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Environmental Health Department <br />i <br />! <br />H <br />APPLICATION <br />1. <br />2. <br />Date: JL <br />5. <br />6. <br />Temporary Event Application <br />Application Review Fee of $152 <br />Temporary Food Vendors Applications for each booth <br />Temporary Event Site Plan <br />Food Vendor List <br />EJ Yes <br />EJYes <br />[0 Yes <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: J <br />Name of sanitary garbage disposal company: <br />Method of disposal of liquid waste for food booths:^ <br />i <br />! <br />ii <br />Event Coordinator . <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 />Average Age.(^^^^), i <br />- <br /> No <br /> No <br /> Nou <br />Number of dumpsters: <br />1868 E. Hazelton Avenue I Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 ( www.sjcehd.com <br />EHD 16-02 Page 1 of 11 TEMP EVENT APR <br />07/3/17 <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 />lisoosal company: (M .OT IlVl <br />‘AN <br />Date(s) of Event: Afril 7-1.! .2^11 ___.Time of Event:_ <br />Location: gtllfifl_____ ______-________- <br />Event e.nnrdinatnrfName):_V^4T /Telephone: <br />Mailing Address: I * 0 • few ' /^i, (h. q&l) <br />Number of Food Booths:_ <br />Approximate attendance at peak time: <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 />• $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 the <br />hourly rate, calculated at one and one half times ($228 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 arrf responsible for meeting California State <br />standards and the Environmental Health Department policies and procedures. <br />SANJOAQUIN <br />------COUNTY------- <br />Greatness grows here.