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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

 

Facility Details

Facility Number: 2042813
Status: Active
Facility Name: Gas Station & Mini-Mart
Address: 2959 W. Fulton Street
Chicago, IL 60612
County: Cook
Property Parcel: 16-12-310-001-0000
Facility Type: Attended Self-Service Station
Owner Type: Private
Green Tag Decal: X001323
Green Tag Issue Date: 12/8/2022
Green Tag Expiration Date: 12/31/2024

Owner Details

Owner Name: Samer Farhan
Owner Address: 8728 W. 98th Place
Palos Hills, IL 60465
Owner Status: Current Owner
Purchase Date: 9/14/2014
Type of Financial Responsibility: Commercial Insurance
Financial Responsibility Reporting Due Date: 7/20/2024

Motor Fuel Dispensing Permits

MFD Permit Type Issue Date Expiration Date
Self Service 8/12/2022 12/31/2024

Owner Summary

Click for Facility/Tank Ownership history
Owner Number Owner Name Owner Status Purchase Date
U0037512 Farhan, Samer Current Owner 9/14/2014
U0032744 Samer T., Inc. Former Owner 4/1/2005

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: 12000 Petroleum Use:
Product: Gasoline - Regular CERCLA Substance:
Status: Currently in use CAS Code:
Regulated Status: Federal Removed Date:
OSFM First Notify Date: 12/29/2005 Abandoned Material:
Current Age: 18 Abandoned Date:
Install Date: 6/21/2005 Red Tag Issue Date:
Last Used Date: Fee Due: $0.00
Product Date: 6/22/2005

Equipment

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 11/22/2022 11/22/2023
Leak Detect - Tank Automatic Tank Gauging Veeder Root TLS 300c 11/22/2022 11/22/2023
Leak Detect - Tank Non-Discriminating Interstitial Monitoring Sensors 11/22/2022 11/22/2023
Overfill Prev Device Overfill Drop Tube Valve 11/22/2022 11/22/2025
Piping Flexible Double Wall N/A N/A
Piping Double Wall STP/Tanktop Sump 11/22/2022 11/22/2025
Leak Detect - Piping Sump Sensor 11/22/2022 11/22/2023
Spill Contain Device Single Wall Spill Bucket 12/7/2022 12/7/2025
Tank Composite Double Wall ACT 100 N/A N/A

Additional Tests

Equipment Type Equipment Test Type Test Result Test Date
Piping Flexible Double Wall Precision Test Pass 11/22/2022



Tank Number 2

Capacity: 6000 Petroleum Use:
Product: Gasoline - Premium CERCLA Substance:
Status: Currently in use CAS Code:
Regulated Status: Federal Removed Date:
OSFM First Notify Date: 12/29/2005 Abandoned Material:
Current Age: 18 Abandoned Date:
Install Date: 6/21/2005 Red Tag Issue Date:
Last Used Date: Fee Due: $0.00
Product Date: 6/22/2005

Equipment

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 11/22/2022 11/22/2023
Leak Detect - Tank Automatic Tank Gauging Veeder Root TLS 300c 11/22/2022 11/22/2023
Leak Detect - Tank Non-Discriminating Interstitial Monitoring Sensors 11/22/2022 11/22/2023
Overfill Prev Device Overfill Drop Tube Valve 11/22/2022 11/22/2025
Piping Flexible Double Wall N/A N/A
Piping Double Wall STP/Tanktop Sump 11/22/2022 11/22/2025
Leak Detect - Piping Sump Sensor 11/22/2022 11/22/2023
Spill Contain Device Single Wall Spill Bucket 12/7/2022 12/7/2025
Tank Composite Double Wall ACT 100 N/A N/A

Additional Tests

Equipment Type Equipment Test Type Test Result Test Date
Piping Flexible Double Wall Precision Test Pass 11/22/2022

Dispenser Information



Name\ID 1/2

Status: Active
Equipment Type Equipment Last Passing Date Test Expire Date
Dispenser Single Wall UDC Sump 11/22/2022 11/22/2025
Leak Detect - Piping Sump Sensor 11/22/2022 11/22/2023



Name\ID 3/4

Status: Active
Equipment Type Equipment Last Passing Date Test Expire Date
Dispenser Single Wall UDC Sump 11/22/2022 11/22/2025
Leak Detect - Piping Sump Sensor 11/22/2022 11/22/2023



Name\ID 5/6

Status: Active
Equipment Type Equipment Last Passing Date Test Expire Date
Dispenser Single Wall UDC Sump 11/22/2022 11/22/2025
Leak Detect - Piping Sump Sensor 11/22/2022 11/22/2023

MFD Motorfuel Dispensing Forms

No Forms Found

Office of the Illinois State Fire Marshal
1035 Stevenson Dr. Springfield, IL 62704 | (217) 785-0969 | Contact Us