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GENERAL EVENT FILE INFORMATION <br />Name of Event:1. <br />2. <br />3. <br />4. <br />5. <br />1200 Average Age: 40Total Attendance:6. <br />UTILITIES <br />1. <br />2. <br />3. <br />4. <br />Number of dumpsters: 1 (120 yds)5. <br />6. <br />APPLICATION <br />1. <br />2. <br />Event Coordinator: Miriam Delgado Date: 01-04-16 <br />TEMP EVENT APRPage 1 of 11 <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 />EHD 16-02 <br />08/01/16 <br />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 $139 <br />c) Temporary Food Vendors Applications for each booth <br />d) Temporary Event Site Plan <br />e) Food Vendor List <br />S Yes <br />S Yes <br />[X] Yes <br /> No <br /> No <br /> No <br />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, weekends and holidays) the inspection is charged at the <br />hourly rate, calculated at one and one half times ($208.50 per hour) <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 />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: 5 male, 5 female <br />Name of sanitary garbage disposal company: Lodi Grape Festival <br />Method of disposal of liquid waste for food booths: Provided by trucks <br />San Joaquin County <br />Environmental Health Department <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 JAN I U ZUU <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.og/^|^ONMENTALHEALTH <br />permit/services <br />The Lodi Home & Garden Show_______________________________________ <br />Date(s) of Event: January 20-22, 2017 Time of Event: Fri:12 PM-5 PM, Sat & Sun: 10 AM-5 PM <br />Location: Lodi Grape Festival Grounds, 413 E Lockeford St, Lodi, CA 95240 <br />Event Coordinator (Name): Miriam Delgado Telephone: (209 941-1880 <br />Mailing Address: PO Box 8126, Stockton, CA 95208 <br />Number of Food Booths: 12__________ <br />Approximate attendance at peak time: 400