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4 <br /> HAZARDOUS MATERIAL MANAGEMENT PLAN <br /> FILE COVER SHEET <br /> FACILITY ID#: FA0000724 P/E: 1921 DATE: 12/12/2013 <br /> PROGRAM RECORD#: PR0521010 P/E: DATE: <br /> CERS ID#: 10180647 P/E: DATE: <br /> OES REFERENCE#: 10142 <br /> ADDRESS: 224 W KETTLEMAN LN CITY: LODI <br /> FACILITY NAME (DBA): KENTUCKY FRIED CHICKEN#120 <br /> FACILITY PHONE: (209)368-7912 FACILITY FAX: <br /> FACILITY CONTACT: DAVE & LISA 120 INC PHONE: <br /> OWNER NAME: HARMAN-DAVE & LISA INC CITY: LODI <br /> OWNER ADDRESS: 224 W KETTLEMAN LN PHONE: <br /> Water Service: ❑ Large PWS ❑ Small PWS ❑ Domestic Well <br /> Sewer Service: ❑ Public Sewer ❑ OnSite WWTX ❑ OnSite Septic System <br /> Stormwater: ❑ Street Drains ❑ Street Ditches ❑ OnSite Ponds ❑ Other <br /> EH 00 18 rev 062013 <br /> rpt#: HMMF New Owner: Create a New Cover Sheet/Change Label of File <br />