Laserfiche WebLink
Environmental Health <br />1. <br />2. <br />3. <br />4. <br />5. <br />Average Age: Total Attendance: 6.Approximate attendance at peak time: <br />2. <br />3. <br />4. <br />5. <br />6. <br />APPLICATION <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 $152 <br />c) Temporary Food Vendors Applications for each booth <br />d) Temporary Event Site Plan <br />e) Food Vendor List <br />1368 E. Hazelton Avenue | Stockton. Californto 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 />SANJOAOUIN <br />.......CGUMTV....... <br />Dagartment <br />JUL I 6 2018 <br />^ERMmSE^LTH <br />| 11 l I <br />UTILITIES <br />1. <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 Envipjnmental Health Department policies and procedures. <br />0Yes No <br /> Yes p^No <br />,0 Yes No <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: dumber of dumpsters: I <br />Method of disposal of liquid waste for food booths: / A CZ1/2XLV (4/ /(Jt/'T <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 Vendor’s Applications no later than two weeks prior to event <br />(MCc <br />GENERAL EVENT FILE INFORMATION [/ <br />Name of Event: <br />Date(s) of Event: J^2^ I Time of Event: Q Prf —IC/ ) <br />Location: T#? 2CVI G ^l/£ <br />Event Coordinator (Name):Telephone: 0?T) 7^? V <br />Mailing Address: <br />Number of Food Booths: