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Environmental He^egf^g, <br />1. <br />2. <br />3. <br />4. <br />5. <br />Total Attendance: Average Age: 6. <br />UTILITIES <br />1. <br />2. <br />3. <br />34. <br />5.Number of dumpsters: <br />6. <br />APPLICATION <br />1. <br />2. <br />^/4//gEvent Coordinator: Date: <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) Temporary Event Application <br />b) Application Review Fee of $152 <br />c) Temporary Food Vendors Applications for each booth <br />d) Temporary Event Site Plan <br />e) Food Vendor List <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjcehd.com <br />EHD 16-02 Pagel of 11 TEMP EVENT APP <br />07/3/17 <br />Date(s) of Event: <br />Location: <br /> Yes [J3 No <br /> Yes No <br /> Yes [^No <br />T1 co ■ <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 />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 />SAN JOAQUIN <br />------COUNTY------ <br />Greutnen grown here. MAR 0 6 2018 <br />TEMPORARY EVENT APPLICATION^ronmentalhealth <br />To be completed and signed by Event Coordinator, then returned to the Environmental HealthPS^ffi^fiW^%ll <br />of the Food Vendor's Applications no later than two weeks prior to event <br />GENERAL EVENT FILE INFORMATION <br />Name of Event: <br />(VAFy-ij Time of Event: <br />Event Coordinator (Name): L-gVlr\ Telephone: STS-S'TgH <br />Mailing Address: IO5S <br />Number of Food Booths:I_____3 <br />Approximate attendance at peak time: