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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:	4008047
Status:	Active
Facility Name:	Holiday Jack Flash
Address:	1502 West Fayette Avenue Effingham, IL 62401
County:	Effingham
Property Parcel:	03-11-019-044
Facility Type:	Attended Self-Service Station
Owner Type:	Private
Green Tag Decal:	X002506
Green Tag Issue Date:	8/16/2022
Green Tag Expiration Date:	12/31/2024

Owner Details

Owner Name:	Wortman-Meyer Properties, LLC
Owner Address:	1502 W. Fayette Effingham, IL 62401
Owner Status:	Current Owner
Purchase Date:	8/1/1999
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	8/11/2022	12/31/2024

Owner Summary

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Owner Number	Owner Name	Owner Status	Purchase Date
U0035617	Wortman-Meyer Properties, LLC	Current Owner	8/1/1999
U0026848	Wortman Properties, Inc.	Former Owner	7/1/1995
U0008722	L. Keller Oil Properties, Inc.	Former Owner	12/31/1967
U0032717	Wortman-Meyer Properties, LLC	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
99-0303	2/10/1999	Removal Log	1060-98

LUST Fund Eligibility and Deductibility Determinations

IEMA Number	Status	OSFM Received Date	OSFM Response Date	Deductible	Letter
98-0523	Eligible	8/11/1998	9/28/1998	$10,000
20200898	Eligible	12/7/2020	12/11/2020	$5,000	Letter

Pay Tank Fees Online

Tank Information

Tank Number	Capacity	Product	Status	Regulated Status	Red Tag Issued	Fee Due	Abandon/Removal Date
1	10000	Gasoline	Removed	Federal		$0.00	02/10/1999 - REM
2	10000	Gasoline	Removed	Federal		$0.00	02/10/1999 - REM
3	10000	Gasoline	Removed	Federal		$0.00	02/10/1999 - REM
4	500	Used Oil	Removed	Federal		$0.00	10/01/1996 - REM
5	550	Heating Oil	Removed	State		$0.00	10/01/1996 - REM
6	10000	B-11	Currently in use	Federal		$0.00
7	12000	Gasoline - Regular	Currently in use	Federal		$0.00
8	12000	Gasoline - Premium	Currently in use	Federal		$0.00

Dispenser Information

Name\ID	Status
1/3 old	Removed
2/4 old	Removed
5/7 old	Removed
6/8 old	Removed
9/11	InActive
10/12 old	Removed
1/2	Active
3/4	Active
5/6	Active
7/8	Active
9/10	Active

MFD Motorfuel Dispensing Forms

Facility Number	Name	City	Received Date	Letter
4008047	Holiday Jack Flash	Effingham	11/23/2020	Letter Form
4008047	Holiday Jack Flash	Effingham	11/17/2020	Letter Form