Laserfiche WebLink
Environmental Health Department <br />1. <br />2. <br />3. <br />4. <br />5. <br />Vr 5cTotal Attendance: Average Age:6. <br />UTILITIES <br />1. <br />2. <br />3. <br />4. <br />5. <br />6. <br />APPLICATION <br />1. <br />2. <br />/-7Event Coordinator: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 $162 <br />c) Temporary Food Vendors Applications for each booth <br />d) Temporary Event Site Plan <br />e) Food Vendor List <br />0"Yes <br />[EfYes <br />[^'Ves <br /> No <br /> No <br /> No <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 TEMPEVENT APR <br />06/29/2023 <br />D <br />rtw i >t ij <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 />• $162 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 $729.00 <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 />SANJOAOUIN <br />-----COUNTY------ <br />Greatness grows here. <br />__________Telephone: OzY/) '1 <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: I 'ift <br />Name of sanitary garbage disposal company: P.A | Number of dumpsters: I prfi. <br />Method of disposal of liquid waste for food booths: Sani <br />GENERAL EVENT FILE INFORMATION <br />Name of Event: O(J pApi t'Ylft ______________________ <br />Date(s) of Event: pCiA 3 OOI Time of Event: 6 /7D -/O-Pm <br />Location: ^5^/0 a) <br />Event Coordinator (Name): LAURT) PeREiPZ) <br />Mailing Address: GRzj 7 N E- /J3/4tj' <br />Number of Food Booths: <br />Approximate attendance at peak time: CvYD