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JB Pritzker, Governor
/
Michele L Pankow, State Fire Marshal
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Blended Fuel Compatibility Form
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Notification Form
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General Information
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Tank Overview
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Summary
Reason for Notification
Select from the Notification Form Types below ALL that apply to this notification.
Page Instructions
New Facility
Only
select this option if the facility location
DOES NOT
have an OSFM facility ID number currently assigned.
New Owner
Select this option if an existing facility location has had a Change of Ownership. Please note: for each facility location owned by this new owner, individual notifications will have to be submitted for each facility location. Deeds and UST facility property tax records are required to be uploaded with each notification.
Note: New Owner Notifications allow for Facility Information Updates and Additional Tanks Found.
Facility Information Update
Select this option if an existing facility has a name or contact change.
Ownership Information Update
Select this option if an existing owner has had a “Change of Address or Contact Name Change”. Unlike the New Owner notification, if you own multiple facility locations, you will only need to identify one location, as the system will update all your facility locations once this form is approved.
Change of Product
Select this option if product stored in an existing tank is being changed.
Change of Service
Select this option if a tank needs to be placed in an out of service status or brought back into a currently-in-use status.
Permitted Notifications
Only select this option if you are notifying the OSFM regarding new tank installations.
Note: Permitted Notifications allow for Changes of Product and Changes of Service.
Additional Tank Found
Select this option if unregistered, regulated petroleum or hazardous substance tanks are found at an existing facility.
Facility Selection
Facility Number
Search
Clear
Owner
-
Owner Name
Address
Contact Person
Phone Number
Facility -
Facility Name
Address
Address 1
Address 2
ApplicationAddressId
0
City
CityCode
0
CityStateZip
, IL
Country
USA
Country
27
County
County
0
EntityLinkId
0
EntityLinkType
ApplicationFacility
State
IL
State
20
Zip Code
Zip Code
, IL
County
Contact Person
Phone Number
Permit Number
Permit Number
Select a Permit
The following documents are required for this application. Please acquire each document, they will be required to be uploaded later during this application.
Document
Required
Description
Authorization to Submit
Required
Download and Sign - Required for all Notification Forms
Certification Form / Installation Oath
Required
Download and Sign - Required for Permitted Installation Notification Forms
Recorded Deed of Ownership
Required
Owner of facility should have this document
UST Facility Property Tax Records
Required
Can be found on most county assessors websites
Compatibility Form
If Applicable
If a tank contains a blended fuel a
Compatibility Form
may be required.
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