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of the Food Vendor's Applications no later than two weeks prior to event I Oi/X Average Age: /c:Total Attendance: ^5^ UTILITIES 4. Number of dumpsters: APPLICATION 1. 2. Date:Event Coordinator: TEMP EVENT APP 1. 2. 5. 6. 1. 2. 3. 5. 6. EHD 16-02 7/14/15 SYes ®Yes a Yes No No No 3. 4. San Joaquin County Environmental Health Department 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd Submit the following to the Environmental Health Department two weeks prior to the event: a) Temporary Event Application b) Application Review Fee of $130 c) Temporary Food Vendors Applications for each booth d) Temporary Event Site Plan e) Food Vendor List If the event is selected for inspection, the Event Coordinator will be billed for inspection time: • $130 per hour (weekdays 8:00 am to 5:00 pm) • After regular business hours (weekday, weekends and holidays) the inspection is charged at the hourly rate, calculated at one and one half times ($195.00 per hour) TEMPORARY EVENT APPLICATION To be completed and signed by Event Coordinator, then returned to the Environmental Health Department with all Is potable water supplied and available for each food vendor: Is electricity supplied and available for each food vendor: Are janitorial facilities available: Number of toilets provided: a Name of sanitary garbage disposal company: /))ickpra\ Method of disposal of liquid waste for food booths: K< This application is to be completed and signed by the Event Coordinator, then returned to the Environmental Health Department with all Food Vendor’s Applications no later than two weeks prior to the event. I understand that as a temporary event coordinator, I am responsible for meeting California State standards and the Environmental Health Department policies and procedures. ____________ Date: - rAv/k______ Page 1 of 11 Name of Event: / CJ / ---------------- Date(s) of Event: 4,/x vUg 6 Time of Event:-------------- Location: ----------------------------------------------------- Event Coordinator (Name): Telephone: Mailing Address: K&O ----- Number of Food Booths: / Approximate attendance at peak time: GENERAL EVENT FILE INFORMATION P SE /4 /p 6- / £