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<ojg^S- <br />GENERAL EVENT FILE INFORMATION <br />Name of Event: 1. <br />ion2. <br />3.-PM <br />4. <br />5. <br />Average Age: 2Total Attendance: ’5006. <br />UTILITIES <br />1.Yes <br />2. <br />3. <br />4. <br />5.Number of dumpsters: <br />6. <br />APPLICATION <br />1. <br />2. <br />Event Coordinator: Date: <br />Page 1 of 11 TEMP EVENT APP <br />,D <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 $139 <br />c) Temporary Food Vendors Applications for each booth <br />d) Temporary Event Site Plan <br />e) Food Vendor List <br /> No <br /> No <br /> No <br />EHD 16-02 <br />AQ/m /I A <br />Yes <br />Yes <br />If the event is selected for inspection, the Event Coordinator will be billed for inspection time: <br />• $139 per 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 ($208.50 per hour) <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 H^lth Department policies and procedures. <br />A?//7 <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: 'Hilton Sityuy <br />Method of disposal of liquid waste for food booths: <br />Date(s) of Event: ZTvgij <;t~ / ? ~ U, <br />Location: -ao?) wMncytOD \ <br />Event Coordinator (Name):. <br />Mailing Address: i- fry <br />Number of Food Booths: <br />Approximate attendance at peak time: ZM <br />'LOH Time of Event: / ? . / 4/oon - /O <br />it Sun to, - /o <br />1 Telephone: £101) 1^1 ~ 3 i V <br />n, 511) L__________ <br />San Joaquin Coun <br />_Environmental Health Department <br />2017 '1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjqov.orq/ehd <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