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Environmental Health Department <br />GENERAL EVENT FILE INFORMATION <br />1.Name of Event: <br />10AM TO 4PM (6AM-6PM)Time of Event:2. <br />3. <br />4. <br />75. <br />1PM 250 Average Age: 20-256.Approximate attendance at time:Total Attendance: <br />UTILITIES <br />1. <br />2. <br />3. <br />84. <br />Number of dumpsters: 25. <br />6. <br />APPLICATION <br />1. <br />2. <br />08/16/2023Date:Event Coordinai <br />Avenue | St< <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 $162 <br />c) Temporary Food Vendors Applications for each booth <br />d) Temporary Event Site Plan <br />e) Food Vendor List <br />pora <br />sntal <br />□ Yes <br />Q Yes <br />[X] Yes <br />S No <br />□ No <br />□ No <br />1868 E. Hazelti <br />EHD 16-02 <br />06/29/2023 <br />;ton, California 95205 | T 209 468-3420] F 209 464-0138 | www.sjgov.org/ehd <br />| Page 1 of 11 TEMP EVENT APP <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 />event coordinator, I am responsible for meeting California State <br />lallh DepartraHRSpolicies and procedures. <br />TRACY PRIDE <br />OCTOBER 7 2023 <br />If the event is selected for inspection, the Event Coordinator will be billed for inspection time: <br />• $162 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 $729.00 <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 th. <br />standards and th <br />SAN JOAQUIN <br />------COUNTY------ <br />Greatness grows here. <br />'as a rt <br />EpVfronj <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: PFI TA WASTE <br />Method of disposal of liquid waste for food booths: DUMPSTERS <br />Date(s) of Event: <br />Location: TRACY LINCOLN PARK, 2-198 EATON AVE, TRACY CA 95376 <br />Event Coordinator (Name): ANDREA JUAREZSMITH Telephone: (209) 740-0278 <br />2455 N NAQLEE RD STE 310, TRACY CA 95304 <br />Mailing Address: _____ <br />Number of Food Booths: