Laserfiche WebLink
'a <br />2. <br />3.OD t <br />4. <br />5. <br />Average Age: 6. <br />2. <br />3. <br />4. <br />5. <br />6. <br />APPLICATION <br />1. <br />2. <br />Date: <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 /> No <br /> No <br /> No <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjcehd.com <br />EHD 16-02 Page 1 of 11 TEMP EVENT APP <br />07/3/17 <br />[^KYes <br />0 Yes <br />H Yes <br />Event Coordinator: r <br />o2o/ 7 <br />s"-r <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 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 />GENERAL EVENT FILE INFORMATION <br />1. <br />__________________________PA <br />0/6 e - aJo s <br />Total Attendance:/6*-'0'^ <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: Z t> o/Number of dumpsters: <br />Method of disposal of liquid waste for food booths: Qi ry —- <br />SAN JOAQUIN Environmental Health Department <br />-COUNTY----- <br />Creulness grows here. <br />TEMPORARY EVENT APPLICATION i3 2 <br />To be completed and signed by Event Coordinator, then returned to the Environmental Healrm^^Xiiignt wirn%\\ <br />of the Food Vendor's Applications no later than two weeks prior to event <br />Name of Event: £A\i<rrH‘s ~TV L D _______ <br />Date(s) of Event: '7~ ^3-^1 7 Time of Event: /G b T^/OtL. <br />Location: ^-1/3 l-oc i<t='F=rc> n-p /-udk 7 3 o? _________________ <br />Event Coordinator (Name):J?^P c D l^yt. 4F Telephone: (^^j <br />Mailing Address: 7 /Vo aJT p/ *7 -T 2- <br />Number of Food Booths: <br />Approximate attendance at peak time: 0