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GENERAL EVENT FILE INFORMATION <br />Kretschmar Mobile TourName of Event:1. <br />9/7/162. <br />3. <br />4. <br />15. <br />35Total Attendance:Average Age:6.200 <br />UTILITIES <br />1. <br />2. <br />3. <br />4. <br />N/A 1Number of dumpsters:5. <br />Off site6. <br />APPLICATION <br />1. <br />2. <br />8/10/16Event Coordinator:Date: <br />Page 1 of 11 TEMP EVENT APPEHD 16-02 <br />7/14/15 <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 $130 <br />c) Temporary Food Vendors Applications for each booth <br />d) Temporary Event Site Plan <br />e) Food Vendor List <br />□ No <br />□ No <br />□ No <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/ehd <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 />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 />G <br />^Tes <br />■^Yes <br />If the event is selected for inspection, the Event Coordinator will be billed for inspection time: <br />• $130 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 ($195.00 per hour) <br />Telephone: (3i2) 467-8134 <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: Inside Save Mart Store <br />Name of sanitary garbage disposal company: <br />Method of disposal of liquid waste for food booths: <br />Date(s) of Event: 9'/7/16 Time of Event: 11 3pm <br />Location' Save Mart: 875 South Tracy Blvd, Tracy, CA 95376 <br />Event Coordinator (Name): Jared Weinstein <br />Mailing Address: 20 w, Kinzie suite 1600, chicao, il 60654 <br />Number of Food Booths: <br />Approximate attendance at peak time: so <br />- STO