Laserfiche WebLink
GENERAL EVENT FILE INFORMATION <br />UTILITIES <br />2 <br />1. <br />2. <br />Event Coordinator Date: <br />Page 1 of 9 TEMP EVENTEHD 10.05 <br />8/2B/0I’; <br />1. <br />2. <br />3. <br />4. <br />5. <br />6. <br />6. <br />7. <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 $105 per hour with a one (1) hour minimum <br />c) Temporary Food Facility food vendors permit application <br />d) Site Plan <br />1. <br />2. <br />3. <br />4. <br />5. <br />San Joaquin County <br />Environmental Health Department <br />600 East Main Street, Stockton, CA 95202-3029 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web; www.sjgov.org/ehd <br />_________Number of dumpsters: <br />TrztsA CA-n S <br />TEMPORARY EVENT APPLICATION <br />(To be completed and signed by Event Coordinator, then returned to the Environmental Health Department <br />With all Food Vendor's Checklists no later than two weeks prior to event) <br />>f Food Handlers: ~TvJ V <br />Total Attendance: <br />Name of Event: <br />Date of Event, <br />Type of Event: 1695 1698 <br />Location: <br />Event Coordinator (Name): Mf)recti'} <br />Mailing Address: ^3/^ £ ' Iffior'L <br />Number of Food Booths: Numb <br />Approximate attendance at peak time: <br /> Yes No <br /> Yes <br />p0Yes No <br />If Festlval/Event is selected for inspection, the Event Coordinator will be billed for inspection time: <br />• $105 per hour, weekdays 8:00 am to 5:00 pm. <br />• After regular business hours, weekday, weekends and holidays, the inspection is charged at the <br />hourly rate, calculated at one and a half times. <br />This application is to be completed and signed by the Event Coordinator, then returned to the <br />Envi ronmental Health Department with all food Vendor’s Checklists no latQr than five* weelte prior to event. <br />I understand that as a temporary event organizer, I am responsible for meeting State standards as <br />described in the Department of Environmental Health policies and procedures. <br />Qatg. £ 1 0 2 O <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: 3 <br />Name of sanitary garbage disposal company:I <br />Method of disposal of liquid waste for food booths: <br />APPLICATION <br />_Tlme of Event: Duration of Event: <br />i ***Piease see Notice to All Temporary Event Organizers**** <br />M hn K YX I 4^ E* in. d** ___ <br />('>■> tD.O \L .C-Y'- ______Telephone: $ I <br />f'nfl dr- Ipo /tonnitin ,CA 7 S3 / <br /> Profit ^Qton-Profit <br />^•Q O Average Age: