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Environmental Health Department <br />© <br />APPLICATION <br />1. <br />2. <br />responsible for meeting California State <br />Event Coordinator: Date: <br />5. <br />6. <br />5. <br />6. <br />Temporary Event Application <br />Application Review Fee of $152 <br />Temporary Food Vendors Applications for each booth <br />Temporary Event Site Plan <br />Food Vendor List <br />TEMPORARY EVENT APPLICATION <br />To be completed and signed by Event Coordinator, then returned to the Environmental Health <br />of the Food Vendor’s Applications no later than two weeks prior to event <br />SAN JOAQUIN <br />-----COU NTY----- <br />c <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 I www siqov orq/ehd <br />oe/wnV2 Pa9e 1 of 11 TEMP event app <br />This i „ . <br />Environmental Health Department with all Food Vendor’s Applications no later than two weeks prior to the <br />Submit the following to the Environmental Health Department two weeks prior to the event: <br />a) <br />b) <br />c) <br />d) <br />e) <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: <br />Name of sanitary garbage disposal company: /^^^^^^^^jmber of dumpsters: <br />Method of disposal of liquid waste for food booths: <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 />application is to be completed and signed by the Event Coordinator, then returned 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 />1. <br />2. <br />3. <br />4. <br />UTILITIES <br />1. <br />2. <br />3. <br />4. <br />M Yes No <br />MYes ONo <br />.^^Yes No <br />Name of Event: <br />Date(s) of Event: Time of Event:. <br />Location: ^Azzz^z^/zz^zz <br />Event Coordinator (Name): Telephone: (^7^ y^^zzh <br />Mailing Address: <br />Number of Food Booths: -f- ZZZ) <br />Approximate attendance at peak time: Total Attendance: Average Age: