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Environmental Health Department <br />i.Name of Event: <br />l?>wEam2.+ <br />3. <br />4. <br />5. <br />2^Total Attendance: ~1 ~ I00|/>D Average Age:6.Approximate attendance at peak time: <br />1. <br />2. <br />3. <br />4. <br />iNumber of dumpsters:5. <br />6. <br />APPLICATION <br />1. <br />2. <br />3.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 $152 <br />c) Temporary Food Vendors Applications for each booth <br />d) Temporary Event Site Plan <br />e) Food Vendor List <br /> No <br /> No <br />© <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />EHD 16-02 Pagel of 11 TEMP EVENT APP <br />06/19/19 <br />[ZfYes No <br />J2” Yes <br />zPTYes <br />li- <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 a <br />minimum three-hour overtime rate of $684.00 <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 />UTILITIES <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:fyjsh bins <br />MAR 0 5 2020 <br />TEMPORARY EVENT APPLICATraN^^™ <br />To be completed and signed by Event Coordinator, then returned to the Environmental with all <br />of the Food Vendor’s Applications no later than two weeks prior to event <br />SANJOAOUIN <br />------COUNTY— <br />Greatness grows here. <br />1,01.0 Time of Event:__ <br />Telephone: (^) <br />S-bztMoh Ch <br />GENERAL EVENT FILE INFORMATION <br />SvnSd LiMe I <br />Date(s) of Event: 21 <br />Location: . <br />Event Coordinator (Name):_ <br />Mailing Address: £lvc <br />Number of Food Booths: