Laserfiche WebLink
GENERAL EVENT FILE INFORMATION <br />1.Name of Event: <br />2. <br />3. <br />4. <br />5. <br />Total Attendance: I STO6.Approximate attendance at peak time: -y <br />UTILITIES <br />1. <br />2. <br />3. <br />4. <br />A5.Number of dumpsters: <br />6. <br />APPLICATION <br />1. <br />If the event is ^elected for inspection, the Event Coordinator will be billed for inspection time:2. <br />Event Coordinator:Date: <br />Page 1 of 11 TEMP EVENT APPEHD 16-02 <br />08/01/16 <br /> No <br /> No <br /> No <br />San Joaquin County <br />Environmental Health Department <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br />Average Age: /tG GS <br />©J^^T <br />H^Yes <br />IZJ Yes <br />0 Yes <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 />• l^isirper 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 one half times ($2G875U per hour) <br />2-25,00 <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 />Date(s) of Event: ' <br />Location: ■Ac' <br />Event Coordinator (Name):. <br />Mailing Address: <br />Number of Food Booths: <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 of | <br />c) Temporary Food Vendors Applications for each booth <br />d) Temporary Event Site Plan <br />e) Food Vendor List <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:1 <br />Name of sanitary garbage disposal company: fcxfeju-CA <br />Method of disposal of liquid waste for food booths: F> Ab <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 /> Date: / / 7 <br />c i M u. s _________________ <br />j Time of Event: <) 4^ i VjkM. <br />> A ___ <br />AGo LC- AR. Telephone: