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Environmental Health Department <br />2.3/17/18 <br />3. <br />4.Telephone: (209) 914-7119 <br />5. <br />6.35 Total Attendance:35 Average Age: 40 <br />2. <br />3. <br />4. <br />5.Number of dumpsters: 2. <br />6. <br />APPLICATION <br />1. <br />2. <br />Event Coordinator:Date: <br />1868 E. Hazelton Avenue <br />EHD 16-02 <br />07/3/17 <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: 12 <br />Name of sanitary garbage disposal company: Allied Waste Services <br />Method of disposal of liquid waste for food booths: Kitchen sink/disposal. <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 $152 <br />c) Temporary Food Vendors Applications for each booth <br />d) Temporary Event Site Plan <br />e) Food Vendor List <br />K Yes <br />K! Yes <br />S Yes <br /> No <br /> No <br /> No <br />Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 [ www.sjcehd.com <br />Page 1 of 11 TEMP EVENT APP <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 />GENERAL EVENT FILE INFORMATION <br />1. <br />UTILITIES <br />1. <br />OANiJOAQUIN <br />------COUNTY------- <br />Greatness grows here. <br />Name of Event: 2018 Murder Mystery Dinner- presented by Team Lathrop- RFL of Greater Manteca Area <br />Date(s) of Event: 3/17/18 Time of Event: 5pm to 9pm <br />Location: Lathrop Senior Center 15707 5th Street Lathrop, Ca 95330 <br />Event Coordinator (Name):Tamara Edwards <br />Mailing Address: 1100 Sherrie Ct Lathrop, Ca 95330 <br />Number of Food Booths: 1-just the kitchen <br />Approximate attendance at peak time: <br />If the event is selected for inspection, the Event Coordinator will be billed for inspection time: <br />• $152 per hour (weekdays 8:00 am to 5:00 pm) <br />• After regular business hours (weekday, weekends and holidays) the inspection is charged at the <br />hourly rate, calculated at one and one half times ($228 per hour) <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 />/ T- ■- Q,".