Laserfiche WebLink
of the Food Vendor’s Applications no later than two weeks prior to event <br />GENERAL EVENT FILE INFORMATION <br />I <br />UTILITIES <br />APPLICATION <br />1. <br />2. <br />responsible for meeting California State <br />Date: <br />Page 1 of 11 <br />Event Coordinator: <br />EHD 16-02 <br />08/01/16 <br />5. <br />6. <br />1. <br />2. <br />3. <br />4. <br /> Yes <br /> Yes <br /> Yes <br />1. <br />2. <br />3. <br />4. <br />5. <br />6. <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 $139 <br />c) Temporary Food Vendors Applications for each booth <br />d) Temporary Event Site Plan <br />e) Food Vendor List <br />San Joaquin County <br />Environmental Health Department <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br />/o|n/Xoa.| <br />TEMP EVENT APP <br />I <br />EzJ'fJo <br />3 No <br />No <br />I understand that as a temporary event coordinator, I am i - <br />standards and the Environmental Health Department policies and procedures. <br />TEMPORARY EVENT APPLICATION <br />To be completed and signed by Event Coordinator, then returned to the Environmental Health Department with all <br />Name of Event: <br />Date(s) of Event: <br />Location: ______tnAvrxl rommuruV <br />Event Coordinator (Name): <Jh <br />Mailing Address: kV Aldv-icii <br />Number of Food Booths: f I <br />Approximate attendance at peaklimef <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 />event. <br />W< W bij <br />OffohCv 3 yc*/____Time of Event:. <br />i/unTiv <br />Total Attendance: <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: CU'H rC <br />k g \ ~i n~] \ ‘ > /yvC, A <br />If > /vi i <■ 5 p ______ <br />Telephone: (^c) <br />cn ______ <br />NZZX t l|£ i4 \<p<9A d Number of dumpsters:[ <br />i. \ / L _ -1 z .Til n n )/-l J