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•Y <br /> 17 <br /> SA NA M U I N Environmental Health Department <br /> - <br /> COUNTY-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 /> GENERAL EVENT FILE INFORMATION <br /> 1. Name of Event: Circus Caballero <br /> 2. Date(s)of Event: August 1 - 11,2024 Time of Event:Vanes Noon to 9:30 pm, see attached <br /> 3. Location: West Valley Mall, 3200 N. Naglee Rd,Tracy <br /> 4. Event Coordinator(Name): Mark Landon Telephone: (909 687-6778 <br /> Mailing Address: 2534 S. Pleasant Ave., Ontario, CA 91761 <br /> 5. Number of Food Booths: One <br /> 6. Approximate attendance at peak time:400 Total Attendance200-400/ShowAverage Age: <br /> UTILITIES <br /> 1. Is potable water supplied and available for each food vendor. ®Yes ❑No <br /> 2. Is electricity supplied and available for each food vendor. ®Yes ❑ No <br /> 3. Are janitorial facilities available: ® Yes ❑ No <br /> 4. Number of toilets provided: Six <br /> 5. Name of sanitary garbage disposal company: <br /> 6. Method of disposal of liquid waste for food bo( <br /> APPLICATION <br /> 1. Submit the following to the Environmental Hea <br /> a) Temporary Event Application <br /> b) Application Review Fee of$162 -- i <br /> c) Temporary Food Vendors Applicatior .Y..� <br /> d) Temporary Event Site Plan <br /> e) Food Vendor List <br /> 2. If the event is selected for inspection, the Event re, r > <br /> • $162 per hour(weekdays 8:00 am to <br /> • After regular business hours(weekda <br /> minimum three-hour overtime rate of <br /> This application is to be completed and sigr _:' if'-�„__a .w _ '•-` • <br /> Environmental Health Department with all Food Vi <br /> event <br /> I understand that as a tempora event coordi <br /> standards and the Environmental earth Departm <br /> Event Coordinator: ' <br /> 1868 E. Hazelton Ave e I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/ehd <br /> END 1"2 Page 1 cf 11 TE1W EVENT APP <br /> 06/29M23 <br />