Division of Petroleum & Chemical Safety

Facility

Facility Number:	2001090
Facility Name:	Adjustable Forms, Inc.
Address:	1 East Progress Road Lombard, IL 60148
County:	Du Page
Status:	Closed

Owner Number	Owner Name	Owner Status	Purchase Date
U0000218	Adjustable Forms, Inc.	Current Owner	6/7/1982

Owner Number	Owner Name	Tank Nbr	Capacity	Product	Tank Status	Owner Status	Date
U0000218	Adjustable Forms, Inc.	1	2000	Diesel Fuel	Removed	Current Owner	1/1/1998
U0000218	Adjustable Forms, Inc.	2	2000	Gasoline	Removed	Current Owner	1/1/1998