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:	2024022
Status:	Active
Facility Name:	Jesse Brown VA Medical Center
Address:	820 S. Damen Chicago, IL 60612
County:	Cook
Property Parcel:
Facility Type:	Federal (Non-Military)
Owner Type:	Federal
Green Tag Decal:	X004005
Green Tag Issue Date:	10/18/2022
Green Tag Expiration Date:	12/31/2024

Owner Details

Owner Name:	VA Westside Medical Center
Owner Address:	820 S. Damen Chicago, IL 60612
Owner Status:	Current Owner
Purchase Date:
Type of Financial Responsibility:	Self-Insurance
Financial Responsibility Reporting Due Date:	3/29/2024

Motor Fuel Dispensing Permits

No MFD Permits Found

Owner Summary

Click for Facility/Tank Ownership history

Owner Number	Owner Name	Owner Status	Purchase Date
U0015583	VA Westside Medical Center	Current 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
19-0627	7/19/2019	Abandonment Log	01226-2019ABN

LUST Fund Eligibility and Deductibility Determinations

No Applications Found

Pay Tank Fees Online

Tank Information

Tank Number 1

Capacity:	10000		Petroleum Use:	None
Product:	Diesel Fuel		CERCLA Substance:
Status:	Abandoned in place		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	9/25/1986		Abandoned Material:	Inert material mixed with portland cement
Current Age:	39		Abandoned Date:	7/19/2019
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
Corrosion Prot - Piping	Fiberglass Non-Corrosive	N/A	N/A
Corrosion Prot - Tank	Fiberglass Non-Corrosive	N/A	N/A
Leak Detect - Piping	European with No Test Req Suction	N/A	N/A
Leak Detect - Piping	Sump Sensor	2/22/2018	2/22/2019
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 300c with CSLD
Leak Detect - Tank	Hydrostatic Reservoir Interstitial Monitoring Sensors	2/22/2018	2/22/2019
Overfill Prev Device	Overfill Alarm
Overfill Prev Device	Overfill Drop Tube Valve
Piping	Fiberglass Double Wall	N/A	N/A
Spill Contain Device	Single Wall Spill Bucket
Tank	Fiberglass Double Wall	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 2

Capacity:	500		Petroleum Use:
Product:	Diesel Fuel		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	8/24/2012
OSFM First Notify Date:	9/25/1986		Abandoned Material:
Current Age:	39		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:	10000		Petroleum Use:	Back-up Generator
Product:	Diesel Fuel		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	11/15/2007		Abandoned Material:
Current Age:	16		Abandoned Date:
Install Date:	9/19/2007		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	9/20/2007

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	European with No Test Req Suction	N/A	N/A
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 300c	4/22/2024	4/22/2025
Leak Detect - Tank	Non-Discriminating Interstitial Monitoring Sensors	4/22/2024	4/22/2025
Overfill Prev Device	Overfill Alarm	1/27/2022	1/27/2025
Overfill Prev Device	Overfill Drop Tube Valve	1/27/2022	1/27/2025
Piping	Fiberglass Double Wall	N/A	N/A
Piping	Single Wall STP/Tanktop Sump	1/27/2022	1/27/2025
Piping	Single Wall Transition Sump	1/27/2022	1/27/2025
Leak Detect - Piping	Sump Sensor	4/22/2024	4/22/2025
Spill Contain Device	Single Wall Spill Bucket	1/27/2022	1/27/2025
Tank	Fiberglass Double Wall	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 4

Capacity:	4000		Petroleum Use:
Product:	Gasoline		CERCLA Substance:
Status:	Does Not Exist		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:			Abandoned Material:
Current Age:			Abandoned Date:
Install Date:			Red Tag Issue Date:
Last Used Date:			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 5

Capacity:	12000		Petroleum Use:
Product:	Gasoline		CERCLA Substance:
Status:	Does Not Exist		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:			Abandoned Material:
Current Age:			Abandoned Date:
Install Date:			Red Tag Issue Date:
Last Used Date:			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:	4000		Petroleum Use:
Product:	Diesel Fuel		CERCLA Substance:
Status:	Does Not Exist		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:			Abandoned Material:
Current Age:			Abandoned Date:
Install Date:			Red Tag Issue Date:
Last Used Date:			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 7

Capacity:	20000		Petroleum Use:	Back-up Generator
Product:	Diesel Fuel		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	7/18/2013		Abandoned Material:
Current Age:	11		Abandoned Date:
Install Date:	11/15/2012		Red Tag Issue Date:
Last Used Date:			Fee Due:
Product Date:	4/24/2013

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	4/22/2024	4/22/2025
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 350 Plus	4/22/2024	4/22/2025
Leak Detect - Tank	Non-Discriminating Interstitial Monitoring Sensors	4/22/2024	4/22/2025
Overfill Prev Device	Overfill Alarm	1/27/2022	1/27/2025
Overfill Prev Device	Overfill Drop Tube Valve	1/27/2022	1/27/2025
Piping	Fiberglass Double Wall Ameron Dualoy 3000/LCX	N/A	N/A
Piping	Single Wall STP/Tanktop Sump	1/27/2022	1/27/2025
Piping	Single Wall Transition Sump	1/27/2022	1/27/2025
Leak Detect - Piping	Discriminating Sump Sensor
Leak Detect - Piping	Non-Discriminating Sump Sensor	2/22/2018	2/22/2019
Leak Detect - Piping	Non-Discriminating Sump Sensor with positive shutdown	1/27/2022	1/27/2023
Leak Detect - Piping	Discriminating Sump Sensor with positive shutdown	3/16/2023	3/16/2024
Leak Detect - Piping	Sump Sensor	4/22/2024	4/22/2025
Spill Contain Device	Single Wall Spill Bucket	1/27/2022	1/27/2025
Tank	Fiberglass Double Wall XERXES	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Dispenser Information

MFD Motorfuel Dispensing Forms

No Forms Found