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1.Name of Event: <br />2. <br />3. <br />4. <br />5. <br />2S6. <br />□ Yes1. <br />2.es <br />3.es <br />4. <br />5. <br />6. <br />APPLICATION <br />1. <br />2. <br />Date: <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 $179 <br />c) Temporary Food Vendors Applications for each booth <br />d) Temporary Event Site Plan <br />e) Food Vendor List <br />□ No <br />□ No <br />□ No <br />SAN JOAQUIN <br />-COUNTY— <br />Greatness grows here. <br />Environmental Health Department <br />Telephone: <br />If the event is selected for inspection, the Event Coordinator will be billed for inspection time: <br />• $179 per hour (weekdays 8:00 am to 5:00 pm) <br />• After regular business hours (weekday, weekends and holidays) the inspection is charged at a <br />minimum three-hour overtime rate of $805.50 <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 />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 />UTILITIES <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:____________ * <br />Name of sanitary garbage disposal company: CxA > ^€<«^g,/*iNumber of dumpsters: <br />Method of disposal of liquid waste for food booths: P>l'd C <br />'Jfeuinesh yrawi nere. - 7\V7/S7rh <br />APR33^s U <br />TEMPORARY EVENT APPLICATION Env'RonmSntal <br />To be completed and signed by Event Coordinator, then returned to the Environmental Health Dep&Vtlf^i^v/gi^^7'^ <br />of the Food Vendor’s Applications no later than two weeks prior to event <br />9 lb <br />______ <br />S' <br />Date(s) of Event: ___ <br />Location: /(^ <br />Event Coordinator (Name): /K-/7 <br />Mailing Address: !C> <br />Number of Food Booths:7_ ( <br />Approximate attendance at peak time: 10, /Q/^^Total Attendance: OC> £ Average Age: <br />GENERAL EVENT FILE INFORMATION <br />—De—------------------ <br />Q 3/^/?,^ Time of Event:. <br />' (A- // <br />Event Coordinator: e, $/"' /([) <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />EHD 16-02 Pagel of 11 T'>r\r^'I i TEMP EVENT APP07/01/2025 0$ 0^ | 2> |