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Aug. 11. 2021 5:23PM No. 0323 P. 1 <br />Environmental Health Department <br />Telephone: (209) 832-6600 ext. 4011 <br />1,500Total Attendance:Average Age: 25 <br />HeCEfVEO <br />AUG 12 2021 <br />APPLICATION <br />1. <br />2. <br />Event Coordinator: Date: 6/6/2021 <br />'fi^Yes <br />t^Yes <br />S^Yes <br /> No <br /> No <br /> No <br />5. <br />6. <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 $152 <br />c) Temporary Food Vendors Applications for each booth <br />d) Temporary Event Site Plan <br />e) Food Vendor List <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: 16 <br />Name of sanitary garbage disposal company: Tracy Delta <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www sioov oro/ehd <br />067?X02 , 10,11 TEMP EVENT APR <br />Received Time Aug. 11. 2021 5:11 PM No. 6857 <br />GENERAL EVENT FILE INFORMATION <br />1. <br />2. <br />3. <br />4. <br />UTILITIES <br />1. <br />2. <br />3. <br />4. <br />5. <br />6. <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 />If the event is selected for inspection, the Event Coordinator will be billed for inspection time: <br />• $152 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 $684.00 <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 />SANJOAQUIN <br />/ -----COUNTY------ <br />Greatness grows /irrre. <br />II.:; <br />I'/ ■'-? <br />1" I "! ■ <br />Name of Event: Kimball High School Football Games Snack Bar <br />Date(s) of Event: 8/27/21, 9/3/21. 9/17/21, 9/24/21,10/15/21 Time of Eventf 5:00 p.m. <br />Location: Kimball High School Stadium ____ <br />Event Coordinator (Name): Ben Keller (Principal) <br />Mailing Address: 32QQ Jaguar Run. Tracy. GA 95377 <br />Number of Food Booths: 1 <br />Approximate attendance at peak time: 1,000 <br />'^'T/SERVICES <br />Number of dumpsters: 5 <br />Method of disposal of liquid waste for food booths: Janitorial Closet - Utility Sink