Division of Petroleum & Chemical Safety

Facility Details

Facility Number:	2045470
Status:	Active
Facility Name:	Sam's Club #6388
Address:	1052 Ogden Avenue Montgomery, IL 60538
County:	Kane
Property Parcel:
Facility Type:	Attended Self-Service/Unattended Self-Service
Owner Type:	Private
Green Tag Decal:	X003246
Green Tag Issue Date:	11/1/2022
Green Tag Expiration Date:	12/31/2024

Owner Details

Owner Name:	Sam's West, Inc.
Owner Address:	2101 SE Simple Savings Drive Bentonville, AR 727160745
Owner Status:	Current Owner
Purchase Date:	9/26/2013
Type of Financial Responsibility:	Commercial Insurance
Financial Responsibility Reporting Due Date:	4/29/2025

Motor Fuel Dispensing Permits

MFD Permit Type	Issue Date	Expiration Date
Self Service	3/14/2022	12/31/2024

Owner Summary

Click for Facility/Tank Ownership history

Owner Number	Owner Name	Owner Status	Purchase Date
U0029973	Sam's West, Inc.	Current Owner	9/26/2013

Permits (Unexpired)

Click for permit history

No Active Permits Found

Deficiencies (Current)

NOV Number: E0020240694 (Pending) Issue Date: 3/7/2024 Expiration Date: 5/6/2024 View NOV Form

Tanks	Deficiency
Facility	Farthest dispenser is greater than 40' and site lacks a communication system or system is inoperable - The attendant shall at all times be able to communicate with persons in the dispensing area. Repair or replace intercom. 175.210 h)

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:	6/23/2014	Abandoned Material:
Current Age:	9	Abandoned Date:
Install Date:	9/26/2013	Red Tag Issue Date:
Last Used Date:		Fee Due:
Product Date:	6/23/2014

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	12/20/2023	12/20/2024
Leak Detect - Piping	Siphon Bar	N/A	N/A
Leak Detect - Tank	Non-Discriminating Interstitial Monitoring Sensors With Monitor	12/20/2023	12/20/2024
Overfill Prev Device	Overfill Drop Tube Valve	1/12/2023	1/12/2026
Piping	Flexible Double Wall OPW Flexworks	N/A	N/A
Piping	Single Wall STP/Tanktop Sump	9/13/2021	9/13/2024
Leak Detect - Piping	Sump Sensor with positive shutdown	12/20/2023	12/20/2024
Spill Contain Device	Double Wall Spill Bucket	12/20/2023	12/20/2026
Tank	Fiberglass Double Wall XERXES	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Leak Detect - Piping	Siphon Bar	Functional	Pass	1/20/2022
Piping	Flexible Double Wall OPW Flexworks	Precision Test	Pass	12/20/2023
Tank	Fiberglass Double Wall XERXES	Precision Test (Tank)	Pass	12/20/2023

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:	6/23/2014	Abandoned Material:
Current Age:	9	Abandoned Date:
Install Date:	9/26/2013	Red Tag Issue Date:
Last Used Date:		Fee Due:
Product Date:	6/23/2014

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	12/20/2023	12/20/2024
Leak Detect - Piping	Siphon Bar	N/A	N/A
Leak Detect - Tank	Non-Discriminating Interstitial Monitoring Sensors With Monitor	12/20/2023	12/20/2024
Overfill Prev Device	Overfill Drop Tube Valve	1/12/2023	1/12/2026
Piping	Flexible Double Wall OPW Flexworks	N/A	N/A
Piping	Single Wall STP/Tanktop Sump	9/13/2021	9/13/2024
Leak Detect - Piping	Sump Sensor with positive shutdown	12/20/2023	12/20/2024
Spill Contain Device	Double Wall Spill Bucket	12/20/2023	12/20/2026
Tank	Fiberglass Double Wall XERXES	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Leak Detect - Piping	Siphon Bar	Functional	Pass	1/20/2022
Piping	Flexible Double Wall OPW Flexworks	Precision Test	Pass	12/20/2023
Tank	Fiberglass Double Wall XERXES	Precision Test (Tank)	Pass	12/20/2023

Tank Number 3

Capacity:	12000	Petroleum Use:
Product:	Gasoline - Premium	CERCLA Substance:
Status:	Currently in use	CAS Code:
Regulated Status:	Federal	Removed Date:
OSFM First Notify Date:	6/23/2014	Abandoned Material:
Current Age:	9	Abandoned Date:
Install Date:	9/26/2013	Red Tag Issue Date:
Last Used Date:		Fee Due:
Product Date:	6/23/2014

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	12/20/2023	12/20/2024
Leak Detect - Tank	Non-Discriminating Interstitial Monitoring Sensors With Monitor	12/20/2023	12/20/2024
Overfill Prev Device	Overfill Drop Tube Valve	1/12/2023	1/12/2026
Piping	Flexible Double Wall OPW Flexworks	N/A	N/A
Piping	Single Wall STP/Tanktop Sump	9/13/2021	9/13/2024
Leak Detect - Piping	Sump Sensor with positive shutdown	12/20/2023	12/20/2024
Spill Contain Device	Double Wall Spill Bucket	12/20/2023	12/20/2026
Tank	Fiberglass Double Wall XERXES	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Piping	Flexible Double Wall OPW Flexworks	Precision Test	Pass	12/20/2023
Tank	Fiberglass Double Wall XERXES	Precision Test (Tank)	Pass	12/20/2023

Tank Number 4

Capacity:	8000	Petroleum Use:
Product:	Diesel Fuel	CERCLA Substance:
Status:	Currently in use	CAS Code:
Regulated Status:	Federal	Removed Date:
OSFM First Notify Date:	6/23/2014	Abandoned Material:
Current Age:	9	Abandoned Date:
Install Date:	9/26/2013	Red Tag Issue Date:
Last Used Date:		Fee Due:
Product Date:	6/23/2014

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	12/20/2023	12/20/2024
Leak Detect - Tank	Non-Discriminating Interstitial Monitoring Sensors With Monitor	12/20/2023	12/20/2024
Overfill Prev Device	Overfill Drop Tube Valve	1/12/2023	1/12/2026
Piping	Flexible Double Wall OPW Flexworks	N/A	N/A
Piping	Single Wall STP/Tanktop Sump	9/13/2021	9/13/2024
Leak Detect - Piping	Sump Sensor with positive shutdown	12/20/2023	12/20/2024
Spill Contain Device	Double Wall Spill Bucket	12/20/2023	12/20/2026
Tank	Fiberglass Double Wall XERXES	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Piping	Flexible Double Wall OPW Flexworks	Precision Test	Pass	12/20/2023
Tank	Fiberglass Double Wall XERXES	Precision Test (Tank)	Pass	12/20/2023

Dispenser Information

Name\ID 1/2

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	9/13/2021	9/13/2024
Leak Detect - Piping	Sump Sensor with positive shutdown	12/20/2023	12/20/2024

Name\ID 11/12

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	9/13/2021	9/13/2024
Leak Detect - Piping	Sump Sensor with positive shutdown	12/20/2023	12/20/2024

Name\ID 3/4

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	9/13/2021	9/13/2024
Leak Detect - Piping	Sump Sensor with positive shutdown	12/20/2023	12/20/2024

Name\ID 5/6

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	9/13/2021	9/13/2024
Leak Detect - Piping	Sump Sensor with positive shutdown	12/20/2023	12/20/2024

Name\ID 7/8

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	9/13/2021	9/13/2024
Leak Detect - Piping	Sump Sensor with positive shutdown	12/20/2023	12/20/2024

Name\ID 9/10

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	9/13/2021	9/13/2024
Leak Detect - Piping	Sump Sensor with positive shutdown	12/20/2023	12/20/2024

MFD Motorfuel Dispensing Forms

No Forms Found