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Environmental Health Department <br />Gr <br />1. <br />2. <br />3. <br />Telephone: (209) 712-23474. <br />5. <br />Average Age: ^ll a9esFirst eventTotal Attendance:6. <br />UTILITIES <br />1. <br />2. <br />3. <br />4. <br />1Number of dumpsters:5. <br />6. <br />APPLICATION <br />1.weeks prior to the event: <br />2. <br />Event Coordinator: Krystal Gouveia <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 />SAN JOAQUIN <br />COUNTY <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 />Every other Wednesday starting <br />July 18th(subject to start 25th <br />through September 26th <br />Time of Event: 5:3°Pm-7:30pm <br />Date: 7/2/2018 <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 />River Islands will <br />. have a clean up crew <br />GENERAL EVENT FILE INFORMATION <br />River Islands Farmers MarketName of Event: <br />Date(s) of Event: See to the right <br />Location: West parking lot of RITechA <br />Event Coordinator (Name):^1^9* Gouveia <br />Mailing Address: 301 Stewart Rd, Lathrop, GA 95330 <br />Number of Food Booths:roughly 15-20 <br />Approximate attendance at peak time: 1 P(> <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 poitable <br />Name of sanitary garbage disposal company: <br />Method of disposal of liquid waste for food booths: <br />Its only a 2 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 , <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