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SAN JOAQUIN COUNT <br /> j izNVIRONMENTAL HEALTH DEPHrcTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: 209 468-3420 Fax: 209 464-0138 Web:www.s ov.or /e Y 15 2018 <br /> p ( ) ( ) 19 9 <br /> ENVIRONMENTAL <br /> p LTH <br /> ERM TISERVIC S <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: Market & Music in Manteca <br /> 2. Date(s) of Event: June 5,12,19, 26 July 3, 10,17,24, 31 Time of Event: Farmers Market <br /> 3. Location: 100 Manteca Ave (Library Park) , Manteca, CA 95336 <br /> 4. Event Coordinator(Name): Joann Beattie Telephone: (209)823-6121 <br /> Mailing Address: 183 W. North Street, Suite 6, Manteca, CA 95336 <br /> 5. Number of Food Booths: 6 <br /> 6. Approximate attendance at peak time: 50 Total Attendance: 200 Average Age: 40 <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: 2 <br /> 5. Name of sanitary garbage disposal company: City of Manteca Number of dumpsters: 4 <br /> 6. Method of disposal of liquid waste for food booths: recycle barrel <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$ �13 <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 /> • $139 per hour(weekdays 8:00 am to 5:00 pm) <br /> • After regular business hours(weekday d at the <br /> hourly rate, calculated at one and one half times ($208.50 per hour) <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 Enyir-o ental Health Depa a 1pclicies and procedures. <br /> Event Coordinator: �� �� • �- Date: <br /> EHD 16-02 / Page 1 of 11 TEMP EVENT APP <br /> 08/01/16 <br />