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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:	2020418
Status:	Active
Facility Name:	Cedar Lake Clark
Address:	1010 Cedar Lake Road Round Lake Beach, IL 60073
County:	Lake
Property Parcel:
Facility Type:	Attended Self-Service/Unattended Self-Service
Owner Type:	Private
Green Tag Decal:	Y001205
Green Tag Issue Date:	1/12/2023
Green Tag Expiration Date:	12/31/2025

Owner Details

Owner Name:	Amanda Li
Owner Address:	1010 N. Cedar Lake Rd. Round Lake Beach, IL 60073
Owner Status:	Current Owner
Purchase Date:	4/27/2015
Type of Financial Responsibility:	Designated Savings Account
Financial Responsibility Reporting Due Date:	2/12/2025

Motor Fuel Dispensing Permits

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

Owner Summary

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Owner Number	Owner Name	Owner Status	Purchase Date
U0037877	Li, Amanda	Current Owner	4/27/2015
U0036818	1010 Cedar Lake, Inc.	Former Owner	2/28/2013
U0029854	Eiserman, Michael and Jeffrey,	Former Owner	4/19/1999
U0008300	National Oil Company	Former Owner	7/15/1965

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
02-0296	7/26/2016	Abandonment Log	00836-2016ABN

LUST Fund Eligibility and Deductibility Determinations

IEMA Number	Status	OSFM Received Date	OSFM Response Date	Deductible	Letter
93-2336	Eligible	11/18/1994	12/13/1994	$10,000
02-0296	Eligible	12/30/2004	1/20/2005	$15,000
02-0296	Eligible	3/11/2013	4/5/2013	$15,000

Pay Tank Fees Online

Tank Information

Tank Number	Capacity	Product	Status	Regulated Status	Red Tag Issued	Fee Due	Abandon/Removal Date
1	4000	Gasoline	Abandoned in place	Federal		$0.00	07/26/2016 - ABN
2	4000	Gasoline	Abandoned in place	Federal		$0.00	02/15/2002 - ABN
3	4000	Gasoline - Premium	Currently in use	Federal		$0.00
4	8000	Gasoline - Regular	Currently in use	Federal		$0.00

Dispenser Information

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

MFD Motorfuel Dispensing Forms

No Forms Found