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:	2000802
Status:	Closed
Facility Name:	7-Eleven #21163
Address:	803 West Rollins Road Round Lake Beach, IL 60073
County:	Lake
Property Parcel:
Facility Type:	Attended Self-Service Station
Owner Type:	Private
Green Tag Decal:	J000268
Green Tag Issue Date:	5/8/2008
Green Tag Expiration Date:	12/31/2010

Owner Details

Owner Name:	7-Eleven, Inc.
Owner Address:	3200 Hackberry Road - Gas Compliance Irving, TX 75063
Owner Status:	Current Owner
Purchase Date:	1/1/1978
Type of Financial Responsibility:	Commercial Insurance
Financial Responsibility Reporting Due Date:	7/27/2010

Motor Fuel Dispensing Permits

MFD Permit Type	Issue Date	Expiration Date
Self Service	5/8/2008	12/31/2010

Owner Summary

Click for Facility/Tank Ownership history

Owner Number	Owner Name	Owner Status	Purchase Date
U0014207	7-Eleven, Inc.	Current Owner	1/1/1978

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
09-1140	10/15/2009	Removal Log	01172-2009REM
09-1140	10/14/2009	Removal Log	01172-2009REM

LUST Fund Eligibility and Deductibility Determinations

IEMA Number	Status	OSFM Received Date	OSFM Response Date	Deductible	Letter
09-1140	Eligible	4/7/2010	5/17/2010	$10,000

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:	10/14/2009
OSFM First Notify Date:	1/30/1986		Abandoned Material:
Current Age:	29		Abandoned Date:
Install Date:	1/30/1980		Red Tag Issue Date:
Last Used Date:	10/8/2009		Fee Due:	$0.00
Product Date:	1/30/1980

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Impressed Current Cathodic Protection
Corrosion Prot - Piping	Fiberglass Non-Corrosive	N/A	N/A
Corrosion Prot - Tank	Impressed Current Cathodic Protection
Leak Detect - Piping	Pressurized Line Leak Detection
Leak Detect - Tank	Automatic Tank Gauging
Overfill Prev Device	Overfill Drop Tube Valve
Piping	Fiberglass Single Wall Piping	N/A	N/A
Piping	Steel Single Wall Piping	N/A	N/A
Spill Contain Device	Manhole Field Constructed
Tank	Steel Single Wall	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 2

Capacity:	10000		Petroleum Use:
Product:	Gasoline		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	10/15/2009
OSFM First Notify Date:	1/30/1986		Abandoned Material:
Current Age:	29		Abandoned Date:
Install Date:	1/30/1980		Red Tag Issue Date:
Last Used Date:	10/8/2009		Fee Due:	$0.00
Product Date:	1/30/1980

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Impressed Current Cathodic Protection
Corrosion Prot - Piping	Fiberglass Non-Corrosive	N/A	N/A
Corrosion Prot - Tank	Impressed Current Cathodic Protection
Leak Detect - Piping	Pressurized Line Leak Detection
Leak Detect - Tank	Automatic Tank Gauging
Overfill Prev Device	Overfill Drop Tube Valve
Piping	Fiberglass Single Wall Piping	N/A	N/A
Piping	Steel Single Wall Piping	N/A	N/A
Spill Contain Device	Manhole Field Constructed
Tank	Steel Single Wall	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 3

Capacity:	10000		Petroleum Use:
Product:	Gasoline		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	10/15/2009
OSFM First Notify Date:	1/30/1986		Abandoned Material:
Current Age:	29		Abandoned Date:
Install Date:	1/30/1980		Red Tag Issue Date:
Last Used Date:	10/8/2009		Fee Due:	$0.00
Product Date:	1/30/1980

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Impressed Current Cathodic Protection
Corrosion Prot - Piping	Fiberglass Non-Corrosive	N/A	N/A
Corrosion Prot - Tank	Impressed Current Cathodic Protection
Leak Detect - Piping	Pressurized Line Leak Detection
Leak Detect - Tank	Automatic Tank Gauging
Overfill Prev Device	Overfill Drop Tube Valve
Piping	Fiberglass Single Wall Piping	N/A	N/A
Piping	Steel Single Wall Piping	N/A	N/A
Spill Contain Device	Manhole Field Constructed
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