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<br />Environmental Health Department <br />Average Age:. 'L.2^-30Total Attendance: L, dop <br />APPLICATION <br />1. <br />2. <br />Event Coordinator:Date: <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420] F 209 464-0138 | www.sjcehd.com <br />5. <br />6. <br />Temporary Event Application <br />Application Review Fee of $152 <br />Temporary Food Vendors Applications for each booth <br />Temporary Event Site Plan <br />Food Vendor List <br /> No <br /> No <br /> No <br />El Yes <br />H Yes <br />KI Yes <br /> <br />SANJOAQUIN <br />-----COUNTY------ <br />Greatness grows here. <br />Submit the following to the Environmental Health Department two weeks prior to the event <br />a) <br />b) <br />c) <br />d) <br />e) <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 />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: <br />Method of disposal of liquid waste for food booths: <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 the <br />hourly rate, calculated at one and one half times ($228 per hour) <br />Tfi/s 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 />IO 3^' Number of dumpsters: <br />Name of Event: ^v-v-^^rc Q^gs-f- <br />Date(s) of Event: _Fe6 Time of Event: &3P <br />Location: _________________________ _______ <br />Event Coordinator (Name): ^Telephone: (2c?/) <br />Mailing Address. ----- <br />Number of Food Booths: 3 <br />Approximate attendance at peak time: 2,^00