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1.Name of Event: <br />2. <br />3. <br />4. <br />5. <br />Average Age: S6. <br />UTILITIES <br />1. <br />2. <br />3. <br />4. <br />I5.Number of dumpsters: <br />6. <br />APPLICATION <br />1. <br />2. <br />Event Coordinator: Date: <br />cun iR.no TPMP EVENT ADD <br />IM! <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 />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 />San Joaquin County <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/e <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 /> Yes <br /> Yes <br /> Yes <br />Total Attendance: 'yuC' <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: <br />Name of sanitary garbage disposal company: <br />Method of disposal of liquid waste for food booths: <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 />Date: <br />Pano 1 nf11 <br /> No Fol^I VdndDf <br /> No A///? <br /> No <br />GENERAL EVENT FILE INFORMATION <br />Cyt Finned Puh _______________________ <br />" 2-I/Sjl'l Time of Event: ?ty\ <br />Telephone: (2^j 7? '23( 3 <br />( 96^7________ <br />Date(s) of Event: 7 " J-j loll I <br />Location: <br />Event Coordinator (Name): <br />Mailing Address: /02-0 Vv7 tnCLCj //> f <br />Number of Food Booths: <br />Approximate attendance at peak time: ZDD <br />^^Oaz <br />TEMPORARY EVENT APPLICATION <br />To be completed and signed by Event Coordinator, then returned to the Environmental Health Department wlWSII <br />of the Food Vendor's Applications no later than two weeks prior to event