Information

JB Pritzker, Governor

James A. Rivera, State Fire Marshal

Division of Petroleum & Chemical Safety

State of Illinois
Employment Opportunities
Ready Illinois
Find us on Facebook

Division of Petroleum & Chemical Safety

Facility Details

Facility Number:	5035605
Status:	Active
Facility Name:	Casey's #4292
Address:	1192 Fifth St. Carrollton, IL 62016
County:	Greene
Property Parcel:	03-92-26-100-018
Facility Type:	Attended Self-Service Station
Owner Type:	Private
Green Tag Decal:	Y000750
Green Tag Issue Date:	2/6/2023
Green Tag Expiration Date:	12/31/2025

Owner Details

Owner Name:	Casey's Retail Company
Owner Address:	3305 SE Delaware Ave. P.O. Box 3004 Ankeny, IA 50021
Owner Status:	Current Owner
Purchase Date:	9/27/2022
Type of Financial Responsibility:	Self-Insurance
Financial Responsibility Reporting Due Date:	10/27/2024

Motor Fuel Dispensing Permits

MFD Permit Type	Issue Date	Expiration Date
Self Service	5/24/2023	12/31/2025

Owner Summary

Click for Facility/Tank Ownership history

Owner Number	Owner Name	Owner Status	Purchase Date
U0002560	Casey's Retail Company	Current Owner	9/27/2022
U0036239	Shady's South Side, LLC	Former Owner	9/20/2011
U0033208	CMB Enterprises, Inc.	Former Owner	10/1/2005
U0036247	Bucks Crossing, Inc.	Former Owner
U0036239	Shady's South Side, LLC	Former Owner
U0002560	Casey's Retail Company	Former Owner

Permits (Unexpired)

Click for permit history

No Active Permits Found

Deficiencies (Current)

No Deficiencies Found

IEMA Numbers Associated with the Facility

No IEMA Numbers Found

LUST Fund Eligibility and Deductibility Determinations

No Applications Found

Pay Tank Fees Online

Tank Information

Tank Number 1

Capacity:	10000		Petroleum Use:
Product:	Gasoline - Regular		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	6/6/1997		Abandoned Material:
Current Age:	27		Abandoned Date:
Install Date:	5/21/1997		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	5/23/1997

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Sacrificial Anode Flex Connector	7/15/2022	7/15/2025
Corrosion Prot - Piping	Fiberglass Non-Corrosive	N/A	N/A
Corrosion Prot - Tank	Fiberglass Non-Corrosive	N/A	N/A
Leak Detect - Piping	Electronic Pressurized Line Leak Detection	12/27/2022	12/27/2023
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 450 Plus with CSLD	12/27/2022	12/27/2023
Overfill Prev Device	Overfill Drop Tube Valve	8/22/2022	8/22/2025
Piping	Flex Connector Steel	N/A	N/A
Piping	Fiberglass Single Wall Piping	N/A	N/A
Piping	Single Wall STP/Tanktop Sump
Leak Detect - Piping	Piping Sump Sensors Not Regulated Not Installed	N/A	N/A
Spill Contain Device	Single Wall Spill Bucket	12/27/2022	12/27/2025
Tank	Fiberglass Single Wall XERXES	N/A	N/A
Vent, Riser, Fill Piping	Steel risers	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Piping	Fiberglass Single Wall Piping	Precision Test	Pass	6/29/2022
Piping	Flex Connector Steel	Precision Test	Pass	7/11/2019
Tank	Fiberglass Single Wall XERXES	Precision Test (Tank)	Pass	6/29/2022

Tank Number 2

Capacity:	10000		Petroleum Use:
Product:	Gasoline - Premium		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	6/6/1997		Abandoned Material:
Current Age:	27		Abandoned Date:
Install Date:	5/21/1997		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	5/23/1997

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Sacrificial Anode Flex Connector	7/15/2022	7/15/2025
Corrosion Prot - Piping	Fiberglass Non-Corrosive	N/A	N/A
Corrosion Prot - Tank	Fiberglass Non-Corrosive	N/A	N/A
Leak Detect - Piping	Electronic Pressurized Line Leak Detection	12/27/2022	12/27/2023
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 450 Plus with CSLD	12/27/2022	12/27/2023
Overfill Prev Device	Overfill Drop Tube Valve	8/22/2022	8/22/2025
Piping	Flex Connector Steel	N/A	N/A
Piping	Fiberglass Single Wall Piping	N/A	N/A
Piping	Single Wall STP/Tanktop Sump
Leak Detect - Piping	Piping Sump Sensors Not Regulated Not Installed	N/A	N/A
Spill Contain Device	Single Wall Spill Bucket	12/27/2022	12/27/2025
Tank	Fiberglass Single Wall XERXES	N/A	N/A
Vent, Riser, Fill Piping	Steel risers	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Piping	Fiberglass Single Wall Piping	Precision Test	Pass	8/22/2022
Piping	Flex Connector Steel	Precision Test	Pass	7/11/2019
Tank	Fiberglass Single Wall XERXES	Precision Test (Tank)	Pass	6/29/2022

Dispenser Information

Name\ID 1/2

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump
Leak Detect - Piping	Piping Sump Sensors Not Regulated Not Installed	N/A	N/A

Name\ID 3/4

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump
Leak Detect - Piping	Piping Sump Sensors Not Regulated Not Installed	N/A	N/A

Name\ID 5/6

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump
Leak Detect - Piping	Piping Sump Sensors Not Regulated Not Installed	N/A	N/A

Name\ID 7/8

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump
Leak Detect - Piping	Piping Sump Sensors Not Regulated Not Installed	N/A	N/A

MFD Motorfuel Dispensing Forms

No Forms Found