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Environmental Health Department <br />4 <br />1. <br />2. <br />Event Coordinator: <br />1. <br />2. <br />3. <br />4. <br />5. <br />6. <br />5. <br />6. <br />1. <br />2. <br />3. <br />4. <br /> No <br /> No <br />No <br />SAN JOAQUIN <br />■COUN'y <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 />__________Time of Event: <br />y (XQJsdtieX'"Telephone^^) 4pz^>S S <br />Total Attendance: 3^"? Average Age: <br />Date: <br />209 464-0138 | '«ww si9°^®pAPp <br />GENERAL EVENT FILE INFORMATION <br />Name of Event: VeTS finTUte <br />Date(s) of Event: 41 j 3-c^-H <br />Location: tJ^J- COlA>€fl-C <br />Event Coordinator (Name): xAr-YTk, ( <br />Mailing Address: <br />Number of Food Booths: / <br />Approximate attendance at peak time: <br />/ ----------- r Number of dumpster^-. <br />,al of liquid waste for food booths:Dv^ ^[l Le Uc^S W <br />Submit the <br />a) <br />b) <br />c) <br />d) <br />e) <br />If the event is selected for inspection, the Event Coordinator will be billed for inspection time: <br />: s x—-—»•• <br />minimum three-hour overtime rate of $729.00 coordinator, then returned to the <br />. ..................... <br />event. ««rdir>atnr I am resoonsible for meeting California State <br />Environrnen°atHealth^epartment policies and procedures. <br />UTILITIES <br />Is potable water supplied and available for each food vendor: "^.Yes <br />Is electricity supplied and available for each food vendor: ^Yes <br />Are janitorial facilities available: Yes <br />Number of toilets provided:-W 1------ <br />Name of sanitary garbage disposal company: <br />Method of dispose. <br />coaler; 11 <br />APPLICATION <br />following to the Environmental Health Department two weeks prior to the event: <br />Temporary Event Application <br />Application Review Fee of $162 <br />Temporary Food Vendors Applications for each booth <br />Temporary Event Site Plan <br />Food Vendor List <br />1868 E. Hazelton Avenue | Stockton, California 95205| 1,209 468-3420 | F <br />EHO 16-02 <br />06/29/2023