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% <br />a <br />GENERAL EVENT FILE INFORMATION <br />Holiday BazaarName of Event:1. <br />2. <br />3. <br />4. <br />5. <br />6.Total Attendance: <br />UTILITIES <br />1. <br />2. <br />3. <br />4. <br />5.Gilton Number of dumpsters: 2 <br />6. <br />APPLICATION <br />1. <br />2. <br />TEMP EVENT APPEHD 16-02 <br />08/01/16 <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 />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 /> Yes <br /> Yes <br />O Yes <br /> No Water provided by City of Escalon <br /> No Not a booth event. <br /> No Not a booth event. <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 />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 />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 />50-75 Average Age: 62 <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: Two - I adies/Men <br />Name of sanitary garbage disposal company: <br />Method of disposal of liquid waste for food booths: Not a booth 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 />Event Coordinator: li Date: <br />PHje 1 of 11 <br />Event Coordinator (Name): Jeanette Parsons/Karen Harris Telephone: (209 ) 606-1781 (Jeanette) <br />Mailing Address: Escalon United Methodist Church, 2000 Jackson Ave., Escalon, CA 95320 <br />Number of Food Booths: None - Not a booth event.____________ <br />Approximate attendance at peak time: Noon <br />Date(s) of Event: Saturday. October 35. 2025 Time of Event: g:Qn p ro, - g^nn p.m. <br />Location: Escalon United Methodist Church, 2000 Jackson Avenue, Escalon, CA 95320