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Environmental Health Department <br />s chows here. <br />1.Name of Event: <br />Time of Event:2. <br />3. <br />Telephone: (76Q-455-39304. <br />5. <br />50Approximate attendance at peak time:Total Attendance: Average Age:6. <br />2. <br />3. <br />Three (3)4. <br />Gilton Number of dumpsters:5. <br />Two double sinks6. <br />APPLICATION <br />1. <br />2. <br />Event Coordinator: <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 />Event Coordinator (Name):. <br />Mailing Address: <br />Number of Food Booths: <br />Date(s) of Event: <br />Location: <br />Q Yes <br /> Yes <br />0 Yes <br /> No <br /> 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 />SAN JOAQUIN <br />-COUNTY— <br />Gre <br />3 - 90 gallon <br />cans <br />Marilyn Boyle <br />2000 Jackson Avenue, Escalon, CA 95320 <br />No booths - event is held in social hall of church <br />80 A /■I <br />GENERAL EVENT FILE INFORMATION <br />Fscalon United Methodist Church Pasta Dinner________________ <br />March 7, 2026 TimpnfFvpnt- 4:30 pm to 7:00 pm <br />2000 Jackson Avenue, Escalon, CA <br />Submit the following to the Environmental Health Department two weeks prior to the event: <br />Temporary Event Application <br />Application Review Fee of $179 <br />Temporary Food Vendors Applications for each booth <br />Temporary Event Site Plan <br />Food Vendor List <br />If the event is selected for inspection, the Event Coordinator will be billed for inspection time: <br />• $179 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 $805.50 <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 />1. <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />x;26o°225 pa9e10f11 R20S0H&H ”TAPP <br />Date: