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1. <br />2. <br />3.+ <br />4. <br />5. <br />70googooTotal Attendance:Average Age:Approximate attendance at peak time:6. <br />1. <br />2. <br />3. <br />4. <br />INumber of dumpsters:5. <br />6. <br />APPLICATION <br />1. <br />2. <br />20'2-6?Date:Event Coordinator: <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420) F 209 464-0138 | www.sjgov.org/ehd <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 $179 <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 /> No <br />^Yes <br />t^Yes <br />^Yes <br />CtX.V' bi Telephone: ( <br />TEMPORARY EVENT APPLICATION <br />To be completed and signed by Event Coordinator, then returned to the Environmental Health Departmen <br />of the Food Vendor’s Applications no later than two weeks prior to event <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 />SAN^JOAOUIN <br />------COU NTY------- <br />Greotness grows here. <br />Environmental Health Department <br />0>i 2026 <br />GENERAL EVENT FILE INFORMATION <br />Name of Event: V) CV\.C)C\ (___________________________________ <br />Date(s) of Event: fcX Time of Event: (p jQQ <br />Location: C-tV'iC AacI, N ■ s-K j ca <br />Event Coordinator (Name): C(X.\~ Telephone: ( ) <br />Mailing Address: V 3> \ z J <br />Number of Food Booths: ( <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: O <br />Name of sanitary garbage disposal company: <br />Method of disposal of liquid waste for food booths: