Laserfiche WebLink
Environmental Health Department <br />2. <br />3. <br />4. <br />5. <br /> Average Age: 6. <br />2. <br />3. <br />4. <br />5. <br />6. <br />APPLICATION <br />1. <br />2. <br />Date: Event Coordinator: z_ <br /> No <br /> No <br /> No <br />SANJOAOUIN <br />-----COUNTY----- <br />Greatness grows here. <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 />LM Yes <br />E^es <br />H^Yes <br />Approximate attendance at peak tinf^^^ ~l^)tal^Attendance: <br />Number of dumpsters: <br />GENERAL EVENT FILE INFORMATION <br />1. <br />UTILITIES <br />1. <br />Name of Event: <br />Date(s) of Event^O^/Z- Time of Event: - z? XW <br />Location: //3,36' 2^/)/0 <br />Event Coordinator (Name): “ S ft aJ Telephone: ti?)) S 7 <br />Mailing Address: 2^0/)j <br />Number of Food Booths: <br />1868 E. Hazelton Avenue I 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 />06/29/2023 <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:3_____________ <br />Name of sanitary garbage disposal company: t/aJlty <br />Method of disposal of liquid waste for food booths: <br />Submit the following to the Environmental Health Department two weeks prior to the event: <br />(ah Temporary Event Application <br />/bj Application Review Fee of $162 <br />(c)) Temporary Food Vendors Applications for each booth <br />d) 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 />• $162 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 $729.00 <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 />-uikA- 3 <br />'i ’