Laserfiche WebLink
Environmental Health Department <br />2. <br />3. <br />4. <br />5. <br />time: 1 '>^C>Average Age: 6.Approximate attendance <br />2. <br />3. <br />4. <br />5. <br />6. <br />APPLICATION <br />1. <br />2. <br />Date: Event Coordinator: <br /> No <br /> No <br /> No <br />G) Yes <br />S Yes <br /> 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 />SAN JOAQUIN <br />COUNTY <br />4^—_ <br />Si}k| 27z <br />£.0 (Tc& ( \ f- <br />4«X$V\ CO.VX5 <br />rcr io <br />GENERAL EVENT FILE INFORMATION <br />1. <br />UTILITIES <br />1. <br />__Time of Event: ‘-IfJr'rt " & ft KYI________ <br />________Telephone: (775) 7 7 6 <br />CA ^<^0^ <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420) F 209 464-0138 | www.sjgov.org/ehd <br />EHD 16-02 Pa9e 1 of 11 TEMP EVENT APP <br />06/29/2023 <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: Cp <br />Name of sanitary garbage disposal company: McsVc Number of dumpster <br />Method of disposal of liquid waste for food booths: (VaftipacVDr ] -Cdr Co <br />lue'H OSb VW haz ujqsK <br />OS C<A d a 11 b PW A valiw a V-ctf; I» <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 $162 <br />c) Temporary Food Vendors Applications for each booth <br />d) Temporary Event Site Plan <br />e) Food Vendor List <br />Name of Event: A nxq2pry (-0 w <br />Date(s) of Event: J&jlj <br />Location: IQjG £ G iTaaV I <br />Event Coordinator (Name): O kan-Gcx Pp.'n/lk- <br />Mailing Address: I G to n ‘r' 2G <br />Number of Food Booth/' ! 1 <br />Total Attendance^ lUOO <br />If the event is selected for inspection, the Event Coordinator will be billed for inspection time: <br />• $162 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 $729.00 <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.