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Environmental Health Department <br />Name of Event:1. <br />2. <br />3. <br />4. <br />5. <br />6.Approximate attendance at peak time: Total Attendance: <br />UTILITIES <br />1. <br />2. <br />3. <br />Lj4. <br />5. <br />6. <br />APPLICATION <br />3 the event: rt <br />G,o^ <br />1. <br />2. <br />Event Coordinator: Date: <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 S152 <br />c) Temporary Food Vendors Applications for each booth I <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 Page 1 of 11 TEMP EVENT APP <br />07/3/17 <br />SANJOAOlBl <br />------COUNTY------ <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 Vendors Applications no later than two weeks prior to event <br />cfga I <br />-Ar p <br /> Yes JyLNo <br /> Yes No <br />Yes No <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 />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:‘" '/ Number of dumpsters: <br />Method of disposal of liquid waste for food booths: \ler>A/?rs W <br />Date(s) of Event: <br />Location: -pitj ^7 u-r,, <br />Event Coordinator (Name):. <br />Mailing Address: <br />Number of Food Booths: <br />- ■S-'4z> e>l t "jy/n <br />GENERAL EVENT FILE INFORMATION <br />er, r, r2 €_____ <br />LfJecLsA\ lYgi, A?) Time of Event: <br />TrznCT py q ia A e jA >9^— ~ o-woii 77ffi. r ol <br />Vr/lc7rg<a| Telephone: (^H?) LpOI — 6 <br />gi7^7 <T.