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

 
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Facility Details

Facility Number: 4008000
Status: Active
Facility Name: Jack Flash
Address: 1200 North Keller Drive
Effingham, IL 62401
County: Effingham
Property Parcel: 03-11-018-115
Facility Type: Attended Self-Service Station
Owner Type: Private
Green Tag Decal: Z001723
Green Tag Issue Date: 3/26/2024
Green Tag Expiration Date: 12/31/2026

Owner Details

Owner Name: Wortman Development, LLC
Owner Address: P.O. Box 217
1301 Mansfield Drive
Effingham, IL 62401
Owner Status: Current Owner
Purchase Date: 2/3/2021
Type of Financial Responsibility: Self-Insurance
Financial Responsibility Reporting Due Date: 6/29/2024

Motor Fuel Dispensing Permits

MFD Permit Type Issue Date Expiration Date
Self Service 3/26/2024 12/31/2026

Owner Summary

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Owner Number Owner Name Owner Status Purchase Date
U0040172 Wortman Development, LLC Current Owner 2/3/2021
U0033182 Wortman-Keller Development, LLC Former Owner 11/1/2005
U0033182 Wortman-Keller Development, LLC Former Owner 8/25/2005
U0033182 Wortman-Keller Development, LLC Former Owner
U0032717 Wortman-Meyer Properties, LLC Former Owner
U0008722 L. Keller Oil Properties, Inc. Former Owner

Permits (Unexpired)

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No Active Permits Found

Deficiencies (Current)

No Deficiencies Found

IEMA Numbers Associated with the Facility

IEMA Number Inspection Date Inspection Type Permit Number
05-0206 4/5/2005 Removal Log 00051-2005REM
05-0690 5/27/2005 Removal Log 00512-2005REM
99-2274 3/6/2000 Removal Log 03510-1999REM

LUST Fund Eligibility and Deductibility Determinations

IEMA Number Status OSFM Received Date OSFM Response Date Deductible Letter
99-2274 Eligible 4/18/2000 5/4/2000 $10,000
05-0690 Eligible 8/4/2005 8/24/2005 $15,000
05-0206 Eligible 9/9/2005 9/26/2005 $15,000
Pay Tank Fees Online

Tank Information

Tank Number Capacity Product Status Regulated Status Red Tag Issued Fee Due Abandon/Removal Date
1 12000 Gasoline Removed Federal $0.00 04/05/2005 - REM
2 12000 Gasoline Removed Federal $0.00 04/05/2005 - REM
3 8000 Gasoline Removed Federal $0.00 03/06/2000 - REM
4 6000 Diesel Fuel Removed Federal $0.00 03/06/2000 - REM
5 500 Used Oil Removed Federal $0.00 04/24/1987 - REM
6 6000 Gasoline Removed Federal $0.00 05/27/2005 - REM
7 4000 Gasoline Removed Federal $0.00 05/27/2005 - REM
8 6000 Gasoline Removed Federal $0.00 05/27/2005 - REM
9 15000 Gasoline - Regular Currently in use Federal $0.00
10 8000 Gasoline - Premium Currently in use Federal $0.00
11 8000 B-11 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
11/12 Active
13/14 Active
15/16 Active
17/18 Active
19/20 Active

MFD Motorfuel Dispensing Forms

No Forms Found

Office of the Illinois State Fire Marshal
1035 Stevenson Dr. Springfield, IL 62704 | (217) 785-0969 | Contact Us