Division of Petroleum & Chemical Safety

 

Facility Details

Facility Number: 2020667
Status: Active
Facility Name: Lake Bluff Petroleum, Inc.
Address: 218 N. Waukegan Rd.
Lake Bluff, IL 60044
County: Lake
Property Parcel:
Facility Type: Self-Service Station
Motor Fuel Type: Self Service
Owner Type: Private
Green Tag Decal: S005249
Green Tag Issue Date: 10/5/2017
Green Tag Expiration Date: 12/31/2019
Motor Fuel Dispensing Permit Inspection Date: 10/5/2017
Motor Fuel Dispensing Permit Expiration Date: 12/31/2019

Owner Details

Owner Name: Muhammad Ansari
Owner Address: 218 N. Waukegan Road
Lake Bluff, IL 60044
Owner Status: Current Owner
Purchase Date:
Type of Financial Responsibility: Commercial Insurance
Financial Responsibility Reporting Due Date: 5/31/2019

Owner Summary

Click for Facility/Tank Ownership history
Owner Number Owner Name Owner Status Purchase Date
U0036922 Ansari, Muhammad Current Owner
U0036558 Lake Bluff Petroleum, Inc. Former Owner 6/13/2012
U0035269 Alliance Oil Corp. Former Owner 3/27/2009
U0034207 A S & K 5, Inc. Former Owner 5/23/2007
U0032773 218 Waukegan, Inc., Former Owner 3/24/2005
U0032209 Combined Real Estate, LLC Former Owner 7/16/2004
U0007721 J & L Oil Co., Inc. Former Owner 9/1/1970

Permits (Unexpired)

Click for permit history
Permit Number Type Status OSFM Receive Date Issue Date Expiration Date Documents
01384-2018UPG Upgrade Approved / Issued 9/21/2018 9/24/2018 3/26/2019 Documents

Deficiencies (Current)

No Deficiencies Found

IEMA Numbers Associated with the Facility

IEMA Number Inspection Date Inspection Type Permit Number
13-0392 5/2/2013 Removal Log 00315-2013REM
13-0392 5/3/2013 Removal Log 00315-2013REM

LUST Fund Eligibility and Deductibility Determinations

IEMA Number Status OSFM Received Date OSFM Response Date Deductible Letter
13-0392 Eligible 5/1/2013 6/25/2013 $5,000

Tank Information



Tank Number 1

Capacity: 10000 Petroleum Use:
Product: Gasoline CERCLA Substance:
Status: Removed CAS Code:
Regulated Status: Federal Removed Date: 5/3/2013
OSFM First Notify Date: 4/28/1986 Abandoned Material:
Current Age: 42 Abandoned Date:
Install Date: 9/1/1970 Red Tag Issue Date:
Last Used Date: Fee Due: $0.00
Product Date: 9/1/1970
Equipment Type Equipment Last Passing Date Test Expire Date
Corrosion Prot - Piping Cathodic Protection 12/7/2010 12/7/2011
Corrosion Prot - Piping Fiberglass Non-Corrosive N/A N/A
Corrosion Prot - Tank Impressed Current Cathodic Protection 12/7/2010 12/7/2011
Corrosion Prot - Tank Lining Materials Internal Armor Shield TL 300M 2/28/2008 2/28/2013
Leak Detect - Piping Electronic Pressurized Line Leak Detection Veeder Root TLS 350 4/30/2010 4/30/2011
Leak Detect - Tank Automatic Tank Gauging Veeder Root TLS 350
Overfill Prev Device Ball Float Vent Valve OPW 53
Overfill Prev Device Overfill Alarm Veeder Root TLS 350
Piping Fiberglass Double Wall Ameron N/A N/A
Piping Fiberglass Single Wall Piping N/A N/A
Spill Contain Device Single Wall Spill Bucket EBW 705
Tank Steel Single Wall Tank N/A N/A



Tank Number 2

Capacity: 6000 Petroleum Use:
Product: Gasoline CERCLA Substance:
Status: Removed CAS Code:
Regulated Status: Federal Removed Date: 5/2/2013
OSFM First Notify Date: 4/28/1986 Abandoned Material:
Current Age: 42 Abandoned Date:
Install Date: 9/1/1970 Red Tag Issue Date:
Last Used Date: Fee Due: $0.00
Product Date: 9/1/1970
Equipment Type Equipment Last Passing Date Test Expire Date
Corrosion Prot - Piping Cathodic Protection 12/7/2010 12/7/2011
Corrosion Prot - Piping Fiberglass Non-Corrosive N/A N/A
Corrosion Prot - Tank Impressed Current Cathodic Protection 12/7/2010 12/7/2011
Corrosion Prot - Tank Lining Materials Internal Armor Shield TL 300M 2/28/2008 2/28/2013
Leak Detect - Piping Electronic Pressurized Line Leak Detection Veeder Root TLS 350 4/30/2010 4/30/2011
Leak Detect - Tank Automatic Tank Gauging Veeder Root TLS 350
Overfill Prev Device Ball Float Vent Valve OPW 53
Overfill Prev Device Overfill Alarm Veeder Root TLS 350
Piping Fiberglass Double Wall Ameron N/A N/A
Piping Fiberglass Single Wall Piping N/A N/A
Spill Contain Device Single Wall Spill Bucket EBW 705
Tank Steel Single Wall Tank N/A N/A



Tank Number 3

Capacity: 6000 Petroleum Use:
Product: Gasoline CERCLA Substance:
Status: Removed CAS Code:
Regulated Status: Federal Removed Date: 5/2/2013
OSFM First Notify Date: 4/28/1986 Abandoned Material:
Current Age: 42 Abandoned Date:
Install Date: 9/1/1970 Red Tag Issue Date:
Last Used Date: Fee Due: $0.00
Product Date: 9/1/1970
Equipment Type Equipment Last Passing Date Test Expire Date
Corrosion Prot - Piping Cathodic Protection 12/7/2010 12/7/2011
Corrosion Prot - Piping Fiberglass Non-Corrosive N/A N/A
Corrosion Prot - Tank Impressed Current Cathodic Protection 12/7/2010 12/7/2011
Corrosion Prot - Tank Lining Materials Internal Armor Shield TL 300M 2/28/2008 2/28/2013
Leak Detect - Piping Electronic Pressurized Line Leak Detection Veeder Root TLS 350 4/30/2010 4/30/2011
Leak Detect - Tank Automatic Tank Gauging Veeder Root TLS 350
Overfill Prev Device Ball Float Vent Valve OPW 53
Overfill Prev Device Overfill Alarm Veeder Root TLS 350
Piping Fiberglass Double Wall Ameron N/A N/A
Piping Fiberglass Single Wall Piping N/A N/A
Spill Contain Device Single Wall Spill Bucket EBW 705
Tank Steel Single Wall Tank N/A N/A



Tank Number 4

Capacity: 12000 Petroleum Use:
Product: Gasoline - Regular CERCLA Substance:
Status: Currently in use CAS Code:
Regulated Status: Federal Removed Date:
OSFM First Notify Date: 6/26/2013 Abandoned Material:
Current Age: 5 Abandoned Date:
Install Date: 5/8/2013 Red Tag Issue Date:
Last Used Date: Fee Due: $0.00
Product Date:
Equipment Type Equipment Last Passing Date Test Expire Date
Corrosion Prot - Piping Flexible Non-Corrosive N/A N/A
Corrosion Prot - Tank Composite Non-Corrosive N/A N/A
Leak Detect - Piping Mechanical Pressurized Line Leak Detection FE Petro STP-MLD 10/11/2018 10/11/2019
Leak Detect - Piping Non-Discriminating Sump Sensor Interstitial Monitoring Veeder Root 10/11/2018 10/11/2019
Leak Detect - Tank Automatic Tank Gauging Veeder Root TLS 350 10/11/2018 10/11/2019
Leak Detect - Tank Interstitial Monitoring Veeder Root TLS 350 10/11/2018 10/11/2019
Overfill Prev Device Overfill Drop Tube Valve OPW 61SO 10/11/2018 10/11/2021
Overfill Prev Device Overfill Alarm Veeder Root TLS 350 11/8/2018 11/8/2021
Piping Flexible Double Wall A.P.T. Poly Tech P175SC N/A N/A
Spill Contain Device Single Wall Spill Bucket OPW 1-2100 10/11/2018 10/11/2021
Tank Composite Double Wall Lannon N/A N/A



Tank Number 5

Capacity: 4000 Petroleum Use:
Product: Gasoline - Premium CERCLA Substance:
Status: Currently in use CAS Code:
Regulated Status: Federal Removed Date:
OSFM First Notify Date: 6/26/2013 Abandoned Material:
Current Age: 5 Abandoned Date:
Install Date: 5/8/2013 Red Tag Issue Date:
Last Used Date: Fee Due: $0.00
Product Date:
Equipment Type Equipment Last Passing Date Test Expire Date
Corrosion Prot - Piping Flexible Non-Corrosive N/A N/A
Corrosion Prot - Tank Composite Non-Corrosive N/A N/A
Leak Detect - Piping Mechanical Pressurized Line Leak Detection FE Petro STP-MLD 10/11/2018 10/11/2019
Leak Detect - Piping Non-Discriminating Sump Sensor Interstitial Monitoring Veeder Root 10/11/2018 10/11/2019
Leak Detect - Tank Automatic Tank Gauging Veeder Root TLS 350 10/11/2018 10/11/2019
Leak Detect - Tank Interstitial Monitoring Veeder Root TLS 350 10/11/2018 10/11/2019
Overfill Prev Device Overfill Drop Tube Valve OPW 61SO 10/11/2018 10/11/2021
Overfill Prev Device Overfill Alarm Veeder Root TLS 350 11/8/2018 11/8/2021
Piping Flexible Double Wall A.P.T. Poly Tech P175SC N/A N/A
Spill Contain Device Single Wall Spill Bucket OPW 1-2100 10/11/2018 10/11/2021
Tank Composite Double Wall Lannon N/A N/A

Dispenser Information



MFD Motorfuel Dispensing Forms

No Forms Found