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:	2020219
Status:	Active
Facility Name:	Fox Lake #5
Address:	49 N. US Hwy 12 Fox Lake, IL 60020
County:	Lake
Property Parcel:
Facility Type:	Attended Self-Service Station
Owner Type:	Private
Green Tag Decal:	Z000762
Green Tag Issue Date:	4/24/2024
Green Tag Expiration Date:	12/31/2026

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	4/24/2024	12/31/2026

Owner Summary

Click for Facility/Tank Ownership history

Owner Number	Owner Name	Owner Status	Purchase Date
U0025940	Graham C-Stores Co.	Current Owner
U0025666	Graham Oil Company	Former Owner	4/10/1997
U0006038	Graham C-Stores Company	Former Owner	4/20/1995
U0001237	Kaczmarek, Tom	Former Owner	12/31/1967

Permits (Unexpired)

Click for permit history

No Active Permits Found

Deficiencies (Current)

No Deficiencies Found

IEMA Numbers Associated with the Facility

No IEMA Numbers Found

LUST Fund Eligibility and Deductibility Determinations

No Applications Found

Pay Tank Fees Online

Tank Information

Tank Number 1

Capacity:	8000		Petroleum Use:
Product:	Gasoline		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	6/14/1995
OSFM First Notify Date:	4/5/1986		Abandoned Material:
Current Age:	27		Abandoned Date:
Install Date:			Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
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 2

Capacity:	8000		Petroleum Use:
Product:	Gasoline		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	6/14/1995
OSFM First Notify Date:	4/5/1986		Abandoned Material:
Current Age:	27		Abandoned Date:
Install Date:			Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
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 3

Capacity:	560		Petroleum Use:
Product:	Kerosene		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	6/8/1988
OSFM First Notify Date:	4/5/1986		Abandoned Material:
Current Age:	27		Abandoned Date:
Install Date:			Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
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 4

Capacity:	560		Petroleum Use:
Product:	Kerosene		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	6/1/1988
OSFM First Notify Date:	4/5/1986		Abandoned Material:
Current Age:	27		Abandoned Date:
Install Date:			Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
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 5

Capacity:	12000		Petroleum Use:
Product:	Gasoline - Regular		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	3/4/1996		Abandoned Material:
Current Age:	28		Abandoned Date:
Install Date:	9/21/1995		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Sacrificial Anode Flex Connector	8/8/2023	8/8/2026
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	8/1/2023	8/1/2024
Leak Detect - Piping	Siphon Bar	N/A	N/A
Leak Detect - Tank	Non-Discriminating Interstitial Monitoring Sensors With Monitor	8/1/2023	8/1/2024
Overfill Prev Device	Overfill Drop Tube Valve	6/20/2022	6/20/2025
Piping	Polyethylene Chase	N/A	N/A
Piping	Fiberglass Single Wall Piping Ameron	N/A	N/A
Piping	Single Wall STP/Tanktop Sump
Leak Detect - Piping	Piping Sump Sensors Not Regulated Not Installed	N/A	N/A
Spill Contain Device	Single Wall Spill Bucket	6/20/2022	6/20/2025
Tank	Composite Double Wall Permatank	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Piping	Fiberglass Single Wall Piping Ameron	Precision Test	Pass	8/1/2023

Tank Number 6

Capacity:	6000		Petroleum Use:
Product:	Gasoline - Regular		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	3/4/1996		Abandoned Material:
Current Age:	28		Abandoned Date:
Install Date:	9/21/1995		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Sacrificial Anode Flex Connector	8/8/2023	8/8/2026
Corrosion Prot - Piping	Fiberglass Non-Corrosive	N/A	N/A
Corrosion Prot - Tank	Composite Non-Corrosive	N/A	N/A
Leak Detect - Piping	Mechanical Other Non-vented check valve	N/A	N/A
Leak Detect - Piping	Siphon Bar	N/A	N/A
Leak Detect - Tank	Non-Discriminating Interstitial Monitoring Sensors With Monitor	8/1/2023	8/1/2024
Overfill Prev Device	Overfill Drop Tube Valve	6/20/2022	6/20/2025
Piping	Polyethylene Chase	N/A	N/A
Piping	Fiberglass Single Wall Piping Ameron	N/A	N/A
Piping	Single Wall STP/Tanktop Sump
Leak Detect - Piping	Piping Sump Sensors Not Regulated Not Installed	N/A	N/A
Spill Contain Device	Single Wall Spill Bucket	6/20/2022	6/20/2025
Tank	Composite Double Wall Permatank	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Piping	Fiberglass Single Wall Piping Ameron	Precision Test	Pass	8/1/2023

Tank Number 7

Capacity:	6000		Petroleum Use:
Product:	Gasoline - Premium		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	3/4/1996		Abandoned Material:
Current Age:	28		Abandoned Date:
Install Date:	9/21/1995		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Sacrificial Anode Flex Connector	8/8/2023	8/8/2026
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	8/1/2023	8/1/2024
Leak Detect - Tank	Non-Discriminating Interstitial Monitoring Sensors With Monitor	8/1/2023	8/1/2024
Overfill Prev Device	Overfill Drop Tube Valve	6/20/2022	6/20/2025
Piping	Polyethylene Chase	N/A	N/A
Piping	Fiberglass Single Wall Piping Ameron	N/A	N/A
Piping	Single Wall STP/Tanktop Sump
Leak Detect - Piping	Piping Sump Sensors Not Regulated Not Installed	N/A	N/A
Spill Contain Device	Single Wall Spill Bucket	6/20/2022	6/20/2025
Tank	Composite Double Wall Permatank	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Piping	Fiberglass Single Wall Piping Ameron	Precision Test	Pass	8/1/2023

Tank Number 8

Capacity:	10000		Petroleum Use:	None
Product:	Diesel Fuel		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	3/4/1996		Abandoned Material:
Current Age:	28		Abandoned Date:
Install Date:	9/21/1995		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Sacrificial Anode Flex Connector	8/8/2023	8/8/2026
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	8/1/2023	8/1/2024
Leak Detect - Tank	Non-Discriminating Interstitial Monitoring Sensors With Monitor	8/1/2023	8/1/2024
Overfill Prev Device	Overfill Drop Tube Valve	6/20/2022	6/20/2025
Piping	Polyethylene Chase	N/A	N/A
Piping	Fiberglass Single Wall Piping Ameron	N/A	N/A
Piping	Single Wall STP/Tanktop Sump
Leak Detect - Piping	Piping Sump Sensors Not Regulated Not Installed	N/A	N/A
Spill Contain Device	Single Wall Spill Bucket	6/20/2022	6/20/2025
Tank	Composite Double Wall Permatank	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Piping	Fiberglass Single Wall Piping Ameron	Precision Test	Pass	8/1/2023

Tank Number 9

Capacity:	2000		Petroleum Use:
Product:	Racing Fuel		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	3/4/1996		Abandoned Material:
Current Age:	28		Abandoned Date:
Install Date:	9/21/1995		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:

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	European with No Test Req Suction	N/A	N/A
Leak Detect - Tank	Non-Discriminating Interstitial Monitoring Sensors With Monitor	8/1/2023	8/1/2024
Overfill Prev Device	Overfill Drop Tube Valve	6/20/2022	6/20/2025
Piping	Fiberglass Single Wall Piping Ameron	N/A	N/A
Piping	Single Wall STP/Tanktop Sump
Leak Detect - Piping	Piping Sump Sensors Not Regulated Not Installed	N/A	N/A
Spill Contain Device	Single Wall Spill Bucket	6/20/2022	6/20/2025
Tank	Composite Double Wall Permatank	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Dispenser Information

Name\ID 1/2

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump
Leak Detect - Piping	Piping Sump Sensors Not Regulated Not Installed	N/A	N/A

Name\ID 11/12

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump
Leak Detect - Piping	Piping Sump Sensors Not Regulated Not Installed	N/A	N/A

Name\ID 13

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump
Leak Detect - Piping	Piping Sump Sensors Not Regulated Not Installed	N/A	N/A

Name\ID 3/4

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump
Leak Detect - Piping	Piping Sump Sensors Not Regulated Not Installed	N/A	N/A

Name\ID 5/6

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump
Leak Detect - Piping	Piping Sump Sensors Not Regulated Not Installed	N/A	N/A

Name\ID 7/8

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump
Leak Detect - Piping	Piping Sump Sensors Not Regulated Not Installed	N/A	N/A

Name\ID 9/10

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump
Leak Detect - Piping	Piping Sump Sensors Not Regulated Not Installed	N/A	N/A

MFD Motorfuel Dispensing Forms

No Forms Found