COMPLIANCE INFO - Laserfiche WebLink

Home Browse Search

GENERAL EVENT FILE INFORMATION 1.Name of Event: 2. 3. 4. 5. '/DTotal Attendance: K6.Approximate attendance at peak time: /ODO Average Age: UTILITIES 1. 2. 3. ^04. 35. 6. APPLICATION 1. 2. Event Coordinator: Date: Page 1 of 11 TEMP EVENT APPEHD 16-02 08/01/16 This application is to be completed and signed by the Event Coordinator, then returned to the Environmental Health Department with all Food Vendor’s Applications no later than two weeks prior to the event. Submit the following to the Environmental Health Department two weeks prior to the event: a) Temporary Event Application b) Application Review Fee of $139 c) Temporary Food Vendors Applications for each booth d) Temporary Event Site Plan e) Food Vendor List S Yes E Yes [3 Yes No No No San Joaquin County Environmental Health Department 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd TEMPORARY EVENT APPLICATION To be completed and signed by Event Coordinator, then returned to the Environmental Health Department with all of the Food Vendor's Applications no later than two weeks prior to event If the event is selected for inspection, the Event Coordinator will be billed for inspection time: • $139 per hour (weekdays 8:00 am to 5:00 pm) • After regular business hours (weekday, weekends and holidays) the inspection is charged at the hourly rate, calculated at one and one half times ($208.50 per hour) mW' I understand that as a temporary event coordinator, I am responsible for meeting California State standards and the Environmental Health Department policies and procedures. Is potable water supplied and available for each food vendor: Is electricity supplied and available for each food vendor: Are janitorial facilities available: Number of toilets provided: Name of sanitary garbage disposal company: tOfrSl-E, Number of dumpsters: Method of disposal of liquid waste for food booths: + fifty OilK. ftp Ffrhmfi Sf)Ci^-l-y________________ Date(s) of Event: IC'& l'l -Zf) /Z)-/Zg'/7 Time of Event: ^7 fifty Location: A/. /i) ZzJ/V ^5^6 Event Coordinator (Name): Ri chftf&L ^dli)RR(Js Telephone: Mailing Address: P[) lx>)! ~77)Z7/S/V Ag/V CR. ___________________ Number of Food Booths:!___________________________________________________________