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Environmental Health Department <br />Name of Event:1. <br />May 6, 20232. <br />3. <br />Telephone: (209) 329-50474.Chet Somera <br />5. <br />35 YOTotal Attendance: 1,800Approximate attendance at peak time: 1,500 Average Age:6. <br />1. <br />2. <br />3. <br />4. <br />Number of dumpsters: One Four Yard5. <br />6. <br />APPLICATION <br />1. <br />2. <br />Date: April 13. 2023Event Coordinator:Chet Somera <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 ofZ5156j <br />c) Temporary Food Vendors Applications for each booth <br />d) Temporary Event Site Plan <br />e) Food Vendor List <br />S Yes <br />□ Yes <br />□ Yes <br />□ No <br />E No <br />S No <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 />06/19/19 <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 />If the event is selected for inspection, the Event Coordinator will be billed for inspection time: <br />• $156 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 $702.00 <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 />GENERAL EVENT FILE INFORMATION <br />Fusion Music Festival <br />UTILITIES <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: Six Stationary & Four Portable <br />Name of sanitary garbage disposal company: Waste Management <br />Method of disposal of liquid waste for food booths: Carried Out <br />Date(s) of Event: <br />Location: 1101 W, Turner Road, Lodi, CA 95242 <br />Event Coordinator (Name):. <br />Mailing Address: P.O. Box 761, Lodi, CA 95241 <br />Number of Food Booths: Six <br />Time of Event: 11:00 am - 7:00 pm