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: 4016902
Status: Closed
Facility Name: Jack Flash Food Plaza
Address: 1207-B N. Keller Drive
Effingham, IL 62401
County: Effingham
Property Parcel:
Facility Type: Attended Self-Service Station
Owner Type: Private
Green Tag Decal: O003174
Green Tag Issue Date: 7/29/2013
Green Tag Expiration Date: 12/31/2015

Owner Details

Owner Name: Wortman-Keller Development, LLC
Owner Address: 1301 Mansfield Dr.
P.O. Box 217
Effingham, IL 62401
Owner Status: Current Owner
Purchase Date: 9/21/2012
Type of Financial Responsibility: Self-Insurance
Financial Responsibility Reporting Due Date: 5/9/2015

Motor Fuel Dispensing Permits

MFD Permit Type Issue Date Expiration Date
Self Service 7/29/2013 12/31/2015

Owner Summary

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Owner Number Owner Name Owner Status Purchase Date
U0033182 Wortman-Keller Development, LLC Current Owner 9/21/2012
U0036467 Aving-Rice, LLC Former Owner 2/23/2012
U0033415 SNC JJ Effingham IV, LLC Former Owner 4/10/2006
U0017339 Niebrugge Oil Company Former Owner 4/1/1989
U0011864 Phillips Petroleum Company Former Owner 12/31/1967
U0036615 Wortman-Keller Development, 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
14-1181 11/26/2014 Removal Log 01024-2014REM

LUST Fund Eligibility and Deductibility Determinations

IEMA Number Status OSFM Received Date OSFM Response Date Deductible Letter
13-0192 Eligible 4/1/2013 5/21/2013 $5,000
14-1181 Eligible 10/23/2014 12/22/2014 $5,000
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Tank Information

Tank Number Capacity Product Status Regulated Status Red Tag Issued Fee Due Abandon/Removal Date
5 10000 Gasoline Removed Federal $0.00 11/26/2014 - REM
6 10000 Gasoline Removed Federal $0.00 11/26/2014 - REM
7 10000 Gasoline Removed Federal $0.00 11/26/2014 - REM
8 6000 Gasoline Removed Federal $0.00 06/27/1989 - REM
9 560 Used Oil Removed Federal $0.00 01/01/1980 - REM
10 6000 Gasoline Removed Federal $0.00 06/27/1989 - REM
11 1000 Gasoline Removed Federal $0.00 01/01/1980 - REM

Dispenser Information

Name\ID Status

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