Laserfiche WebLink
Environmental Health Department <br /> <br />4. <br />600 C, COtime:Total Attendai (Average Age: <br />6. <br />APPLICATION <br />1. <br />2. <br />Event Coordinator: Date: <br />2. <br />3. <br />5. <br />6. <br />2. <br />3. <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 $156 <br />c) Temporary Food Vendors Applications for each booth <br />d) Temporary Event Site Plan <br />e) Food Vendor List <br />4. <br />5. <br />TEM PORARY 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 />qrjwj he; <br />■ i l <br />’-W ... <br /> Yes No <br /> Yes No <br />53 Yes No <br />GENERAL EVENT RLE INFORMATION <br />1. <br />UTILITIES <br />1. <br />P^^Number of dumpsters: <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: X, <br />Name of sanitary garbage disposal company:j <br />Method of disposal of liquid waste for food booths: <br />Name of Event: U W 03 . <br />Date(s) of Event: Ff <br />Location: ,g~ M/xlvA 1 <br />Event Coordinator (Name): <br />Mailing Address: 3 £ ? fe: <br />Number of Food Booths: / T <br />Approximate attendance aTee <br />N 0 £ F g D£ N C E- PfM <br />L _________Time of Event: 4-PM <br />c g- 1-um <br />U. TH Telephone: 4 <br />VAC .'?Vxy,£-- ILh z? ( J ./V^-zryVX ______________ <br />If the event is selected for inspection, the Event Coordinator wilt be billed for inspection time: <br />• $156 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 $702.00 <br />This application Is to be completed and signed by the Event Coordinator, then returned tn 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 />yk'zW.z7<;>- <br />'^E HazeltonAvenuel Stockton, California 95205 I T 209 468-34201 F 209 464-0138 I www.sjqov.ora/ehd <br />Pa98 1 of « TEMP EVENT APP