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lipv;Qz 10if <br /> �6u�N SANAANIN Environmental Health Department <br /> COUNTY . <br /> \cgcr �. 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 Ale ria <br /> 2. Date(s) of Event:December 4 - 29, 2025 Time of EventVaries 2:00 to 9:30 pm, see attached <br /> 3. Location: Promenade Shops, 1422 Grove Ave., Manteca _ <br /> 4. Event Coordinator(Name):Mark Landon Telephone: P09)687-6778 <br /> Mailing Address: 348 Es uina Dr. Henderson NV 89014 <br /> 5. Number of Food Booths: One <br /> 6. Approximate attendance at peak time:150 Total Attendancei00-150 per sho4erage Age: 35 <br /> UTILITIES <br /> 1. Is potable water supplied and available for each food vendor: [5J Yes ❑ No <br /> 2. Is electricity supplied and available for each food vendor: (3 Yes ❑ No <br /> 3. Are janitorial facilities available: Yes ❑ No <br /> 4. Number of toilets provided: 3 <br /> 5. Name of sanitary garbage disposal company: We have our own dumpsteNumber of dumpsters: . I_y <br /> 6. Method of disposal of liquid waste for food booths: Tanks, to be pumped, as needed <br /> APPLICATION <br /> 1. 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$179 <br /> c) Temporary Food Vendors Applications for each booth <br /> d) Temporary Event Site Plan <br /> e) Food Vendor List <br /> 2. If the event is selected for inspection, the Event Coordinator will be billed for inspection time: <br /> • $179 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$805.50 <br /> This application is to be completed and signed by the Event coordinator, then returnee to the <br /> Environmental Health Department with all Food Vendor's Applications no later than two weeks 12rior to the <br /> event. <br /> I understand that as a temporary a nt coordinator, I am responsible for meeting California State <br /> standards and the Environmental He th Department policies and procedures. <br /> Event Coordinator: Date: 1 1-12-2025 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/ehd <br /> EHD 16-02 Page 1 of 11 TEMP EVENT APP <br /> 07101,2025 <br />