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Environmental Health Department <br />2. <br />3. <br />4. <br />5. <br />>ak time: 6. <br />2. <br />o3. <br />4. <br />5. <br />6. <br />APPLICATION <br />1. <br />2. <br />CA .Date:Event Coordinator: <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 $172 <br />c) Temporary Food Vendors Applications for each booth <br />d) Temporary Event Site Plan <br />e) Food Vendor List <br />Io <br />[Rtio <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: <4-4^- <br />Name of sanitary garbage disposal company: esV ^^PS^mlber of dumpsters: <br />Method of disposal of liquid waste for food booths: Vendor is <br />Fh <Sp / o <br />UTILITIES <br />1. <br />GENERAL EVENT FILE INFORMATION <br />1. <br />SANJOAQUIN <br />------COUNTY------- <br />Greatness grows here. <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420) F 209 464-0138 | www.sjgov.org/ehd <br />EHD 16-02 Page 1 of 11 TEMP EVENT APP <br />07/01/2024 <br />If the event is selected for inspection, the Event Coordinator will be billed for inspection time: <br />• $172 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 $774.00 <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 />of the Food Vendor’s Applications no later than two weeks prior to event <br />Total Attendance^ Average Age^^Q J <br /> Yes EkfN' <br /> Yes <br /> Yes [WY <br />3 CC>fY\ <br />3 <br />Name of Event: MourrM/n Hispanic^ I'l'&rI----- <br />Date(s) of Event: I O/ Tjme of Event:3 prr^ ~ ~7 pnd-------------------------------— <br />Location: M 6X t K| MoU ------------------------ <br />Event Coordinator (Name): Telephone: (’20^ — <br />Mailing Address: S <br />Number of Food Booths: f'J J <br />Approximate attendance afpeak ti