environmental Health Department wi(& <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: eea_ <br /> 2. Date(s) of Event: 41 <br /> ,Xr, h/,3, ��`1� g l� Time of Event: <br /> 3. Location: eea_ 1 Spp ��✓f✓i'�� �i o�' �f� 9,5&6 4i <br /> 4. Event Coordinator(Name): b,C A G C_L'.aA t Telephone: (7&!J S_073 <br /> Mailing Address: <br /> 5. Number of Food Booths: <br /> 6. Approximate attendance at peak time: 3 00 Total Attendance: Average Age: �. <br /> UTILITIES <br /> 1. Is potable water supplied and available for each food vendor: 5Q Yes ❑ No <br /> 2. Is electricity supplied and available for each food vendor: [9] Yes ❑ No <br /> 3. Are janitorial facilities available: ❑ Yes ❑ No <br /> 4. Number of toilets provided: <br /> 5. Name of sanitary garbage disposal company: �/r/ J� r c: llb t&mber of dumpsters: <br /> 6. Method of disposal of liquid waste for food booths: <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$162 <br /> e Temporary Food Vendors Applications for each booth <br /> d) Temporary Event Site Plan <br /> W Food Vendor List <br /> 2, if the event is selected for inspection, the Event Coordinator will be billed for inspection time: <br /> • $162 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$729.00 <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 De artment policies and procedures. <br /> ri <br /> Event Coordinator: Date: __- <br /> 1868 E. Hazeiton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/ehd <br /> EiD 16-02 Page 1 of 11 TEMP EVENT APP <br /> 06/29/2023 <br />