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Name of Event: 1. <br />2. <br />3. <br />4. <br />5. <br />Approximate attendance at peak time:6. <br />UTILITIES <br /> No1 <br />No2. <br />n no3 <br />4. <br />/Number of dumpsters:5. <br />6. <br />APPLICATION <br />1. <br />2. <br />DateEvent Coordinator: <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 />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 />Date(s) of Event: <br />Location: <br />bO <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 />Yes <br /> Yes <br />I^Yes <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 />•e? -—■ '-A 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/e^^o <br />.verage Age; ^5Total 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:/ C)_____ <br />Name of sanitary garbage disposal company: <br />Method of disposal of liquid waste for food booths: <br />" 5 ?0p <br />TEMPORARY EVEMT APPLICATION ' <br />To be completed and signed by Event Coordinator, then returned to the Environmental Health Department witn^ll <br />of the Food Vendor's Applications no later than two weeks prior to event <br />GENERAL EVENT FiLE iNFORMATiON <br />SgXX <br />__Time of Event:_______________ <br />Event Coordinator (Name):5 Telephone:^2^1) <br />Mailing Address; 1^0/ <br />Number of Food Booths: <br /><<60