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:	2045315
Status:	Closed
Facility Name:	Sam's Club Fueling Station #6237
Address:	460 South Weber Road Romeoville, IL 60544
County:	Will
Property Parcel:
Facility Type:	Attended Self-Service Station
Owner Type:	Private
Green Tag Decal:	S000528
Green Tag Issue Date:	5/25/2017
Green Tag Expiration Date:	12/31/2019

Owner Details

Owner Name:	Sam's West, Inc.
Owner Address:	2101 SE Simple Savings Drive Bentonville, AR 727160745
Owner Status:	Current Owner
Purchase Date:	10/3/2013
Type of Financial Responsibility:	Commercial Insurance
Financial Responsibility Reporting Due Date:	5/3/2019

Motor Fuel Dispensing Permits

MFD Permit Type	Issue Date	Expiration Date
Self Service	5/25/2017	12/31/2019

Owner Summary

Click for Facility/Tank Ownership history

Owner Number	Owner Name	Owner Status	Purchase Date
U0029973	Sam's West, Inc.	Current Owner	10/3/2013

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
N/A	3/12/2019	Removal Log	01339-2018REM
N/A	3/11/2019	Removal Log	01339-2018REM

LUST Fund Eligibility and Deductibility Determinations

IEMA Number	Status	OSFM Received Date	OSFM Response Date	Deductible	Letter
20190261	Eligible	8/7/2020	8/10/2020	$5,000	Letter

Pay Tank Fees Online

Tank Information

Tank Number 1

Capacity:	20000		Petroleum Use:
Product:	Gasoline		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	3/12/2019
OSFM First Notify Date:	10/3/2013		Abandoned Material:
Current Age:	5		Abandoned Date:
Install Date:	4/22/2013		Red Tag Issue Date:
Last Used Date:	1/26/2018		Fee Due:	$0.00
Product Date:	10/3/2013

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	Mechanical Pressurized Line Leak Detection	4/24/2017	4/24/2018
Leak Detect - Piping	Siphon Bar	N/A	N/A
Leak Detect - Piping	Sump Sensor	4/24/2017	4/24/2018
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 450
Leak Detect - Tank	Non-Discriminating Interstitial Monitoring Sensors	4/24/2017	4/24/2018
Overfill Prev Device	Overfill Drop Tube Valve
Piping	Flexible Double Wall OPW Flexworks	N/A	N/A
Spill Contain Device	Double Wall Spill Bucket
Tank	Fiberglass Double Wall XERXES	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 2

Capacity:	20000		Petroleum Use:
Product:	Gasoline		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	3/11/2019
OSFM First Notify Date:	10/3/2013		Abandoned Material:
Current Age:	5		Abandoned Date:
Install Date:	4/22/2013		Red Tag Issue Date:
Last Used Date:	1/26/2018		Fee Due:	$0.00
Product Date:	10/3/2013

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	Mechanical Pressurized Line Leak Detection	4/24/2017	4/24/2018
Leak Detect - Piping	Siphon Bar	N/A	N/A
Leak Detect - Piping	Sump Sensor	4/24/2017	4/24/2018
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 450
Leak Detect - Tank	Non-Discriminating Interstitial Monitoring Sensors	4/24/2017	4/24/2018
Overfill Prev Device	Overfill Drop Tube Valve
Piping	Flexible Double Wall OPW Flexworks	N/A	N/A
Spill Contain Device	Double Wall Spill Bucket
Tank	Fiberglass Double Wall XERXES	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 3

Capacity:	12000		Petroleum Use:
Product:	Gasoline		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	3/11/2019
OSFM First Notify Date:	10/3/2013		Abandoned Material:
Current Age:	5		Abandoned Date:
Install Date:	4/22/2013		Red Tag Issue Date:
Last Used Date:	1/26/2018		Fee Due:	$0.00
Product Date:	10/3/2013

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	Mechanical Pressurized Line Leak Detection	4/24/2017	4/24/2018
Leak Detect - Piping	Sump Sensor	4/24/2017	4/24/2018
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 450
Leak Detect - Tank	Non-Discriminating Interstitial Monitoring Sensors	4/24/2017	4/24/2018
Overfill Prev Device	Overfill Drop Tube Valve
Piping	Flexible Double Wall OPW Flexworks	N/A	N/A
Spill Contain Device	Double Wall Spill Bucket
Tank	Fiberglass Double Wall XERXES	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 4

Capacity:	8000		Petroleum Use:
Product:	Diesel Fuel		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	3/11/2019
OSFM First Notify Date:	10/3/2013		Abandoned Material:
Current Age:	5		Abandoned Date:
Install Date:	4/22/2013		Red Tag Issue Date:
Last Used Date:	1/26/2018		Fee Due:	$0.00
Product Date:	10/3/2013

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	Mechanical Pressurized Line Leak Detection	4/24/2017	4/24/2018
Leak Detect - Piping	Sump Sensor	4/24/2017	4/24/2018
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 450
Leak Detect - Tank	Non-Discriminating Interstitial Monitoring Sensors	4/24/2017	4/24/2018
Overfill Prev Device	Overfill Drop Tube Valve
Piping	Flexible Double Wall OPW Flexworks	N/A	N/A
Spill Contain Device	Double Wall Spill Bucket
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