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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:	2025658
Status:	Active
Facility Name:	Roosevelt 66
Address:	905 W. Roosevelt Maywood, IL 60153
County:	Cook
Property Parcel:	15-15-431-036-0000
Facility Type:	Attended Self-Service Station
Owner Type:	Private
Green Tag Decal:	Y002123
Green Tag Issue Date:	12/11/2023
Green Tag Expiration Date:	12/31/2025

Owner Details

Owner Name:	Pothen Vallikalam
Owner Address:	5335 N. Meade Avenue Chicago, IL 60630
Owner Status:	Current Owner
Purchase Date:
Type of Financial Responsibility:	Commercial Insurance
Financial Responsibility Reporting Due Date:	12/11/2024

Motor Fuel Dispensing Permits

MFD Permit Type	Issue Date	Expiration Date
Self Service	12/11/2023	12/31/2025

Owner Summary

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Owner Number	Owner Name	Owner Status	Purchase Date
U0031306	Vallikalam, Pothen	Current Owner
U0015075	Lee Robin	Former Owner

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
91-2972	10/17/1991	Removal Log

LUST Fund Eligibility and Deductibility Determinations

IEMA Number	Status	OSFM Received Date	OSFM Response Date	Deductible	Letter
20180158	Ineligible	5/9/2018	6/12/2018	$No Deductible	Letter
20180158	Eligible	1/12/2023	3/8/2023	$5,000	Letter

Pay Tank Fees Online

Tank Information

Tank Number	Capacity	Product	Status	Regulated Status	Red Tag Issued	Fee Due	Abandon/Removal Date
1	4000	Gasoline	Removed	Federal		$0.00	10/01/1991 - REM
2	8000	Gasoline	Removed	Federal		$0.00	10/17/1991 - REM
3	10000	Gasoline	Removed	Federal		$0.00	10/01/1991 - REM
4	550	Used Oil	Removed	Federal		$0.00	10/01/1991 - REM
5	500	Heating Oil	Removed	State		$0.00	10/17/1991 - REM
6	12000	Gasoline - Regular	Currently in use	Federal		$0.00
7	8000	Gasoline - Premium	Currently in use	Federal		$0.00

Dispenser Information

Name\ID	Status
1/2	Active
3/4	Active
5/6	Active
7/8	Active

MFD Motorfuel Dispensing Forms

No Forms Found