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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:	3040859
Status:	Active
Facility Name:	Casey's #3889
Address:	1045 University Ave. Henry, IL 61537
County:	Marshall
Property Parcel:	03-16-154-040
Facility Type:	Attended Self-Service Station
Owner Type:	Private
Green Tag Decal:	Z001918
Green Tag Issue Date:	4/23/2024
Green Tag Expiration Date:	12/31/2026

Owner Details

Owner Name:	Casey's Retail Company
Owner Address:	3305 SE Delaware Ave. P.O. Box 3004 Ankeny, IA 50021
Owner Status:	Current Owner
Purchase Date:	10/24/2019
Type of Financial Responsibility:	Self-Insurance
Financial Responsibility Reporting Due Date:	10/27/2024

Motor Fuel Dispensing Permits

MFD Permit Type	Issue Date	Expiration Date
Self Service	4/23/2024	12/31/2024
Unattended Self Service	6/24/2016	12/31/2018

Owner Summary

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Owner Number	Owner Name	Owner Status	Purchase Date
U0002560	Casey's Retail Company	Current Owner	10/24/2019
U0036454	Ghanshym, Inc.	Former Owner	5/16/2011
U0030527	Henry Developers, Inc.	Former Owner

Permits (Unexpired)

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Permit Number	Type	Status	OSFM Receive Date	Issue Date	Expiration Date	Documents
00148-2024UPG	Upgrade	Approved / Issued	2/7/2024	2/7/2024	8/7/2024	Documents

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
20200920	Eligible	4/2/2021	4/3/2021	$5,000	Letter

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Tank Information

Tank Number	Capacity	Product	Status	Regulated Status	Red Tag Issued	Fee Due	Abandon/Removal Date
1	12000	Gasoline - Regular	Currently in use	Federal		$0.00
2	8000	Gasoline - Premium	Currently in use	Federal		$0.00
3	4000	Gasoline - Premium	Currently in use	Federal		$0.00
4	12000	Diesel Fuel	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
9s	Active

MFD Motorfuel Dispensing Forms

Facility Number	Name	City	Received Date	Letter
3040859	Casey's #3889	Henry	10/19/2020	Letter Form