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

Facility Details

Facility Number:	6000112
Status:	Closed
Facility Name:	Meadowbrook Dairy Store
Address:	Highway 140 Bethalto, IL 62010
County:	Madison
Property Parcel:
Facility Type:	Attended Self-Service/Unattended Self-Service
Owner Type:	Private
Green Tag Decal:	B002921
Green Tag Issue Date:	5/10/2000
Green Tag Expiration Date:	12/31/2003

Owner Details

Owner Name:	Dickerson Petroleum
Owner Address:	920 North Illinois Street Belleville, IL 62220
Owner Status:	Current Owner
Purchase Date:	12/1/1984
Type of Financial Responsibility:	Other (add note) and Self-Insurance
Financial Responsibility Reporting Due Date:

Motor Fuel Dispensing Permits

No MFD Permits Found

Owner Summary

Click for Facility/Tank Ownership history

Owner Number	Owner Name	Owner Status	Purchase Date
U0004080	Dickerson Petroleum	Current Owner	12/1/1984

Permits (Unexpired)

Click for permit history

No Active Permits Found

Deficiencies (Current)

No Deficiencies Found

IEMA Numbers Associated with the Facility

IEMA Number	Inspection Date	Inspection Type	Permit Number
04-0602	6/23/2004	Removal Log	04616-2004REM

LUST Fund Eligibility and Deductibility Determinations

IEMA Number	Status	OSFM Received Date	OSFM Response Date	Deductible	Letter
04-0602	Eligible	5/13/2004	5/24/2004	$10,000

Pay Tank Fees Online

Tank Information

Tank Number 1

Capacity:	10000		Petroleum Use:
Product:	Gasoline		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	6/23/2004
OSFM First Notify Date:	12/30/1985		Abandoned Material:
Current Age:	19		Abandoned Date:
Install Date:	12/1/1984		Red Tag Issue Date:
Last Used Date:	12/1/2001		Fee Due:	$0.00
Product Date:	12/1/1984

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 2

Capacity:	10000		Petroleum Use:
Product:	Gasoline		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	6/23/2004
OSFM First Notify Date:	12/30/1985		Abandoned Material:
Current Age:	19		Abandoned Date:
Install Date:	12/1/1984		Red Tag Issue Date:
Last Used Date:	12/1/2001		Fee Due:	$0.00
Product Date:	12/1/1984

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Dispenser Information

MFD Motorfuel Dispensing Forms

No Forms Found