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Environmental Health Department <br />1. <br />2. <br />3. <br />4. <br />5. <br />Average Ag£( 40iak time: 200 Total Attendanc6.Approximate attendance <br />UTILITIES <br />1. <br />2. <br />3. <br />4. <br />Number of dumpsters: 5. <br />6. <br />APPLICATION <br />1. <br />2. <br />Nimesh Gajjar 29-Feb-2024Date:Event Coordinator: <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 $162 <br />c) Temporary Food Vendors Applications for each booth <br />d) Temporary Event Site Plan <br />e) Food Vendor List <br />0 Yes <br />0 Yes <br />0 Yes <br /> No <br /> No <br /> No <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 />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/ehd <br />EHD 16-02 Page 1 of 11 TEMP EVENT APP <br />If the event is selected for inspection, the Event Coordinator will be billed for inspection time: <br />• $162 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 $729.00 <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 />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 />SAN JOAQUIN <br />------COU NTY------- <br />Greatness grows here. <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: 2 <br />Name of sanitary garbage disposal company: <br />Method of disposal of liquid waste for food booths: <br />GENERAL EVENT FILE INFORMATION <br />Name of Event: CVGCA Holi and Uttarayan 2024 <br />Date(s) of Event: 16-Mar-2024 Time of Event: 10 AM <br />Location: 251 E. Main Street Mountain House CA 95391 <br />Event Coordinator (Name): Nimesh Gajjar Telephone: (408 8413016 <br />Mailing Address: 56 Sean Ave Mountain House CA 95391 <br />Number of Food Booths^ 2 >/' _________________ <br />250