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o <br />GENERAL EVENT FILE INFORMATION <br />1. <br />2. <br />Event: <br />Telephone: ) <br />Number of Food Booths:5. <br />Average Age: <br />UTILITIES <br />1.No <br />2.Yes No <br />3.Noes <br />4. <br />5. <br />6. <br />APPLICATION <br />1. <br />Pagel of 13 TEMP EVENT APP <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 />EHD 16-02 <br />7/-1 4/IC <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 />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 />Name of Event: . <br /> /es Muerfcs F/esj'G <br />Date(s) of Event: Time of <br />: ^2-4 phn <br />3. Location: <br />4. Event Coordinator (Name): F _______ <br />W- <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: /<O <br />Name of sanitary garbage disposal company: 4l' e Number of dumpsters: <br />Method of disposal of liquid waste for food booths: s ts <br />6. Approximate attendance at peak time: <br />'JO <br />Mailing Address: 1 (Ltf-l <br />Total Attendance: - <br />D