Division of Petroleum & Chemical Safety

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Facility Details

Facility Number:	3045514
Status:	Closed
Facility Name:	Sam's Club #4061
Address:	6561 42nd Avenue Moline, IL 61265
County:	Rock Island
Property Parcel:
Facility Type:	Attended Self-Service Station
Owner Type:	Private
Green Tag Decal:	R002058
Green Tag Issue Date:	4/4/2016
Green Tag Expiration Date:	12/31/2018

Owner Name:	Sam's West, Inc.
Owner Address:	2101 SE Simple Savings Drive Bentonville, AR 727160745
Owner Status:	Current Owner
Purchase Date:	11/25/2013
Type of Financial Responsibility:	Commercial Insurance
Financial Responsibility Reporting Due Date:	5/3/2019

MFD Permit Type	Issue Date	Expiration Date
Self Service	4/4/2016	12/31/2018

Click for Facility/Tank Ownership history

Owner Number	Owner Name	Owner Status	Purchase Date
U0029973	Sam's West, Inc.	Current Owner	11/25/2013

Click for permit history

No Active Permits Found

No Deficiencies Found

No IEMA Numbers Found

No Applications Found

Pay Tank Fees Online

Tank Number	Capacity	Product	Status	Regulated Status	Fee Due	Abandon/Removal Date
1	20000	Gasoline	Removed	Federal	$0.00	09/11/2018 - REM
2	20000	Gasoline	Removed	Federal	$0.00	09/11/2018 - REM
3	12000	Gasoline	Removed	Federal	$0.00	09/12/2018 - REM
4	8000	Diesel Fuel	Removed	Federal	$0.00	09/12/2018 - REM

Name\ID	Status

No Forms Found