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:	4008086
Status:	Active
Facility Name:	Circle K #4700045
Address:	1315 Koester Road Forsyth, IL 62535
County:	Macon
Property Parcel:	07-07-23-104-001
Facility Type:	Attended Self-Service Station
Owner Type:	Private
Green Tag Decal:	X001237
Green Tag Issue Date:	4/26/2022
Green Tag Expiration Date:	12/31/2024

Owner Details

Owner Name:	Mac's Convenience Stores, LLC
Owner Address:	1100 Situs Court, Suite 100 Raleigh, NC 27606
Owner Status:	Current Owner
Purchase Date:	12/30/2020
Type of Financial Responsibility:	Guarantee
Financial Responsibility Reporting Due Date:	10/27/2024

Motor Fuel Dispensing Permits

MFD Permit Type	Issue Date	Expiration Date
Self Service	4/26/2022	12/31/2024

Owner Summary

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Owner Number	Owner Name	Owner Status	Purchase Date
U0030949	Mac's Convenience Stores, LLC	Current Owner	12/30/2020
U0030258	Kooshtard Property III, LLC	Former Owner	6/21/2001
U0023515	Johnson Oil Company, L.L.C.	Former Owner	8/3/1998
U0008722	L. Keller Oil Properties, Inc.	Former Owner	12/31/1967

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
99-1516	6/23/1999	Removal Log	00913-1999REM

LUST Fund Eligibility and Deductibility Determinations

IEMA Number	Status	OSFM Received Date	OSFM Response Date	Deductible	Letter
97-1618	Eligible	6/11/1999	6/28/1999	$15,000
97-1618	Eligible	5/21/2012	7/19/2012	$15,000

Pay Tank Fees Online

Tank Information

Tank Number	Capacity	Product	Status	Regulated Status	Red Tag Issued	Fee Due	Abandon/Removal Date
1	8000	Gasoline	Removed	Federal		$0.00	06/23/1999 - REM
2	12000	Gasoline	Removed	Federal		$0.00	06/23/1999 - REM
3	12000	Gasoline	Removed	Federal		$0.00	06/23/1999 - REM
4	12000	Diesel Fuel	Removed	Federal		$0.00	06/23/1999 - REM
5	8000	Diesel Fuel	Currently in use	Federal		$0.00
6	8000	Gasoline - Premium	Currently in use	Federal		$0.00
7	8000	Gasoline - Regular	Currently in use	Federal		$0.00
8	15000	Gasoline - Regular	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

MFD Motorfuel Dispensing Forms

No Forms Found