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No. 4977 P. 3Mar. 30. 20 1 8 8:45AM <br />GENERAL EVENT FILE INFORMATION <br />1. <br />6:00pm-8:00pmTime of Event:2. <br />3. <br />831-62244. <br />5. <br />400 Total Attendance: 400 35Approximate attendance at peak time:Average Age:6. <br />UTILITIES <br />1. <br />2. <br />3. <br />4. <br />5. <br />6. <br />APPLICATION <br />1. <br />2. <br />Date: <br />Pago 1 of 11 <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 $125 <br />c) Temporary Food Vendors Applications for each booth <br />d) Temporary Event Site Plan <br />e) Food Vendor List <br />[Z Yes <br />(3 Yes <br />QYes <br /> No <br /> No <br /> No <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 />If the event is selected for inspection, the Event Coordinator will be billed for inspection time: <br />• $125 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 ($183 per hour) <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: Gir|s Ni9ht Qut ~ A Ni9ht in the City <br />Date(s) of Event: APr‘l 20, 2018 ‘ <br />Location: Grand Theatre Center for the Arts <br />Event Coordinator (Name): jOj I Telephone: (2.09) <br />Mailing Address: 715 N. Central Avenue Tracy, CA 95376 <br />Number of Food Booths: J <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: 6 <br />Name of sanitary garbage disposal company: Tracy Disposal Service Number of dumpsters: 3. <br />Method of disposal of liquid waste for food booths: ^/A <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; Date: <br />Received Time Mar. 30. 2018 8:39AM No. 3 2 7 7 Pagoiofii tempeventapp <br />7/28/10