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of the Food Vendor’s Applications no later than two weeks prior to event <br />GENERAL EVENT FILE INFORMATION <br />1. <br />9;00 a.m.-HsOO p-m. <br />4. <br />UTILITIES <br />1. <br />4. <br />Gilton <br />APPLICATION <br />1. <br />(Exempt - see attached info) <br />2. <br />Date: Event Coordinator <br />TEMP EVENT APP <br />2. <br />3. <br />5. <br />6. <br />2. <br />3. <br />5. <br />6. <br />EHD 16-02 <br />7/14/15 <br />0 Yes <br />£]Yes <br />£] Yes <br />□ No <br />□ No <br />□ No <br />So J <br />lor <br />Number of dumpstersThr ee 90 gal. <br />Two double sinks ‘ cans. <br />TEMPORARY EVENT APPLICATION <br />To be completed and signed by Event Coordinator, then returned to the Environmental Health Department with all <br />Name of Event: .Holiday Bazaar-----—-------------------——--------- <br />Date(s) of EventOctober 29 > 2016 Time of Event: <br />Location- Eecalon United Methodist Church <br />Event Coordinator (NdM* Dovnard <br />Mailing Address: <br />Number of Food Booths: <br />Approximate attendance at peak time: <br />note} SAME AS PREVIOU'’ YEARS <br />Jeff Carrv o <br />received <br />OCT 13 20K <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: Three (3) <br />Name of sanitary garbage disposal company: <br />Method of disposal of liquid waste for food booths: <br />- NO BOOTHS - USING KITCHEN AT CHURCH. <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 />) 838-1726 <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 />If the event is selected for inspection, the Event Coordinator will be billed for inspection 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 ($195.00 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 pnor 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 />A <br />' z i/ aA <br />Page 1 of 11 <br />Telephone: ( <br />2000 Jackson Avenue, Escalon, CA 95320 <br />One (1) <br />50-60 Total Attendance: 300 Average Age: SCUfiQ