Laserfiche WebLink
Environmental Health Department <br />1.fTPVtbA l-L <br />2.Time of Event: "7'^0 to ,Pm <br />3. <br />4.Telephone: (Hdfe) fcz^t -ofei3 <br />5. <br />Approximate attendance at peak time: 7<X>6.Total Attendance: —'Leo Average Age: I 7~ <br />UTILITIES <br />1. <br />2. <br />3. <br />4. <br />Number of dumpsters: 5. <br />6. <br />APPLICATION <br />1. <br />2. <br />Event Coordinator: <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 />Date(s) of Event: <br />Location: <br />coordinator, I am responsible for meeting California State <br />artment policies and procedures. <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 Pagel of 11 TEMP EVENT APP <br />07/3/17 <br />j Department yvith all Food Vendor’s Applications no later than two weeks prior to the <br />a temporary event cooi <br />nvironmental Health Depart <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 Heah <br />event. <br />I understand that I <br />standards and the E <br />SAN JOAQUIN <br />E*'- ... ' -----COUNTY <br />Greatness grows here. <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 />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: Z <br />Name of sanitary garbage disposal company: <br />Method of disposal of liquid waste for food booths: <br />Date: (T <br />GENERAL EVENT FILE INFORMATION <br />Name of Event: 6 <br />q^/22.; <br />Event Coordinator (Name): <br />Mailing Address: <br />Number of Food Booths: <br />S^Yes <br />53 Yes <br />QsYes