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PP- ■SMiStlc <br />Environmental Health Department <br />Greatness grows here. <br />1. <br />2. <br />3, <br />209 712 2347)Telephone: (4. <br />5. <br />c All agesAverage Ag<6. <br />2. <br />3. <br />4. <br />1Number of dumpsters:5. <br />6. <br />APPLICATION <br />1. <br />2. <br />Event Coordinator: Krystal Gouveia Date: May 20th, 2019 <br /> Yes <br /> Yes <br /> Yes <br />0 No <br />0 No <br />0 No <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjcehd.com <br />EHD 16-02 Page 1 of 11 TEMP EVENT APP <br />07/3/17 <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 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 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 />1. <br />GENERAL EVENT FILE INFORMATION <br />Name of Event: River Islands Farmers Market______________________ <br />Date(s) of Even^very Wednesday, June 5th-Sept. 4thTime of Event:5:QQ'8:0QPm <br />Location: 1051 River Islands Parkway <br />Event Coordinator (Name): Krystal Gouveia <br />Mailing Address: 73 w Stewart Road, Lathrop CA 95330 <br />Number of Food Booths: J2-15 <br />SAN JOAOUIN <br />“ Site ' -----COUNTY— <br />\ -if <br />Approximate attendance at peak time: <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: 1 handicapped portable <br />Name of sanitary garbage disposal company: ^'ver Islands will have a ( <br />clean up crew <br />Method of disposal of liquid waste for food booths: <br />Its only a 3 hour event so <br />vendors are in charge for <br />their own grey water <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