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Environmental Health Department <br />later than two weeks prior to event <br />7^s7-f tral <br />3ooTotal Attendance:Average Age: 2-~ ~7_C) <br />2. <br />APPLICATION <br />1. <br />2. <br />Event Coordinatoi Date: <br />5. <br />6. <br />S Yes <br />0 Yes <br />S Yes <br /> No <br /> No <br /> No <br />209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />TEMP EVENT APP <br />SAN JOAQUIN <br />-----COUNTY----- <br />GENERAL EVENT FILE INFORMATION <br />1. <br />2. <br />3. <br />4. <br />fT Number of dumpsters: <br />- SevCC-t- <br />EHD b3 o2 Hazelton AvenL,e I Stockton. California 95205 I T 2' <br />06/19/19 Pagel of 11 <br />UTILITIES <br />1. <br />2. <br />3. <br />4. <br />5. <br />6. <br />Da inF lUgry 'S /^mi L <br />-O I ________Time of Event: Sa't' /~C <br />» £f/</U , Sun <br /> n co <br />UO CVS O \ Qc\ 'Vo»1 <br />Name of Event: _ _ <br />Date(s) of Event: HuAli vb <br />Location: 7 03 <br />Event Coordinator (Name): fi'OC <br />Mailing Address: StD3 <br />Number of Food Booths: <br />Approximate attendance at peak time: <5lOO <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 $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 />and holidays>the in^cti°n is - <br /> <br />— -ting California State <br />TEMPORARY EVENT APPLICATION <br />o e completed ancIsigned by'Event Coordinator, then returned to the Environmental Health Department with all <br />ot the Food Vendor s Applications no later than two weeks orior to m/ont <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: <br />Method of disposal of liquid waste for food booths: <br />__________/Z Qoon - Z6 <br />____Sun <br />_Telephone: (2^)) <br />T__Nollen 6R- ^57.0?