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S AN D QA Q U I N Environmental Health Department <br /> COUNTY-- - <br /> I <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 /> GENERAL EVENT FILE INFORMATION <br /> 1, Name of Event: Vets (Veterans) and Pets <br /> 2. Date(s) of Event: 4/11/2Q26 Time of Event: 9:00 am- 3.00 pm <br /> 3. location: Doctor Powers Park <br /> 4. Event Coordinator(Name): Roberta Carpenter Telephone: (209) 346-6595 <br /> Mailing Address: 1040 Vallerand Road, Tracy, CA 95376 <br /> 5. Number of Food Booths: 1 <br /> 6. Approximate attendance at peak time: 300 Total Attendance 00 Average Age: Cagges <br /> UTILITIES <br /> 1- Is potable water supplied and available for each food vendor: E Yes ❑ No <br /> 2. Is electricity supplied and available for each food vendor: E Yes ❑ No <br /> 3. Are janitorial facilities available: ❑ Yes E No <br /> 4. Number of toilets provided. 4 <br /> 5. Name of sanitary garbage disposal company: Tracy Material Recovery Inc. Number of dumpsters: <br /> 6. Method of disposal of liquid waste for food booths: Collect in containers and send to dump <br /> APPLICATION <br /> 1. Submit the following tcrthe Environmental Health Department two weeks prior to the event: <br /> a) Temporary Event Application <br /> b) Application Review Fee of$172 <br /> c) Temporary Food Vendors Applications for each booth <br /> d) Temporary Event Site Plan <br /> e) Food Vendor list <br /> 2. If the event is selected for inspection, the Event Coordinator will be billed for inspection time: <br /> $172 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$774.00 <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 /> 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 /> Event Coordinator: Rccvy� Date: 2/1 5/2026 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 E 209 464-0138 1 www.sjgov.org/ehd <br /> EHD 16-02 Page 1 of 11 TEMP EVENT ARP <br /> 07101/2024 <br />