Laserfiche WebLink
Environmental Heal-UM <br />s <br />2. <br />1500 <br />APPLICATION <br />1. <br />2. <br />Date: <br />3. <br />4. <br />3. <br />4. <br />5. <br />6. <br />Temporary Event Application <br />Application Review Fee of $152 <br />Temporary Food Vendors Applications for each booth <br />Temporary Event Site Plan <br />Food Vendor List <br />5. <br />6. <br />■ _______________________________________ <br />^JfXelephone: H 0-3 7 <br />SAN JOAQUIN <br />-COUNTY <br />Greatness grows here. <br />Average Age: { <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: <br />GENERAL EVENT FILE INFORMATION <br />1. <br />UTILITIES <br />1. <br />2. <br />1868 E. Hazelton Avenue I 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 />5s\\a V <br />\ \V.i5-^Telephone: Q <br />22 <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 />IJ^gepartment <br />Submit the following to the Environmental Health Department two weeks prior to the event: <br />a) <br />b) <br />c) <br />d) <br />e) <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 />\O0D Total Attendance: <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: 5 <br />Name of sanitary garbage disposal company: . ' >5 “ ~ Number of dumpsters: <br />Method of disposal of liquid waste for food booths: <br /> Yes [^No <br />Yes No <br />[^) Yes No <br />Lt= IIMrUKMA I lUIN <br />Name of Event: <br />Date(s) of Event: ' Time of Event: <br />Location: <br />Event Coordinator (Name):. <br />Mailing Address: <br />Number of Food Booths: <br />Approximate attendance at peak time: