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Environmental Health Department <br />of the Food Vendor's Applications no later than two weeks prior to event <br />2. <br />3. <br />4. <br />5. <br />) oo Average Age: 6.Total Attendance: <br />2. <br />3. <br />4. <br />Number of dumpsters: 5. <br />6. <br />APPLICATION <br />1. <br />2. <br />Event Coordinator: Date: A7 <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 $152 <br />c) Temporary Food Vendors Applications for each booth <br />d) Temporary Event Site Plan <br />e) Food Vendor List <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjcehd.com <br />EHD 16-02 Pagel of 11 TEMP EVENT APP <br />07/3/17 <br />temporary everj^ coordinator, I am responsible for meeting California State <br />partment policies and procedures. <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 <br />standards and the En^ufonhental Healtl <br />GENERAL EVENT FILE INFORMATION <br />1. <br />UTILITIES <br />1. <br />TEMPORARY EVENT APPLICATION APR j 0 <br />To be completed and signed by Event Coordinator, then returned to the Environmental Healtkrtepartment with am <br />of the Food Vendor's Applications no later than two weeks prior to event PFDNMENrAL HEai Tu <br />hermit/services TH <br /> Yes ^fNo <br /> Yes J^TNo <br /> Yes 8"No <br />SAN JOAQUIN <br />-COUNT Y— <br />Creotness grows here. <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: — <br />Name of sanitary garbage disposal company: <br />Method of disposal of liquid waste for food booths: — <br />Name of Event: yisl+fx <br />Date(s) of Event: Time of Event: <br />Location: <br />Event Coordinator (Name): T) (L & X Telephone: (^"/^ 7 <br />Mailing Address: !/ ^3 AW/ <br />Number of Food Booths: ( <br />Approximate attendance at peak time: /