Laserfiche WebLink
GENERAL EVENT FILE INFORMATION <br />< C7<~\<cSe»nName of Event:1. <br />2. <br />3. <br />4. <br />CA <br />5. <br />Average Age: 6. <br />UTILITIES <br />1. <br />2. <br />3. <br />4. <br />5. <br />6. <br />APPLICATION <br />1. <br />2. <br />TEMP EVENT APRPage 1 of 11 <br />IIl <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 />EHD 16-02 <br />11/4/14 <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 $130 <br />c) Temporary Food Vendors Applications for each booth <br />d) Temporary Event Site Plan <br />e) Food Vendor List <br />-Telephone: (7^$) *741 <br />^57X3^ <br /> No <br /> No <br /> No <br />San Joaquin County <br />Environmental Health Department <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www sjgov.org/ehd <br />Yes <br />S Yes <br />0 Yes <br />If the event is selected for inspection, the Event Coordinator will be billed for inspection and travel time: <br />• $130 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 ($195 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 T p <br />Name of sanitary garbage disposal company: Number of dumpsters: I <br />Method of disposal of liquid waste for food booths: -tyuckx <br />Date(s) of Event: <br />Location: L-orV <br />Event Coordinator (Name): (S <br />Mailing Address: PO >x <br />Number of Food Booths: <br />Approximate attendance at peak time: MOO Total Attendance: LL-O Q <br />vironmental Health Department policies and procedures. <br /> Date: 0^^ <br />□'V->LXV_________________________ <br />Time of Event: SV\v| <br />P)V2lo SAlv'' krxt vi <br />I understand that as a temporary event coordinator, I am responsible for meeting California State <br />standards and the Epv <br />Event Coordinator: