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:	3026495
Status:	Closed
Facility Name:	Memorial Hospital
Address:	South Adams Street, Po Box 160 Carthage, IL 62321
County:	Hancock
Property Parcel:
Facility Type:	Private Institution
Owner Type:	Private
Green Tag Decal:	P005314
Green Tag Issue Date:	7/25/2014
Green Tag Expiration Date:	12/31/2016

Owner Details

Owner Name:	Memorial Hospital
Owner Address:	South Adams Street, Po Box 160 Carthage, IL 62321
Owner Status:	Current Owner
Purchase Date:
Type of Financial Responsibility:	Certificate of Deposit and Commercial Insurance
Financial Responsibility Reporting Due Date:	7/16/2015

Motor Fuel Dispensing Permits

No MFD Permits Found

Owner Summary

Click for Facility/Tank Ownership history

Owner Number	Owner Name	Owner Status	Purchase Date
U0010087	Memorial Hospital	Current Owner

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

IEMA Number	Status	OSFM Received Date	OSFM Response Date	Deductible	Letter
15-1278	Eligible	2/3/2016	3/7/2016	$5,000

Pay Tank Fees Online

Tank Information

Tank Number 1

Capacity:	1000		Petroleum Use:
Product:	Diesel Fuel		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	12/7/1998
OSFM First Notify Date:	11/7/1990		Abandoned Material:
Current Age:	38		Abandoned Date:
Install Date:	6/21/1960		Red Tag Issue Date:
Last Used Date:	12/7/1998		Fee Due:	$0.00
Product Date:	7/21/1960

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 2

Capacity:	4000		Petroleum Use:	Back-up Generator
Product:	Diesel Fuel		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	11/24/2015
OSFM First Notify Date:	11/7/1990		Abandoned Material:
Current Age:	45		Abandoned Date:
Install Date:	1/1/1970		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	2/1/1970

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Impressed Current Cathodic Protection	7/7/2014	7/7/2015
Corrosion Prot - Tank	Impressed Current Cathodic Protection	7/7/2014	7/7/2015
Leak Detect - Piping	European with No Test Req Suction	N/A	N/A
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 300c
Overfill Prev Device	Overfill Drop Tube Valve
Piping	Steel Single Wall Piping	N/A	N/A
Spill Contain Device	Single Wall Spill Bucket
Tank	Steel Single Wall	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 3

Capacity:	6000		Petroleum Use:	Consumptive Use on Premises for Heating
Product:	Heating Oil		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Exempt		Removed Date:	11/17/1995
OSFM First Notify Date:	11/7/1990		Abandoned Material:
Current Age:	48		Abandoned Date:
Install Date:			Red Tag Issue Date:
Last Used Date:	1/1/1969		Fee Due:
Product Date:

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 4

Capacity:	6000		Petroleum Use:	Consumptive Use on Premises for Heating
Product:	Heating Oil		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Exempt		Removed Date:	11/17/1995
OSFM First Notify Date:	11/7/1990		Abandoned Material:
Current Age:	48		Abandoned Date:
Install Date:			Red Tag Issue Date:
Last Used Date:	1/1/1969		Fee Due:
Product Date:

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 5

Capacity:	600		Petroleum Use:	Back-up Generator
Product:	Diesel Fuel		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	11/24/2015
OSFM First Notify Date:	2/17/1999		Abandoned Material:
Current Age:	16		Abandoned Date:
Install Date:	12/8/1998		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	12/8/1998

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	European with No Test Req Suction	N/A	N/A
Leak Detect - Piping	Sump Sensor	7/7/2014	7/7/2015
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 300c
Overfill Prev Device	Overfill Drop Tube Valve
Piping	Flexible Double Wall Environ Geo Flex	N/A	N/A
Spill Contain Device	Single Wall Spill Bucket
Tank	Fiberglass Double Wall	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Dispenser Information

MFD Motorfuel Dispensing Forms

No Forms Found