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SA N : J aA Q U I N Environmental Health Department <br /> -COUNTY -- <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: Downtown Tracy Farmers Market <br /> 2. Date(s) of Event: Saturdays Year Round Time of Event:8:00 am to 1:00 pm <br /> 3. Location: Central Ave Between 9th Street and 6th Street <br /> 4. Event Coordinator(Name): Chris Dutra Telephone: (209 405-2074 <br /> Mailing Address: _ 4119 Toreno Way Valley Springs, CA 95252 <br /> 5. Number of Food Booths: 30 <br /> 6. Approximate attendance at peak time: 250 Total Attendan 500 Average Age: 35 <br /> r � <br /> UTILITIES <br /> 1. Is potable water supplied and available for each food vendor: ❑ Yes ® No <br /> 2. Is electricity supplied and available for each food vendor: ❑ Yes ® No <br /> 3. Are janitorial facilities available: ❑Yes ® No <br /> 4. Number of toilets provided: 2 <br /> 5. Name of sanitary garbage disposal company: SJCFM Number of dumpsters: 1 <br /> 6. Method of disposal of liquid waste for food booths: Self Disposal <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$152 <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 bi[led 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 a <br /> minimum three-hour overtime rate of$684.00 <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 /> Event Coordinator: Date: April 25, 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 /> EHO 16-02 Page i of 11 TEMP EVENT APP <br /> 06119/19 <br />