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1. <br />4. <br />5. <br />7 7<6.Total Attendance: <br />UTILITIES <br />1. <br />2. <br />3 <br />4. <br />5.Number of dumpsters: <br />6. <br />APPLICATION <br />1. <br />2. <br />then returned to the <br />event. <br />responsible for meeting California State <br />Event Coordinator: Date: <br />Page 1 of 11 TEMP EVENT APPEHD 16-02 <br />08/01/16 <br />2. <br />3. <br /> No <br /> No <br /> No <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 S139 <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: <br />Name of sanitary garbage disposal company: <br />Method of disposal of liquid waste for food booths: <br />San Joaquin County <br />Environmental Health Depa..(ment <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www sjqov.org. <br />£1 Yes <br />Yes <br />[zf Yes <br />ime of Event: <br />^5 A. <br />A r- <br />A3P 31S~-3P>3S <br />I understand that as a temporary event coordinator, I am r _,L‘_ <br />standards and the Environmental Health Department policies and procedures <br />Name of Event: __________________ ________ <br />Date(s) of Event: <br />Location: <br />Event Coordinator (Name):^VA^Af>£v^ C <br />Mailing Address: <br />Number of Food Booths: I <br />Approximate attendance at peak time: <br />If the event is selected for inspection, the Event Coordinator will be billed for inspection time: <br />• $139 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 ($208.50 per hour) <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 />Average Age: <br />GENERAL EVENT FILE INFORMATION <br />\\\-c 2)a22- <br />A 130 prvi J < <br />k-zj^F^ieohone: <br />SrtxJs4t>T CA, <br />TEMPORARY EVENT APPLICATION 1 <br />To be completed and signed by Event Coordinator, then returned to the Environmental Health Dj^ftljjept with <br />of the Food Vendor’s Applications no later than two weeks prior to event