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kireairio? y <br />Average Age: Total Attendance: <br />Number of dumpsters: <br />1. <br />2. <br />... *7 / -T- ✓ ? W <br />0Yes <br />O'Yes <br />0'Yes <br /> No <br /> No <br /> No <br />5. <br />6. <br />GENERAL EVENT FILE INFORMATION <br />1. <br />2. <br />3. <br />4. <br />UTILITIES <br />1. <br />2. <br />3. <br />4. <br />5. <br />6. <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:Lt------------------— <br />Name of sanitary garbage disposal company:-------------------- <br />Method of disposal of liquid waste for food booths:------------- <br />9<32>C> <br />S Sq ’ t b 0 <br />APPLICATION <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 $152 <br />c) Temporary Food Vendors Applications for each booth <br />d) Temporary Event Site Plan <br />e) Food Vendor List <br />If the event is selected for inspection, the Event Coordinator will be billed 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 />TEMPORARY EVENT APPLICATION <br />To be completed and signed by Event Coordinator, then returned to the Environmental Health Department with all <br />To De compie vendor’s Applications no later than two weeks prior to event <br />Name of Event: ---------------------- <br />Date(s) of Event: 07 / 3l / 24Time of Event:---------------- <br />Location: 700 <br />Event Coordinator (Name): R- uxj 11. u i >----------------------Telephone: (mOS) <br />Mailing Address: ( <br /> Number of Food Booths: { •I y <br />Approximate attendance avpeaKnme: