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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:	6026948
Status:	Active
Facility Name:	Ma Tulja, Inc.
Address:	3 The Game Drive Glen Carbon, IL 62034
County:	Madison
Property Parcel:	14-2-15-32-00-000-031
Facility Type:	Attended Self-Service Station
Owner Type:	Private
Green Tag Decal:	Z001922
Green Tag Issue Date:	12/22/2023
Green Tag Expiration Date:	12/31/2026

Owner Details

Owner Name:	Ma Tulja, Inc.
Owner Address:	3 The Game Drive Glen Carbon, IL 62034
Owner Status:	Current Owner
Purchase Date:	5/30/2018
Type of Financial Responsibility:	Commercial Insurance
Financial Responsibility Reporting Due Date:	7/8/2024

Motor Fuel Dispensing Permits

MFD Permit Type	Issue Date	Expiration Date
Self Service	12/22/2023	12/31/2026

Owner Summary

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Owner Number	Owner Name	Owner Status	Purchase Date
U0034976	Ma Tulja, Inc.	Current Owner	5/30/2018
U0005900	Glen West Enterprises Inc	Former Owner

Permits (Unexpired)

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Permit Number	Type	Status	OSFM Receive Date	Issue Date	Expiration Date	Documents
00524-2023INS	Install	Extension Granted	5/15/2023	5/16/2023	5/16/2024	Documents

Deficiencies (Current)

No Deficiencies Found

IEMA Numbers Associated with the Facility

IEMA Number	Inspection Date	Inspection Type	Permit Number
2023-0761	10/24/2023	Removal Log	01083-2023REM

LUST Fund Eligibility and Deductibility Determinations

IEMA Number	Status	OSFM Received Date	OSFM Response Date	Deductible	Letter
20230761	Eligible	2/2/2024	2/7/2024	$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	10000	Diesel Fuel	Removed	Federal		$0.00	10/24/2023 - REM
2	10000	Gasoline - Premium	Removed	Federal		$0.00	10/24/2023 - REM
3	12000	Gasoline - Regular	Removed	Federal		$0.00	10/24/2023 - REM
4	20000	Gasoline - Regular	Currently in use	Federal		$0.00
5	5000	Gasoline - Premium	Currently in use	Federal		$0.00
6	5000	Diesel Fuel	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

MFD Motorfuel Dispensing Forms

Facility Number	Name	City	Received Date	Letter
6026948	Ma Tulja, Inc.	Glen Carbon	12/11/2023	Letter Form