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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

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Facility Details

Facility Number:	2009880
Status:	Active
Facility Name:	Fox Lake Mobil
Address:	95 E. Grand Ave. Fox Lake, IL 60020
County:	Lake
Property Parcel:
Facility Type:	Attended Self-Service Station
Owner Type:	Private
Green Tag Decal:	Y001228
Green Tag Issue Date:	3/30/2023
Green Tag Expiration Date:	12/31/2025

Owner Details

Owner Name:	Karim Ebrahim
Owner Address:	95 E. Grand Ave. Fox Lake, IL 60020
Owner Status:	Current Owner
Purchase Date:	7/26/2015
Type of Financial Responsibility:	Designated Savings Account
Financial Responsibility Reporting Due Date:	4/1/2024

Motor Fuel Dispensing Permits

MFD Permit Type	Issue Date	Expiration Date
Self Service	1/5/2023	12/31/2025

Owner Summary

Click for Facility/Tank Ownership history

Owner Number	Owner Name	Owner Status	Purchase Date
U0038673	Ebrahim, Karim	Current Owner	7/26/2015
U0031502	Grand Avenue Mini Mart & Gas, Inc.	Former Owner	9/3/2003
U0003073	Clark Retail Enterprises, Inc.	Former Owner	11/22/1988
U0029789	Clark Retail Enterprises, Inc.	Former Owner
U0028787	Clark Retail Enterprises, Inc.,	Former Owner

Permits (Unexpired)

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No Active Permits Found

Deficiencies (Current)

No Deficiencies Found

IEMA Numbers Associated with the Facility

IEMA Number	Inspection Date	Inspection Type	Permit Number
06-1286	5/17/2007	Removal Log	00569-2007REM

LUST Fund Eligibility and Deductibility Determinations

IEMA Number	Status	OSFM Received Date	OSFM Response Date	Deductible	Letter
95-1100	Eligible	8/29/1995	10/13/1995	$10,000
95-1100	Eligible	5/6/2004	5/19/2004	$10,000
95-1100	Returned	9/8/2004	9/21/2004	$Not Selected
95-1100	Eligible	10/4/2004	10/13/2004	$10,000
06-1286	Eligible	10/23/2006	11/1/2006	$10,000

Pay Tank Fees Online

Tank Information

Tank Number	Capacity	Product	Status	Regulated Status	Red Tag Issued	Fee Due	Abandon/Removal Date
1	4000	Gasoline	Removed	Federal		$0.00	05/17/2007 - REM
2	4000	Gasoline	Removed	Federal		$0.00	05/17/2007 - REM
3	4000	Gasoline	Removed	Federal		$0.00	05/17/2007 - REM
4	4000	Gasoline	Removed	Federal		$0.00	05/17/2007 - REM
5	12000	Gasoline - Regular	Currently in use	Federal		$0.00
6	4000	Gasoline - Premium	Currently in use	Federal		$0.00

Dispenser Information

Name\ID	Status
1/2	Active
3/4	Active
5/6	Active

MFD Motorfuel Dispensing Forms

No Forms Found