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ft. <br />Total Attendance: S®}Average Age: <br />UTILITIES <br />/umber of dumpsters: <br />APPLICATION <br />1. <br />2. <br />Page 1 of 11 <br />TEMP EVENT APP <br />1. <br />2. <br />3. <br />4. <br />5. <br />6. <br />5. <br />6. <br />1. <br />2. <br />3. <br />4. <br />^l)0f <br />I understand that <br />standards and the Enw <br />Event Coordinator. <br />EHD 16-02 <br />7/14/15 <br />Name of sanitary garbage disposal company: [l fi/rC /iu <br />Method of disposal of liquid waste for food booths: <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: ^2 <br />sub”rvc^^tz“'Heai,h Dspsrtnen* weeks p"°r ,o ,he <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 />'f the event is selected for Inspection, the Event Coordinator win be billed for inspection (me: <br />$130 per hour (weekdays 8:00 am to 5:00 pm) <br />• <br />0Yes No <br /> Yes Sl^o <br />fzfYes No <br />San Joaquin County <br />Environmental Health Department <br />t^i »,1868r^St Haze,ton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov org(ehd 04 <br />To be co itH TEMPORARY EVENT APPLICATION <br />XXXXXrfhan tao weXpTo"^ e'ent D<!Pa,1menl <br />general event file information <br />/I , <br />Name of Event: lOC^G. CjF <br />Date(s) of Event: MOS) / 2#/L? <br />Location: P/K)iT STfceeT <br />Event Coordinator (Name): H>6 Cb <br />Mailing Address: <br />Number of Food Booths: <br />Approximate attendance at peak time: <br />as a tempera^ event coordinator, I am responsible for meetinq California State <br />•onmental Health Department policies and procedures. Cailfomia State <br />'---------------------------- - . <br />A A ---------- 8^c /+" <br />—18/ of Event; 4^ IQfoAfjA <br />-------- ---------—- - ■■--------------------------.Telephone: