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:	2010685
Status:	Active
Facility Name:	Lake Zurich #3
Address:	1 N. Rand Road Lake Zurich, IL 60047
County:	Lake
Property Parcel:	14-18-300-040
Facility Type:	Attended Self-Service Station
Owner Type:	Private
Green Tag Decal:	Y001217
Green Tag Issue Date:	2/23/2023
Green Tag Expiration Date:	12/31/2025

Owner Details

Owner Name:	Graham C-Stores Co.
Owner Address:	39109 N. US Hwy 41 Wadsworth, IL 60083
Owner Status:	Current Owner
Purchase Date:
Type of Financial Responsibility:	Commercial Insurance
Financial Responsibility Reporting Due Date:	6/28/2024

Motor Fuel Dispensing Permits

MFD Permit Type	Issue Date	Expiration Date
Self Service	2/23/2023	12/31/2025

Owner Summary

Click for Facility/Tank Ownership history

Owner Number	Owner Name	Owner Status	Purchase Date
U0025940	Graham C-Stores Co.	Current Owner
U0006038	Graham C-Stores Company	Former Owner	7/15/1992
U0002208	Butt Richard	Former Owner	12/31/1967
U0027627	Graham C-Stores Co.	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
00-0529	1/29/2001	Removal Log	00089-2001REM
00-0529	3/12/2001	Removal Log	00236-2001REM

LUST Fund Eligibility and Deductibility Determinations

IEMA Number	Status	OSFM Received Date	OSFM Response Date	Deductible	Letter
00-0529	Eligible	4/26/2000	5/9/2000	$10,000

Pay Tank Fees Online

Tank Information

Tank Number 1

Capacity:	8000		Petroleum Use:
Product:	Gasoline - Regular		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	5/8/1986		Abandoned Material:
Current Age:	42		Abandoned Date:
Install Date:	6/9/1981		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	6/9/1981

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Fiberglass Non-Corrosive	N/A	N/A
Corrosion Prot - Tank	Fiberglass Non-Corrosive	N/A	N/A
Leak Detect - Piping	Mechanical Other Non-vented check valve	N/A	N/A
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 350	5/16/2024	5/16/2025
Overfill Prev Device	Overfill Alarm	2/23/2023	2/23/2026
Overfill Prev Device	Overfill Drop Tube Valve	2/23/2023	2/23/2026
Piping	Flexible Double Wall NUPI Smartflex	N/A	N/A
Piping	Single Wall STP/Tanktop Sump	2/22/2023	2/22/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	5/16/2024	5/16/2025
Spill Contain Device	Single Wall Spill Bucket	2/22/2023	2/22/2026
Tank	Fiberglass Single Wall	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Piping	Fiberglass Double Wall Ameron Dualoy 3000/LCX	Precision Test	Pass	8/19/2022
Piping	Flexible Double Wall NUPI Smartflex	Precision Test	Pass	5/16/2024
Tank	Fiberglass Single Wall	Precision Test (Tank)	Pass	2/22/2023

Tank Number 2

Capacity:	6000		Petroleum Use:
Product:	Gasoline - Premium		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	5/8/1986		Abandoned Material:
Current Age:	42		Abandoned Date:
Install Date:	6/9/1981		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	6/9/1981

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Fiberglass Non-Corrosive	N/A	N/A
Corrosion Prot - Tank	Fiberglass Non-Corrosive	N/A	N/A
Leak Detect - Piping	Electronic Pressurized Line Leak Detection	5/16/2024	5/16/2025
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 350	5/16/2024	5/16/2025
Overfill Prev Device	Overfill Alarm	2/23/2023	2/23/2026
Overfill Prev Device	Overfill Drop Tube Valve	2/23/2023	2/23/2026
Piping	Flexible Double Wall NUPI Smartflex	N/A	N/A
Piping	Single Wall STP/Tanktop Sump	2/22/2023	2/22/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	5/16/2024	5/16/2025
Spill Contain Device	Single Wall Spill Bucket	2/22/2023	2/22/2026
Tank	Fiberglass Single Wall	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Piping	Fiberglass Double Wall Ameron Dualoy 3000/LCX	Precision Test	Pass	8/19/2022
Piping	Flexible Double Wall NUPI Smartflex	Precision Test	Pass	5/16/2024
Tank	Fiberglass Single Wall	Precision Test (Tank)	Pass	2/22/2023

Tank Number 3

Capacity:	6000		Petroleum Use:
Product:	Diesel Fuel		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	5/8/1986		Abandoned Material:
Current Age:	42		Abandoned Date:
Install Date:	6/9/1981		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	6/9/1981

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Fiberglass Non-Corrosive	N/A	N/A
Corrosion Prot - Tank	Fiberglass Non-Corrosive	N/A	N/A
Leak Detect - Piping	Electronic Pressurized Line Leak Detection	5/16/2024	5/16/2025
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 350	5/16/2024	5/16/2025
Overfill Prev Device	Overfill Alarm	2/23/2023	2/23/2026
Overfill Prev Device	Overfill Drop Tube Valve	2/23/2023	2/23/2026
Piping	Flexible Double Wall NUPI Smartflex	N/A	N/A
Piping	Single Wall STP/Tanktop Sump	2/22/2023	2/22/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	5/16/2024	5/16/2025
Spill Contain Device	Single Wall Spill Bucket	2/22/2023	2/22/2026
Tank	Fiberglass Single Wall	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Piping	Fiberglass Double Wall Ameron Dualoy 3000/LCX	Precision Test	Pass	8/19/2022
Piping	Flexible Double Wall NUPI Smartflex	Precision Test	Pass	5/16/2024
Tank	Fiberglass Single Wall	Precision Test (Tank)	Pass	2/22/2023

Tank Number 4

Capacity:	12000		Petroleum Use:
Product:	Gasoline		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	3/12/2001
OSFM First Notify Date:	4/15/2001		Abandoned Material:
Current Age:	0		Abandoned Date:
Install Date:	1/23/2001		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	1/24/2001

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Fiberglass Non-Corrosive	N/A	N/A
Corrosion Prot - Tank	Composite Non-Corrosive	N/A	N/A
Leak Detect - Piping	Electronic Pressurized Line Leak Detection
Leak Detect - Piping	Sump Sensor
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 350
Leak Detect - Tank	Non-Discriminating Interstitial Monitoring Sensors
Overfill Prev Device	Overfill Drop Tube Valve
Piping	Flexible Double Wall Ameron Flex III	N/A	N/A
Spill Contain Device	Single Wall Spill Bucket
Tank	Composite Double Wall Glasteel II	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 5

Capacity:	550		Petroleum Use:
Product:	Heating Oil		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	State		Removed Date:	1/29/2001
OSFM First Notify Date:	1/22/2001		Abandoned Material:
Current Age:			Abandoned Date:
Install Date:			Red Tag Issue Date:
Last Used Date:	12/31/1970		Fee Due:
Product Date:

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 6

Capacity:	12000		Petroleum Use:
Product:	Gasoline - Regular		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	6/21/2001		Abandoned Material:
Current Age:	23		Abandoned Date:
Install Date:	3/14/2001		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	3/14/2001

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Fiberglass Non-Corrosive	N/A	N/A
Corrosion Prot - Tank	Fiberglass Non-Corrosive	N/A	N/A
Leak Detect - Piping	Electronic Pressurized Line Leak Detection	5/16/2024	5/16/2025
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 350	5/16/2024	5/16/2025
Leak Detect - Tank	Non-Discriminating Interstitial Monitoring Sensors	5/16/2024	5/16/2025
Overfill Prev Device	Overfill Alarm	2/23/2023	2/23/2026
Overfill Prev Device	Overfill Drop Tube Valve	2/23/2023	2/23/2026
Piping	Flexible Double Wall NUPI Smartflex	N/A	N/A
Piping	Single Wall STP/Tanktop Sump	2/22/2023	2/22/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	5/16/2024	5/16/2025
Spill Contain Device	Single Wall Spill Bucket	2/22/2023	2/22/2026
Tank	Composite Double Wall Glasteel II	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Piping	Fiberglass Double Wall Ameron Dualoy 3000/LCX	Precision Test	Pass	8/19/2022
Piping	Flexible Double Wall NUPI Smartflex	Precision Test	Pass	5/16/2024
Tank	Composite Double Wall Glasteel II	Precision Test (Tank)	Pass	2/22/2023

Dispenser Information

Name\ID 1/2

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	2/22/2023	2/22/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	5/16/2024	5/16/2025

Name\ID 11/12

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	2/22/2023	2/22/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	5/16/2024	5/16/2025

Name\ID 13/14

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	2/22/2023	2/22/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	5/16/2024	5/16/2025

Name\ID 15/16

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	2/22/2023	2/22/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	5/16/2024	5/16/2025

Name\ID 17/18

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	2/22/2023	2/22/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	5/16/2024	5/16/2025

Name\ID 3/4

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	2/22/2023	2/22/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	5/16/2024	5/16/2025

Name\ID 5/6

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	2/22/2023	2/22/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	5/16/2024	5/16/2025

Name\ID 7/8

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	2/22/2023	2/22/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	5/16/2024	5/16/2025

Name\ID 9/10

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	2/22/2023	2/22/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	5/16/2024	5/16/2025

MFD Motorfuel Dispensing Forms

No Forms Found