Information

JB Pritzker, Governor

James A. Rivera, State Fire Marshal

Division of Petroleum & Chemical Safety

State of Illinois
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Division of Petroleum & Chemical Safety

Facility Details

Facility Number:	1006514
Status:	Closed
Facility Name:	Country Market Conv. Store, Inc.
Address:	1004 E. Church St. Sandwich, IL 60548
County:	De Kalb
Property Parcel:
Facility Type:	Attended Self-Service Station
Owner Type:	Private
Green Tag Decal:	N001461
Green Tag Issue Date:	11/13/2012
Green Tag Expiration Date:	12/31/2014

Owner Details

Owner Name:	Becky Lueken
Owner Address:	2597 N. 45th Rd. Leland, IL 60531
Owner Status:	Current Owner
Purchase Date:	1/1/1982
Type of Financial Responsibility:	Commercial Insurance
Financial Responsibility Reporting Due Date:	1/21/2015

Motor Fuel Dispensing Permits

MFD Permit Type	Issue Date	Expiration Date
Self Service	11/13/2012	12/31/2014

Owner Summary

Click for Facility/Tank Ownership history

Owner Number	Owner Name	Owner Status	Purchase Date
U0037158	Lueken, Becky	Current Owner	1/1/1982
U0013408	Sandwich Country Market, Inc.	Former Owner

Permits (Unexpired)

Click for permit history

No Active Permits Found

Deficiencies (Current)

No Deficiencies Found

IEMA Numbers Associated with the Facility

IEMA Number	Inspection Date	Inspection Type	Permit Number
14-0920	8/26/2014	Removal Log	00756-2014REM

LUST Fund Eligibility and Deductibility Determinations

IEMA Number	Status	OSFM Received Date	OSFM Response Date	Deductible	Letter
14-0920	Eligible	9/2/2014	10/24/2014	$5,000

Pay Tank Fees Online

Tank Information

Tank Number 1

Capacity:	10000		Petroleum Use:
Product:	Gasoline		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	8/26/2014
OSFM First Notify Date:	3/27/1986		Abandoned Material:
Current Age:	34		Abandoned Date:
Install Date:	1/1/1980		Red Tag Issue Date:
Last Used Date:	10/26/2013		Fee Due:	$0.00
Product Date:	1/1/1980

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Fiberglass Non-Corrosive	N/A	N/A
Corrosion Prot - Tank	Lining Materials Internal	2/5/2009	2/5/2014
Leak Detect - Piping	Mechanical Pressurized Line Leak Detection	2/1/2012	2/1/2013
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 300c
Overfill Prev Device	Overfill Drop Tube Valve
Piping	Fiberglass Single Wall Piping	N/A	N/A
Spill Contain Device	Single Wall Spill Bucket
Tank	Steel Single Wall	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 2

Capacity:	6000		Petroleum Use:
Product:	Gasoline		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	8/26/2014
OSFM First Notify Date:	3/27/1986		Abandoned Material:
Current Age:	34		Abandoned Date:
Install Date:	1/1/1980		Red Tag Issue Date:
Last Used Date:	10/26/2013		Fee Due:	$0.00
Product Date:	1/1/1980

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Fiberglass Non-Corrosive	N/A	N/A
Corrosion Prot - Tank	Lining Materials Internal	2/5/2009	2/5/2014
Leak Detect - Piping	Mechanical Pressurized Line Leak Detection	2/1/2012	2/1/2013
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 300c
Overfill Prev Device	Overfill Drop Tube Valve
Piping	Fiberglass Single Wall Piping	N/A	N/A
Spill Contain Device	Single Wall Spill Bucket
Tank	Steel Single Wall	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Dispenser Information

MFD Motorfuel Dispensing Forms

No Forms Found