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1. <br />2. <br />3. <br />4. <br />5. <br />6.Total Attendance: Average Age: 35 <br />4. <br />5.Number of dumpsters: 3 <br />6. <br />APPLICATION <br />1. <br />2. <br />then returned to the <br />Date: 12/16/2025 <br />2. <br />3. <br />Environmental Health Department <br />EfYes <br />SfYes <br />www.sjcehd.com <br />TEMP EVENT APP <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 />SAN JOAQUIN <br />-COUNTY- <br />Greatness urons here <br />Yes No <br /> No <br /> No <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: <br />Name of sanitary garbage disposal company: '^ASI L MAN Au t MLN l <br />Method of disposal of liquid waste for food booths: Cl i Y <br />UTILITIES <br />1. <br />1868 E. Hazelton Avenue | Stockton. California 95205 I T 209 468-3420 1 F 209 464-0138 I <br />EHD 16-02 Pagel of 11 <br />07/3/17 <br />GENERAL EVENT FILE INFORMATION <br />Name of Event: 209BFA I DOWN <br />Date(s) of Event: <br />Location: 525 N CENITR STRLt <br />Event Coordinator (Name):Telephone: ( 992-9665 <br />Mailing Address: 10403 EL PASi) WAY, S IOCK 1.'N (:A ',<530? <br />Number of Food Booths: <br />Approximate attendance at peak time: soo <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, w unr <br />Environmental Health Department with all Food Vendor’s Applications no later than two weeks prior to the <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 />Event Coordinator: HA> <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 />January 11, 2025 Time of Event: 4:00 PM