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<br /> <br />Environmental Health Department <br /> <br />-C OU NT Y-- <br />Greatness grows here. <br /> <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: Holiday Bazaar <br />Date(s) of Event: October 26, 2024 Time of Event: 9:00 am. - 3 p m. <br />Location: Escalort United Methodist Church <br />EVOnt.Coordinator (Name): Karam Harris Telephone: (209) 613-3479 <br />Mailing Address: 2000 Jackson Avenue, Escalon, CA 95320 <br />Number of. Food. Booths; None. <br />6. Approximate attendance at peak time: 50,60 Total Attendance: 3nn Average Age: 50130 <br />UTILITIES <br />1, Is potable water supplied and available for each food vendor; al Yes NO No vendors <br />?, Is electricity supplied and available for each food vendor: Yea D.ro NQ .p <br />Are janitorial facilities availaNe; Yes El No <br />4, Number of toilets provided: <br />Name of sanitary garbage disposal company: <br />Method of disposal of liquid waste for food booths: Two double sinks <br />APPLICATION <br />1. Submit the following to the Environmental Health Department two weeks prior to the event: <br />Temporary Event Application <br />Application Review Fee of $156 <br />Temporary Food Vendors Applications for each booth <br />Temporary Event Site Plan <br />Food Vendor List <br />2. 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 />Gilton Garbage Number of dumpsters: 2 <br /> <br />Event Coordinator: Date: September 29, 2024 <br /> <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sjgov.org/ehd <br />END 16-02 Page 1 of 11 TEMP EVENT APP <br />0e,119/19-