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g'� � S A N J O A Q U I N Environmental Health Department <br /> `1' COUNTY <br /> Greatness grows here. G%Opy <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: S- -. ZAoL <br /> 2. Date(s) of Event: Dckh6cf 21T 2 D-2.1 ip of Event: 9:DD M" - 3.0V Mz <br /> 3. Location: mam S+: A °ISPIWo <br /> 4. Event Coordinator(Name): �� Telephone: (M) 51 �91.(o1�j` <br /> Mailing Address: �. S <br /> 1 <br /> ccll� <br /> 5. Number of Food Booths: _ O <br /> 6. Approximate attendance at peak time: 1500 Total Attendance: SDOD Average Age: !tD <br /> UTILITIES <br /> 1. Is potable water supplied and available for each food vendor: ❑Yes [� o <br /> 2. Is electricity supplied and available for each food vendor: ❑Yes [No <br /> 3. Are janitorial facilities available: /dyes ❑ No <br /> 4. Number of toilets provided: 11�_7 A_ <br /> 5. Name of sanitary garbage disposal company: 1{'yl ok n Number of dumpsters: D <br /> 6. Method of disposal of liquid waste for food booths: VA&As�- <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 /> 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 /> • $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 Department policies and procedures. <br /> Event Coordinator: f Date: 1��0 123 <br /> 1868 E. Hazelton Avenue I Stoc on, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/ehd <br /> EHD 16-02 Page 1 of 11 TEMP EVENT APP <br /> 06/29/2023 <br />