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4 <br />Environmental Health Department <br />3. <br />4. <br />3. <br />6. <br />APPLICATION <br />1. <br />2. <br />April 24, 2025Event Coordinator: Date: <br />0 <br />4. <br />5. <br />5. <br />6. <br />Temporary Event Application <br />Application Review Fee of $172 <br />Temporary Food Vendors Applications for each booth <br />Temporary Event Site Plan <br />Food Vendor List <br />® Yes <br />B Yes <br />Q Yes <br />TEMPORARY EVENT APPLICATION <br />To be completed and signed by Event Coordinator, then returned to the Environmental Health Department with all <br />of the Food Vendor’s Applications no later than two weeks prior to event <br />.Ox SANJOAOUIN <br />J -----COUNTY----- <br />Greatness grows here. <br />Submit the following to the Environmental Health Department two weeks prior to the event: <br />a) <br />b) <br />c) <br />d) <br />e) <br />Total Attendance:200-400/Sho\vAveraqe Age: <br />I <br /> No <br /> No <br /> No <br />Is potable water supplied and available for each food vendor: <br />Is electricity supplied and available for each food vendor: <br />Are janitorial facilities available: <br />Number of toilets provided: Five <br />Name of sanitary garbage disposal company: We have our own dumpster Number of dumpsters: One <br />Method of disposal of liquid waste for food booths: tanks. Pumped as needed <br />Name of Event. Circus Caballero <br />Date(s) of Event: August 14-24, 2025 Time of Event: Varies Noon to 9:30 pm, see attached <br />Location: West Valley Mall, 3200 N. Naglee Rd, Tracy______________________________ <br />Event Coordinator (Name): Mark Landon^Telephone: (90$) 687-6778 <br />Mailing Address: 2534 S. Pleasant Ave., Ontario, CA 91761 <br />Number of Food Booths: One <br />Approximate attendance at peak time: 400 <br />UTILITIES <br />1. <br />2. <br />GENERAL EVENT FILE INFORMATION <br />1. <br />2. <br />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 event coordinator, I am responsible for meeting California State <br />standards and the Environmental Health Department policies and procedures. <br />1868 E. Hazelton AvenDe | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov org/ehd <br />P.». 1 -11 TEMP EVENTAPP