Laserfiche WebLink
Environmental Health Department <br />Name of Event: <br />2. <br />3.408-831-87414.) <br />5. <br />350 30500-6006.Approximate attendance at peak time:Total Attendant <br />2. <br />3. <br />14. <br />15. <br />6. <br />APPLICATION <br />1. <br />2. <br />5/15/23Date: <br />Date(s) of Event: <br />Location: _____ <br />Temporary Event Application <br />Application Review Fee of $156 <br />Temporary Food Vendors Applications for each booth <br />Temporary Event Site Plan <br />Food Vendor List <br /> Yes <br /> Yes <br /> Yes <br />Number of dumpsters: <br />Method of disposal of liquid waste for food booths: they take home after market <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 />Submit the following to the Environmental Health Department two weeks prior to the event: <br />a) <br />b) <br />c) <br />d) <br />e) <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: Republic Disposal Co <br />River Islands CFM <br />Time of Event: 8:30 AM-12:30 PM <br />If the event is selected for inspection, the Event Coordinator will be billed for inspection time: <br />• $156 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 $702.00 ■ ’ <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 />Event Coordinator: <br />GENERAL EVENT FILE INFORMATION <br />1. <br />UTILITIES <br />1. <br />SAN JOAQUIN <br />COUNTY <br />Greatness grows here. <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />EHD 16-02 Page 1 of 11 TEMP EVENT APP <br />ewMnrxn <br />.verage Age: <br /> No <br /> No <br /> No <br />673^11/18/23----------- <br />1'175 Marina Drive, Lathrop <br />Event Coordinator (Name): Bill HarlOW^Telephone: ( <br />Mailing Address: PO BOX 9898, South Lake Tahoe, CA 96158 <br />Number of Food Booths: 20_____________________________~