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APPLICATION <br />1. <br />2. <br />1Date:Event Coordinator <br />T 209 468-3420) F 209 464-0138 | www.sjgov.org/ehd1868 E. Hazelton <br />5. <br />6. <br />Environment^Health Department <br /> No <br /> No <br /> No <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 />Stockton, California 9520^) <br />GENERAL EVENT FILE INFORMATION <br />1. ~ <br />2. <br />3. <br />4. <br />Total Attend j^Tcel^ OOy Average <br />.;o^. <br />Greotness grows here. <br />Submit the following to the Environmental Health Department fveJi? <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 />Ik CIO <br />UTILITIES <br />1. <br />2. <br />3. <br />4. <br />5. <br />6. <br />SEP 0 9 2019 <br />environmental health <br />PERMIT/SERVICES <br />Name of Event: <br />Date(s) of Event^ ^C^V 9-0 / Time of Event: /IKO S <br />Location: IL5 Ua 8 aAo KJ ~~Vt CX___________ <br />Event Coordinator (Name): O \ N K Telephone: pOj G | -Jy" \ ^0(5 <br />Mailing Address: ------------------- <br />Number of Food Booths: ( / <br />Approximate attendance at peak time: JXjO <br />SANJOAOUl# <br />------COUNTY— <br />Is potable water supplied and available for each food vendor: Yes <br />Is electricity supplied and available for each food vendor: ^0 Yes <br />Are janitorial facilities available: Q Yes <br />Number of toilets provided:X?____________ <br />Name of sanitary garbage disposal company: \ Q f\,CLC_.i X i-S pOSA^ Number of dumpsters: <br />Method of disposal of liquid waste for food booths RO \a VcXaT? KJ