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:	5014341
Status:	Closed
Facility Name:	Midway Stop & Shop
Address:	R R #1 Box 55 Hardin, IL 62047
County:	Calhoun
Property Parcel:
Facility Type:	Attended Self-Service Station
Owner Type:	Private
Green Tag Decal:	Q000429
Green Tag Issue Date:	11/12/2015
Green Tag Expiration Date:	12/31/2017

Owner Details

Owner Name:	Jo Ann Tepen
Owner Address:	R R #1 Box 28 Golden Eagle, IL 62036
Owner Status:	Current Owner
Purchase Date:	6/10/1994
Type of Financial Responsibility:	Commercial Insurance
Financial Responsibility Reporting Due Date:	9/16/2016

Motor Fuel Dispensing Permits

MFD Permit Type	Issue Date	Expiration Date
Self Service	11/12/2015	12/31/2017
Full Service	6/24/2014	12/31/2015

Owner Summary

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Owner Number	Owner Name	Owner Status	Purchase Date
U0026719	Tepen, Jo Ann	Current Owner	6/10/1994
U0001052	Baalman Fuel Ser 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
16-1062	12/15/2016	Removal Log	01462-2016REM

LUST Fund Eligibility and Deductibility Determinations

IEMA Number	Status	OSFM Received Date	OSFM Response Date	Deductible	Letter
20161062	Eligible	2/8/2017	2/8/2017	$5,000	Letter

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Tank Information

Tank Number	Capacity	Product	Status	Regulated Status	Red Tag Issued	Fee Due	Abandon/Removal Date
1	2000	Gasoline	Removed	Exempt			06/01/1986 - REM
2	1000	Gasoline	Unknown	Exempt
3	1000	Kerosene	Removed	Federal		$0.00	02/09/1998 - REM
4	6000	Gasoline	Removed	Federal		$0.00	12/15/2016 - REM
5	6000	Gasoline	Removed	Federal		$0.00	12/15/2016 - REM

Dispenser Information

Name\ID	Status

MFD Motorfuel Dispensing Forms

No Forms Found