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:	2039969
Status:	Active
Facility Name:	Costco #378
Address:	680 South Rand Street Lake Zurich, IL 60047
County:	Lake
Property Parcel:	14-20-307-003
Facility Type:	Unattended Self-Service Station
Owner Type:	Private
Green Tag Decal:	Y003013
Green Tag Issue Date:	7/18/2023
Green Tag Expiration Date:	12/31/2025

Owner Details

Owner Name:	Costco Wholesale Corporation
Owner Address:	P.O. Box 35005 Seattle, WA 98124
Owner Status:	Current Owner
Purchase Date:	8/16/2011
Type of Financial Responsibility:	Commercial Insurance
Financial Responsibility Reporting Due Date:	3/6/2025

Motor Fuel Dispensing Permits

MFD Permit Type	Issue Date	Expiration Date
Unattended Self Service	7/18/2023	12/31/2025
Self Service	11/18/2009	12/31/2011

Owner Summary

Click for Facility/Tank Ownership history

Owner Number	Owner Name	Owner Status	Purchase Date
U0029489	Costco Wholesale Corporation	Current Owner	8/16/2011

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:	20000		Petroleum Use:
Product:	Gasoline - Regular		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	3/5/2001		Abandoned Material:
Current Age:	23		Abandoned Date:
Install Date:	11/16/2001		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	2/15/2001

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Flexible Non-Corrosive	N/A	N/A
Corrosion Prot - Tank	Fiberglass Non-Corrosive	N/A	N/A
Leak Detect - Piping	Electronic Pressurized Line Leak Detection	5/8/2024	5/8/2025
Leak Detect - Piping	Siphon Bar	N/A	N/A
Leak Detect - Tank	Hydrostatic Reservoir Interstitial Monitoring Sensors with monitor	5/8/2024	5/8/2025
Overfill Prev Device	Overfill Alarm	6/15/2022	6/15/2025
Overfill Prev Device	Overfill Drop Tube Valve	6/15/2022	6/15/2025
Piping	Fiberglass Double Wall A.O. Smith	N/A	N/A
Piping	Flexible Double Wall Environ Geo Flex	N/A	N/A
Piping	Flexible Double Wall A.P.T. Poly Tech P175SC	N/A	N/A
Piping	Single Wall STP/Tanktop Sump	5/26/2023	5/26/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	5/8/2024	5/8/2025
Spill Contain Device	Single Wall Spill Bucket	6/17/2021	6/17/2024
Tank	Fiberglass Brine Filled Double Wall Containment Solutions	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Leak Detect - Piping	Siphon Bar	Functional	Pass	6/7/2023
Piping	Flexible Double Wall Environ Geo Flex	Precision Test	Pass	5/8/2024
Leak Detect - Tank	SIR and Prec Tightness Testing	Precision Test (Tank)	Pass	10/13/2015

Tank Number 2

Capacity:	20000		Petroleum Use:
Product:	Gasoline - Regular		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	3/5/2001		Abandoned Material:
Current Age:	23		Abandoned Date:
Install Date:	11/16/2001		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	2/15/2001

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Flexible Non-Corrosive	N/A	N/A
Corrosion Prot - Tank	Fiberglass Non-Corrosive	N/A	N/A
Leak Detect - Piping	Electronic Pressurized Line Leak Detection	5/8/2024	5/8/2025
Leak Detect - Piping	Siphon Bar	N/A	N/A
Leak Detect - Tank	Hydrostatic Reservoir Interstitial Monitoring Sensors with monitor	5/8/2024	5/8/2025
Overfill Prev Device	Overfill Alarm	6/15/2022	6/15/2025
Overfill Prev Device	Overfill Drop Tube Valve	6/15/2022	6/15/2025
Piping	Fiberglass Double Wall A.O. Smith	N/A	N/A
Piping	Flexible Double Wall Environ Geo Flex	N/A	N/A
Piping	Flexible Double Wall A.P.T. Poly Tech P175SC	N/A	N/A
Piping	Single Wall STP/Tanktop Sump	5/26/2023	5/26/2026
Leak Detect - Piping	Non-Discriminating Sump Sensor	7/22/2020	7/22/2021
Leak Detect - Piping	Sump Sensor with positive shutdown	5/8/2024	5/8/2025
Spill Contain Device	Single Wall Spill Bucket	6/17/2021	6/17/2024
Tank	Fiberglass Brine Filled Double Wall Containment Solutions	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Leak Detect - Piping	Siphon Bar	Functional	Pass	6/7/2023
Piping	Flexible Double Wall Environ Geo Flex	Precision Test	Pass	5/8/2024
Leak Detect - Tank	SIR and Prec Tightness Testing	Precision Test (Tank)	Pass	10/13/2015

Tank Number 3

Capacity:	20000		Petroleum Use:
Product:	Gasoline - Premium		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	3/5/2001		Abandoned Material:
Current Age:	23		Abandoned Date:
Install Date:	11/16/2001		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	2/15/2001

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Flexible Non-Corrosive	N/A	N/A
Corrosion Prot - Tank	Fiberglass Non-Corrosive	N/A	N/A
Leak Detect - Piping	Electronic Pressurized Line Leak Detection	5/8/2024	5/8/2025
Leak Detect - Tank	Hydrostatic Reservoir Interstitial Monitoring Sensors with monitor	5/8/2024	5/8/2025
Overfill Prev Device	Overfill Alarm	6/15/2022	6/15/2025
Overfill Prev Device	Overfill Drop Tube Valve	6/15/2022	6/15/2025
Piping	Flexible Double Wall Environ Geo Flex	N/A	N/A
Piping	Flexible Double Wall A.P.T. Poly Tech P175SC	N/A	N/A
Piping	Single Wall STP/Tanktop Sump	6/17/2021	6/17/2024
Leak Detect - Piping	Non-Discriminating Sump Sensor with positive shutdown	7/21/2021	7/21/2022
Leak Detect - Piping	Sump Sensor with positive shutdown	5/8/2024	5/8/2025
Spill Contain Device	Single Wall Spill Bucket	6/17/2021	6/17/2024
Tank	Fiberglass Brine Filled Double Wall Containment Solutions	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Piping	Flexible Double Wall Environ Geo Flex	Precision Test	Pass	5/8/2024
Leak Detect - Tank	SIR and Prec Tightness Testing	Precision Test (Tank)	Pass	10/13/2015

Tank Number 4

Capacity:	1500		Petroleum Use:
Product:	Ultrazol - Fuel Additive		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	9/22/2011		Abandoned Material:
Current Age:	12		Abandoned Date:
Install Date:	8/16/2011		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	9/9/2011

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	Mechanical Pressurized Line Leak Detection	5/8/2024	5/8/2025
Leak Detect - Tank	Hydrostatic Reservoir Interstitial Monitoring Sensors with monitor	5/8/2024	5/8/2025
Overfill Prev Device	Overfill Alarm	6/15/2022	6/15/2025
Overfill Prev Device	Overfill Drop Tube Valve	6/15/2022	6/15/2025
Piping	Fiberglass Double Wall A.O. Smith	N/A	N/A
Piping	Single Wall STP/Tanktop Sump	6/17/2021	6/17/2024
Leak Detect - Piping	Sump Sensor with positive shutdown	5/8/2024	5/8/2025
Piping	Single Wall Transition Sump	6/17/2021	6/17/2024
Leak Detect - Piping	Sump Sensor with positive shutdown	5/8/2024	5/8/2025
Piping	Single Wall Transition Sump	6/17/2021	6/17/2024
Leak Detect - Piping	Sump Sensor with positive shutdown	5/8/2024	5/8/2025
Piping	Single Wall Transition Sump	6/17/2021	6/17/2024
Leak Detect - Piping	Sump Sensor with positive shutdown	5/8/2024	5/8/2025
Spill Contain Device	Single Wall Spill Bucket	6/17/2021	6/17/2024
Tank	Fiberglass Brine Filled Double Wall Containment Solutions	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Piping	Fiberglass Double Wall A.O. Smith	Precision Test	Pass	5/8/2024
Leak Detect - Tank	SIR and Prec Tightness Testing	Precision Test (Tank)	Pass	10/13/2015

Dispenser Information

Name\ID 1/2

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	6/17/2021	6/17/2024
Leak Detect - Piping	Sump Sensor with positive shutdown	5/8/2024	5/8/2025

Name\ID 11/12

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	6/17/2021	6/17/2024
Leak Detect - Piping	Sump Sensor with positive shutdown	5/8/2024	5/8/2025

Name\ID 13/14

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	6/17/2021	6/17/2024
Leak Detect - Piping	Sump Sensor with positive shutdown	5/8/2024	5/8/2025

Name\ID 15/16

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	6/17/2021	6/17/2024
Leak Detect - Piping	Sump Sensor with positive shutdown	5/8/2024	5/8/2025

Name\ID 17/18

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	6/17/2021	6/17/2024
Leak Detect - Piping	Sump Sensor with positive shutdown	5/8/2024	5/8/2025

Name\ID 3/4

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	6/17/2021	6/17/2024
Leak Detect - Piping	Sump Sensor with positive shutdown	5/8/2024	5/8/2025

Name\ID 5/6

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	6/17/2021	6/17/2024
Leak Detect - Piping	Sump Sensor with positive shutdown	5/8/2024	5/8/2025

Name\ID 7/8

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	6/17/2021	6/17/2024
Leak Detect - Piping	Sump Sensor with positive shutdown	5/8/2024	5/8/2025

Name\ID 9/10

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	6/17/2021	6/17/2024
Leak Detect - Piping	Sump Sensor with positive shutdown	5/8/2024	5/8/2025

MFD Motorfuel Dispensing Forms

Facility Number	Name	City	Received Date	Letter
2039969	Costco #378	Lake Zurich	10/22/2018	Letter Form