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Environmental Health Department <br />2. <br />3. <br />4. <br />5. <br />3Total Attendam Average Age.6. <br />Yel1. <br />2. <br />3. <br />4. <br />5. <br />6. <br />APPLICATION <br />1. <br />2. <br />Date:Event Coordinator. <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 $162 <br />c) Temporary Food Vendors Applications for each booth <br />d) Temporary Event Site Plan <br />e) Food Vendor List <br />fj No <br /> No <br /> No <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 />06/29/2023 <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 />0c,\ <br />GENERAL EVENT FILE INFORMATION <br />1. <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 />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:3___________ <br />Name of sanitary garbage disposal company: J^G-LTA Number of dumpsters:t <br />Method of disposal of liquid waste for food booths:AKJ kCi&M <br />Name of Event: <br />Date(s) of Event: *7^ (3^, 0c\ Time of Event: V ^OrJr <br />Location: Mo^AJTA-Jaj / PM <br />Event Coordinator (Name): Mx a* AS VonAglx o A Telephone: (^J) - <br />Mailing Address: M U m. op KHAIM h QQlG C A - <br />Number of Food Booths:Q <br />Approximate attendance at peak time: Total Attendance! 3 0 \ Average Age:\ 3 0 / <br />es