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PdO'SB'oW <br />Environmental Health Department <br />_Telephone: (209) 831-6224 <br />Total Attendani <br />APPLICATION <br />2, <br />Date: <br />5. <br />6. <br />,4® <br />. 1 <br />Name of Event: Downtown Tracy Block Party <br />Date(s) of Event: May 5, 2023 Time of Event: 6:0Qpm-9:00pm <br />Location' ^r°rit Street Plaza (6th Street & Central Avenue) <br />Event Coordinator (Name): Lauren Repetto <br />Mailing Address: 333 CpAe-Center Plaza <br />Number of Food Booths 1_y _ <br />Approximate attendance at peak time: 7:00Pm <br />UTILITIES <br />1. <br />2. <br />3. <br />4. <br />5. <br />6. <br />GENERAL EVENT FILE INFORMATION <br />1. <br />2. <br />3. <br />4. <br />Average Age: 35 <br />,f SANJOAOUIN <br />, wW® / -—“COUNTY— <br />\ *r^ jUf / ■ ■ \ \ <br />y1' C''*'"'-.''' 'HdWS n^rt. <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 />■g. 900 <br />0 Yes No <br />0 Yes No <br />d Yes No <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: Tracy Delta Solid Waste Management Number of dumpsters: .3. <br />Method of disposal of liquid waste for food booths: N/A <br />1. 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 $156 <br />c) Temporary Food Vendors Applications for each booth <br />d) Temporary Event Site Plan <br />e) Food Vendor List <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 />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420] F 209 464-0138 | www.sjgov.org/ehd <br />EHD 16-02 Page lofll TEMP EVENT APP <br />06/19/19