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Environmental Health Department <br />1. <br />2. <br />3. <br />4. <br />5.2 <br />250 0-65Total Attendance:6.Approximate attendance at peak time:Average Age: <br />1. <br />2. <br />3. <br />4. <br />1Number of dumpsters:5. <br />6. <br />APPLICATION <br />1. <br />2. <br />Event Coordinator: <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 $179 <br />c) Temporary Food Vendors Applications for each booth <br />d) Temporary Event Site Plan <br />e) Food Vendor List <br />Event Coordinator (Name):. <br />Mailing Address: _______ <br />Number of Food Booths: <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 />EHD 16-02 Pagel of 11 TEMP EVENT APP <br />07/01/2025 T-Js-, <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 />/■ og\ <br />- i. . <br />\ / <br />If the event is selected for inspection, the Event Coordinator will be billed for inspection time: <br />• $179 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 $805.50 <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 />GENERAL EVENT FILE INFORMATION <br />Name of Event: 3rd Annul Stockton Community Health Fair <br />Date(s) of Event: May 16, 2026 Time of Event: pm-5pm <br />1151 W ROBINHOOD DR, STE C-10 STOCKTON <br />Location: ca,95207______________________________________________________________ <br />Sandra Stultz Telephone: ( 5)10 395-4814 <br />1151 W ROBINHOOD DR, STE C-10 STOCKTON <br />------CA,95207--------------------------------------------------------------------------------------- <br />I am counting Italian Ice <br />150 <br />SANJOAQUIN <br />-COUNTY— <br />Greatness grows here. <br />UTILITIES <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: 3-1 0 <br />Method of disposal of liquid waste for food booths: <br />Date: 5/11/2025