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Environmental Health Department <br />1. <br />2. <br />3. <br />269-4934Telephone: (20^4. <br />5. <br />3000 356.Total Attendance:Average Age: <br />UTILITIES <br />1. <br />2. <br />3. <br />4. <br />CAL WASTE 4Number of dumpsters:5. <br />6. <br />APPLICATION <br />1. <br />2. <br />06/25/2025Date: <br />0 Yes <br /> Yes <br />0 Yes <br /> No <br />0 No <br /> No <br />a) <br />b) <br />c) <br />d) <br />e) <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 />Temporary Event Application <br />Application Review Fee of $172 <br />Temporary Food Vendors Applications for each booth <br />Temporary Event Site Plan <br />Food Vendor List <br />Date(s) of Event: <br />Location- 1 West Turner Road, Lodi 95242 <br />Event Coordinator (Name): Breanna Meyer <br />Mailing Address: 230 W. Elm Street, Lodi 95240 <br />Number of Food Booths: <br />If the event is selected for inspection, the Event Coordinator will be billed for inspection time: <br />• $172 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 $774.00 <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 />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: <br />GENERAL EVENT FILE INFORMATION <br />Name of Event: 4th °f Ju,y Celebration at the Lake <br />07/04/2025 <br />SAN JOAQUIN <br />------COUNTY------- <br />Grcotness grows here. <br />Event Coordinator: <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 />07/01/2024 A" •'’J/■'I <br />Time of Event: 12.00 <br />Approximate attendance at peak time: 2500