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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

 

Facility Details

Facility Number: 6028248
Status: Active
Facility Name: 4-0-11 Quick Shop
Address: 810 South Morrison
Collinsville, IL 62234
County: Madison
Property Parcel: 13-1-21-34-17-301-004.001
Facility Type: Attended Self-Service Station
Owner Type: Private
Green Tag Decal: Z001945
Green Tag Issue Date: 3/14/2024
Green Tag Expiration Date: 12/31/2026

Owner Details

Owner Name: Jiya Corporation
Owner Address: 810 S. Morrison Ave.
Collinsville, IL 62234
Owner Status: Current Owner
Purchase Date: 7/31/2020
Type of Financial Responsibility: Commercial Insurance
Financial Responsibility Reporting Due Date: 8/22/2024

Motor Fuel Dispensing Permits

MFD Permit Type Issue Date Expiration Date
Self Service 3/14/2024 12/31/2026

Owner Summary

Click for Facility/Tank Ownership history
Owner Number Owner Name Owner Status Purchase Date
U0039926 Jiya Corporation Current Owner 7/31/2020
U0035019 Diagonal Enterprises, Inc. Former Owner 11/1/2006
U0027817 Prash Corporation Former Owner 9/7/1989
U0001718 Bob Harrison 4 O Quick Shop Former Owner 12/31/1967

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: 12000 Petroleum Use:
Product: Gasoline - Regular CERCLA Substance:
Status: Currently in use CAS Code:
Regulated Status: Federal Removed Date:
OSFM First Notify Date: 7/23/1991 Abandoned Material:
Current Age: 34 Abandoned Date:
Install Date: Red Tag Issue Date:
Last Used Date: Fee Due: $0.00
Product Date: 12/1/1989

Equipment

Equipment Type Equipment Last Passing Date Test Expire Date
Corrosion Prot - Piping Sacrificial Anode Flex Connector 10/2/2023 10/2/2026
Corrosion Prot - Piping Fiberglass Non-Corrosive N/A N/A
Corrosion Prot - Tank STIP3 Cathodic Protection with Dielectric Coating 10/2/2023 10/2/2026
Leak Detect - Piping Mechanical Pressurized Line Leak Detection 12/8/2023 12/8/2024
Leak Detect - Tank Automatic Tank Gauging Veeder Root TLS 350 Plus with CSLD 12/8/2023 12/8/2024
Overfill Prev Device Overfill Drop Tube Valve 11/16/2021 11/16/2024
Piping Fiberglass Single Wall Piping N/A N/A
Piping Not Installed STP/Tanktop Sump N/A N/A
Spill Contain Device Single Wall Spill Bucket 11/16/2021 11/16/2024
Tank STIP3 Single Wall 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 12/8/2023



Tank Number 2

Capacity: 12000 Petroleum Use:
Product: Diesel Fuel CERCLA Substance:
Status: Currently in use CAS Code:
Regulated Status: Federal Removed Date:
OSFM First Notify Date: 7/23/1991 Abandoned Material:
Current Age: 34 Abandoned Date:
Install Date: Red Tag Issue Date:
Last Used Date: Fee Due: $0.00
Product Date: 12/1/1989

Equipment

Equipment Type Equipment Last Passing Date Test Expire Date
Corrosion Prot - Piping Sacrificial Anode Flex Connector 10/2/2023 10/2/2026
Corrosion Prot - Piping Fiberglass Non-Corrosive N/A N/A
Corrosion Prot - Tank STIP3 Cathodic Protection with Dielectric Coating 10/2/2023 10/2/2026
Leak Detect - Piping Mechanical Pressurized Line Leak Detection 12/8/2023 12/8/2024
Leak Detect - Tank Automatic Tank Gauging Veeder Root TLS 350 Plus with CSLD 12/8/2023 12/8/2024
Overfill Prev Device Overfill Drop Tube Valve 11/16/2021 11/16/2024
Piping Fiberglass Single Wall Piping N/A N/A
Piping Not Installed STP/Tanktop Sump N/A N/A
Spill Contain Device Single Wall Spill Bucket 11/16/2021 11/16/2024
Tank STIP3 Single Wall 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 12/8/2023



Tank Number 3

Capacity: 12000 Petroleum Use:
Product: Gasoline - Premium CERCLA Substance:
Status: Currently in use CAS Code:
Regulated Status: Federal Removed Date:
OSFM First Notify Date: 7/23/1991 Abandoned Material:
Current Age: 34 Abandoned Date:
Install Date: Red Tag Issue Date:
Last Used Date: Fee Due: $0.00
Product Date: 12/1/1989

Equipment

Equipment Type Equipment Last Passing Date Test Expire Date
Corrosion Prot - Piping Sacrificial Anode Flex Connector 10/2/2023 10/2/2026
Corrosion Prot - Piping Fiberglass Non-Corrosive N/A N/A
Corrosion Prot - Tank STIP3 Cathodic Protection with Dielectric Coating 10/2/2023 10/2/2026
Leak Detect - Piping Mechanical Pressurized Line Leak Detection 12/8/2023 12/8/2024
Leak Detect - Tank Automatic Tank Gauging Veeder Root TLS 350 Plus with CSLD 12/8/2023 12/8/2024
Overfill Prev Device Overfill Drop Tube Valve 11/16/2021 11/16/2024
Piping Fiberglass Single Wall Piping N/A N/A
Piping Not Installed STP/Tanktop Sump N/A N/A
Spill Contain Device Single Wall Spill Bucket 11/16/2021 11/16/2024
Tank STIP3 Single Wall 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 12/8/2023

Dispenser Information



Name\ID 1/2

Status: Active
Equipment Type Equipment Last Passing Date Test Expire Date
Dispenser Not Installed UDC Sump N/A N/A



Name\ID 3/4

Status: Active
Equipment Type Equipment Last Passing Date Test Expire Date
Dispenser Not Installed UDC Sump N/A N/A



Name\ID 5/6

Status: Active
Equipment Type Equipment Last Passing Date Test Expire Date
Dispenser Not Installed UDC Sump N/A N/A

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