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Environmental Health Department <br />Name of Event: <br />2. <br />3. <br />4. <br />5. <br />6.Approximate attendance at peak time: Total Attendance: <br />I <br />2. <br />3. <br />4. <br />35.Number of dumpsters: <br />6. <br />APPLICATION rec 'J <br />1. <br />2. <br />08/^7 / 2-6Event Coordinator: Date: <br />'r A C>co IM <br /> Yes <br /> Yes <br />Q-Yes <br />0 No <br />3 No <br /> No <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 1 F 209 464-0138 | www.sjgov.org/ehd <br />EHD 16-02 Page 1 of 11 TEMP EVENT APP <br />07/01/2025 <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 />SAN JOAQUIN <br />COUNTY <br />--- 5________ <br />Average Age: © <br />0 <br />If the event is selected for inspection, the Event Coordinator will be billed for inspection time: <br />• $179 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 $805.50 <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 />UTILITIES <br />1. <br />GENERAL EVENT FILE INFORMATION <br />1. <br />Telephone: 2° J S J <br />C <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: 6 JI Q <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 i <br />b) Application Review Fee of $179 <br />c) Temporary Food Vendors Applications for each booth ofr''k Iq f <br />d) Temporary Event Site Plan <br />e) Food Vendor List <br />f \/nWI (rircnj k Hsgv_______________ <br />Date(s) of Event: Se pV 1, 2.Q2-6 Time of Event: \ IS 41 - 5« 3 <br />Location: )Y\dip Moun-hm kou-K CA- 4 T3 I____________ <br />Event Coordinator (Name): Vt e.»vn.<av-iA~ <br />Mailing Address: <br />Number of Food Booths: