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RECEIVED <br />GENERAL EVENT FILE INFORMATION <br />1. <br />2. <br />3. <br />4. <br />5. <br />Total Attendance: 15006. <br />UTILITIES <br />1. <br />2. <br />3. <br />4. <br />5. <br />6. <br />APPLICATION <br />1. <br />2. <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 />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: 8 <br />Name of sanitary garbage disposal company: <br />Method of disposal of liquid waste for food booths: <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 $139 <br />c) Temporary Food Vendors Applications for each booth <br />d) Temporary Event Site Plan <br />e) Food Vendor List <br /> Yes <br />0 Yes <br /> Yes <br />[3 No <br /> No <br />[3 No <br />OAN UUAQUIN VUUN I Y <br />Environmental Health Department <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd AUG 2 2 2017 <br />If the event is selected for inspection, the Event Coordinator will be billed for inspection time: <br />• $139 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 ($208.50 per hour) <br />Number of dumpsters: .1 <br />Approximate attendance at peak time: 1500 <br />TEMPORARY EVENT APPLICATION “mmSS" <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 />I understand that as a tempora <br />standards and the Etjvironmentjaf <br />Event Coordinator: <br />Average Age: 25 <br />ry_§yent coordinator, I am responsible for meeting California State <br />Health Department policies and procedures. . <br />nat.: h I go-11 n <br />Name of Event: Stockton Black Family Day <br />Date(s) of Event: Monday, September 4, 2017 Time of Event:9:00aiTi <br />Location: Weber Point Event Center \ Cc*- <br />Event Coordinator (Name): Erin Reynolds ~ Telephone: ( ) 209-423-7097 <br />Mailing Address: P-O- Box 1079 Stockton, Ca 95201 <br />Number of Food Booths: J _____