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Environmental Health Department4* <br />1.Name of Event: <br />11am-5pmTime of Event:2. <br />3.Location: <br />Telephone: (4. <br />5. <br />6. <br />2. <br />3. <br />4. <br />4Number of dumpsters:5. <br />City Sower ta6. <br />APPLICATION <br />1. <br />2. <br />Mike MillerickEvent Coordinator: <br />Number of toilets provided: <br />Name of sanitary garbage disposal company: <br />Method of disposal of liquid waste for food booths: <br />Temporary Event Application <br />Application Review Fee of SI56 <br />Temporary Food Vendors Applications for each booth <br />Temporary Event Site Plan <br />Food Vendor List <br /> Yes <br /> Yes <br /> Yes <br /> No <br /> No <br /> No <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />EHO 16-02 Page 1 ot 11 TEMP EVENT APP <br />06/19/19 <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 />QUIN <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 />6 r-rooms with 6 per <br />California Waste <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 />• Si56 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 S702.00 <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 tQ th? <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 />UTILITIES <br />1. <br />Date: 4-26-24 <br />Approximate attendance at peak time: 2^00 Total Attendance: 3500 Average Age: <br />GENERAL EVENT FILE INFORMATION <br />Lodi Comic Con_____ <br />Date(s) of Event: MaV 11 ’ 2024 <br />Lodi Grape Festival Grounds <br />Event Coordinator (Name): Mike Millerick <br />Mailing Address: PQ BOX 7202. Stockton, CA 95267 <br />Number of Food Booths: Z <br />) 209-471-5478