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<br />Environmental Health Department <br />Average Age:. <Z-^-3oTotal Attendance: L>, poo <br />APPLICATION <br />1. <br />2. <br />Event Coordinator:Date: <br />1868 E. Hazelton Avenue | Stockton, California 95205 ] T 209 468-3420) F 209 464-0138 | www.sjcehd.com <br />5. <br />6. <br />Temporary Event Application <br />Application Review Fee of $152 <br />Temporary Food Vendors Applications for each booth <br />Temporary Event Site Plan <br />Food Vendor List <br />B Yes <br />HYes <br />KYes <br /> No <br /> No <br /> No <br />Telephone: {2gi) <br />, MAfliArthCy ~7'73S~V_____________ <br />Submit the following to the Environmental Health Department two weeks prior to the event <br />a) <br />b) <br />c) <br />d) <br />e) <br />Name of Event: <br />Date(s) of Event: Fcg <br />Location: SArO <br />Event Coordinator (Name):. <br />Mailing Address: <br />Number of Food Booths: 3 ’ <br />Approximate attendance at peak time: 2-jgoo <br />______Time of Event: IPcyAs fl3p -yp^ <br />GENERAL EVENT FILE INFORMATION <br />1. <br />2. <br />3. <br />4. <br />UTILITIES <br />1. <br />2. <br />3. <br />4. <br />5. <br />6. <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: <br />Method of disposal of liquid waste for food booths: <br />\ SANJOAQUIN <br />-----COUNTY----- <br />■ Greatness grows here. <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 />to Number of dumpsters: <br />/a) <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