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Environmental Health Department <br />Name of Event: <br />2. <br />3. <br />4.Telephone: ( <br />5. <br />6. <br />UTILITIES <br />1. <br />2. <br />3. <br />4. <br />5. <br />6. <br />APPLICATION <br />1. <br />2. <br />Event Coordinator:M <br />Temporary Event Application <br />Application Review Fee of $179 <br />Temporary Food Vendors Applications for each booth <br />Temporary Event Site Plan <br />Food Vendor List <br />E3 Yes <br />K Yes <br />K Yes <br />□ No <br />□ No <br />□ No <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 APR <br />08/14/2026 <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 />Our Lady of Fatima Society of Thornton <br />10/16/26 to 10/19/26 <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 />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 />Approximate attendance at peak time: 1-000 -j-Qigi Attendance: 2000-4000 <br />Number of dumpsters: 2.Waste Management <br />Sanitary Sewer <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 />Date: 8/26/2026 <br />SAN JOAQUIN <br />COUNTY- <br />G rGQ I. n e s i, g i o w s h t- r e <br />Average Age: .12 <br />Date(s) of Event: Time of Event: 24 HrB. Per Day <br />Location- 26590 N Sacramento Blvd., Thornton, CA 95686 <br />Event Coordinator (Name): Laura Pereira <br />Mailing Address: 900 Jordine WaV Galt- CA 95632 <br />Number of Food Booths: J <br />j 209-712-3683