Laserfiche WebLink
N 054 3 33/-1 <br />Environmental Health Department SAN.JOAQUIN <br />j —COUNTY -- , 44r-m 45:Larr Pit tx‘ / 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 />Name of Event: .1`6- 40e-‘- iti/d ° ferli * <br />Date(s) of Event: /9-p- I I-. - 27 -2e2-J - Time of Event: AZfild 710 rril'y <br />Location: W ebe / Et)( rit-1 ST -06,KrOdt ) <br />Event Coordinator (Name): 5.4c/c /1,41177/fICI Telephone: (4-106. 1(02r- 0-8-- P er <br />,e)::) /4/41A,ks 4-__s A k/ e . ,5 v / 7- i gtociacileo a } a 1 Mailing Address: <br />Number of Food Booths: 13f/LOA la MILLI//2 /4j 7-13 C 0 *7-/f-U6X--2 ' <br />Approximate attendance at peak time: (AM- Total Attendance: /4/00 Average Age: 6eziehis-c- <br />UTILITIES <br />Is potable water supplied and available for each food vendor: Y s No <br />Is electricity supplied and available for each food vendor:L 's El No <br />Are janitorial facilities available: 2/Yes LI No <br />Number of toilets provided: 2i2 <br />Name of sanitary garbage disposal company: vie_sle- /1/4/9Vileltiltmber of dumpsters: <br />Method of disposal of liquid waste for food booths: 9c04,/, <br />APPLICATION <br />Submit the following to the Environmental Health Department two weeks prior to the event: <br />Temporary Event Application <br />Application Review Fee of $172 <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 />$172 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 $774.00 <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 ent oordinator, I am responsible for meeting California State <br />standards and the Environ iental lie.l h D partment policies and procedures. <br />Event Coordinator: Date: /4"-C-if - <br /> <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I wvvw.sjgov.org/ehd <br />END 16-02 Page 1 of 11 TEMP EVENT APP <br />07/01/2024 <br />k6