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Environmental Health Department <br />2. <br />3. <br />Telephone: (4. <br />5. <br />500 30500Total Attendance:Average Age:Approximate attendance at peak time:6. <br />Yes No <br />Yes No2. <br />No3. <br />4. <br />5. <br />6. <br />APPLICATION <br />1. <br />2. <br />Event Coordinator: <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 />Number of dumpsters: ^enue Dumpsters <br />The food truck utilizes self-contained wastewater tank. <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420] F 209 464-0138 | www.sjgov.org/ehd <br />EHD 16-02 Page 1 of 11 TEMP EVENT APP <br />SAN JOAQUIN <br />COUNTY------ <br />Greatness grows here. <br />Yes <br />. Per Stockton Civic Memorial Auditorium Permanent Restroom Facilities <br />If the event is selected for inspection, the Event Coordinator will be billed for inspection time: <br />• $179 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 $805.50 <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 />GENERAL EVENT FILE INFORMATION <br />1. <br />UTILITIES <br />1.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: Venue Facilities <br />Method of disposal of liquid waste for food booths: <br />The food booth beverage vendor has access to auditorium concession stand sink, which is <br />connected to the sanitary sewer. This is in addition to their waste water container. <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 $179 <br />c) Temporary Food Vendors Applications for each booth <br />d) Temporary Event Site Plan <br />e) Food Vendor List <br />Name of Event: Style Elements 32nd Anniversary - Origins: Back to the Roots <br />Date(s) of Event: 2/26 Time of Event: 1 QQp ~ 10-00p <br />Location: Stockton Civic Memorial Auditorium, 525 N Center St, Stockton, CA 95202 <br />Event Coordinator (Name): David Lara Telephone: ( ) 209-420-4793 <br />Mailing Address: 3752 Jagger Lane, Stockton, CA 95212 <br />Number of Food Booths: 3 <br />Date: 8/13/26