Laserfiche WebLink
GENERAL EVENT FILE INFORMATION <br />1. <br />2. <br />3. <br />4. <br />q szo? <br />5. <br />/do6.Total Attendance: Average Age: <br />UTILITIES <br />1.No <br />2.No <br />3.No <br />4. <br />5. <br />6. <br />APPLICATION <br />1. <br />2. <br />Event Coordinator: Date: <br />Page 1 of 11 TEMP EVENT APP <br />I <br />EHD 16-02 <br />11/4/14 <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 $130 <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 /> Yes <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 and travel 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 ($195 per hour) <br />Is potable water supplied and available for each food vendor: <br />Is electricity supplied and available for each food vendor: <br />Are janitorial facilities available: <br />Number of toilets provided: .'T'"- <br />Name of sanitary garbage disposal company: Number of dumpsters: <br />Method of disposal of liquid waste for food booths: S OO <br />I understand that as a temporary event coordinator, I am responsible for meeting California State <br />standards and the Environment^LtLealth Department policies and procedures. <br />3/ ^// b <br />ime of Event: A ann -1 P rkv <br />.Telephone: (^$ H \ <br />Name of Event: \j0eS>Y C-Ar <br />Date(s) of Event: - Oca- <br />Location: / O M TV" \ \ <br />Event Coordinator (Name): Vt aV'—L-C4^)o~? <br />Mailing Address: 4 - OTW- <br />Number of Food Booths: <br />Approximate attendance at peak time: