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1.Name of Event: <br />2.Time of Event: <br />3. <br />4. <br />5. <br />Total Attendance: )6. <br />\UTILITIES <br />1.Is potable water supplied and available for each food vendor: <br />2. <br />3.±t4. <br />5.Number of dumpsters: <br />6. <br />APPLICATION <br />1. <br />2. <br />i' i5^_Date:Event Coordinator: <br />1868 E. Hazelton Avenue | Stockton, <br />EHD 16-02 <br />07/01/2025 <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: <br />Method of disposal of liquid waste for food booths: <br />0 Yes <br /> Yes <br />Yes <br /> No <br />EETno <br /> No <br />Submit the following to the Environmental Health Department two weeks prior to the <br />a) Temporary Event Application' <br />b) Application Review Fee of $179 <br />c) Temporary Food Vendors Applications for each booth <br />d) Temporary Event Site Plan-' <br />e) ruuu veiiuui Lisi t/ <br />=$ <br />la 95205 | T 209 468-3420] F 209 464-0138 | www.sjgov.org/ehd <br />Page 1 of 11 TEMP EVENT APP <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 />SANJOAOUIN <br />-COUNTY <br />VR050S^H\ <br />Environmental Health Department <br />Date(s) of Event: <br />Location: Z|MC(gtAz <br />Average Age:\ I ) <br />_____Telephone: (-^7^ *7 <br />CJ53^ <br />GENERAL EVENT FILE INFORMATION <br />j) <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 />Event Coordinator (Name):. /y-e <br />Mailing Address: ' Sty <br />Number of Food Booths: ScVcT^ <br />Approximate attendance at peak time: <br />eyent: lz/C