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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:	2040091
Status:	Active
Facility Name:	Costco Gasoline #380
Address:	2746 N. Clybourn Avenue Chicago, IL 60614
County:	Cook
Property Parcel:
Facility Type:	Attended Self-Service Station
Owner Type:	Private
Green Tag Decal:	Y001521
Green Tag Issue Date:	10/13/2023
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:	5/13/2011
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
Self Service	10/13/2023	12/31/2025

Owner Summary

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Owner Number	Owner Name	Owner Status	Purchase Date
U0029489	Costco Wholesale Corporation	Current Owner	5/13/2011

Permits (Unexpired)

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Permit Number	Type	Status	OSFM Receive Date	Issue Date	Expiration Date	Documents
00492-2024UPG	Upgrade	Approved / Issued	4/30/2024	4/30/2024	5/14/2024	Documents

Deficiencies (Current)

No Deficiencies Found

IEMA Numbers Associated with the Facility

IEMA Number	Inspection Date	Inspection Type	Permit Number
00-0918	5/15/2000	Removal Log	105610

LUST Fund Eligibility and Deductibility Determinations

No Applications Found

Pay Tank Fees Online

Tank Information

Tank Number	Capacity	Product	Status	Regulated Status	Red Tag Issued	Fee Due	Abandon/Removal Date
1	3000	Fuel Oil	Removed	State			05/15/2000 - REM
2	1500	Ultrazol - Fuel Additive	Currently in use	Federal		$0.00
3	20000	Gasoline - Regular	Currently in use	Federal		$0.00
4	20000	Gasoline - Regular	Currently in use	Federal		$0.00
5	20000	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
9/10	Active
11/12	Active

MFD Motorfuel Dispensing Forms

Facility Number	Name	City	Received Date	Letter
2040091	Costco Gasoline #380	Chicago	09/22/2020	Letter Form
2040091	Costco Gasoline #380	Chicago	02/12/2020	Letter Form