Information
JB Pritzker, Governor
Michele L Pankow, State Fire Marshal
Division of Petroleum & Chemical Safety
State of Illinois
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Division of Petroleum & Chemical Safety
Facility Details
Facility Number:
2026027
Status:
Active
Facility Name:
1422 Countryside Station, LLC - Shell
Address:
1422 W. 55th Street Countryside, IL 60525
County:
Cook
Property Parcel:
18-08-406-001-0000
Facility Type:
Attended Self-Service Station
Owner Type:
Private
Green Tag Decal:
AA00207
Green Tag Issue Date:
5/23/2025
Green Tag Expiration Date:
12/31/2027
Owner Details
Owner Name:
Azeem Ali Khan and Nadir Ali Khan
Owner Address:
1422 W. 55th Street Countryside, IL 60525
Owner Status:
Current Owner
Purchase Date:
1/25/2021
Type of Financial Responsibility:
Commercial Insurance
Financial Responsibility Reporting Due Date:
3/20/2026
Motor Fuel Dispensing Permits
MFD Permit Type
Issue Date
Expiration Date
Self Service
5/23/2025
12/31/2027
Owner Summary
Click for Facility/Tank Ownership history
Owner Number
Owner Name
Owner Status
Purchase Date
U0040103
Azeem Ali Khan and Nadir Ali Khan
Current Owner
1/25/2021
U0038548
1422 Countryside Station, LLC
Former Owner
6/1/2016
U0027695
Farokitian, Mathew
Former Owner
8/10/1998
U0005185
First Il Bank & Tr
Former Owner
4/21/1997
Permits (Unexpired)
Click for permit history
Permit Number
Type
Status
OSFM Receive Date
Issue Date
Expiration Date
Documents
01097-2025LIN
Lining Inspection
Approved / Issued
8/20/2025
8/21/2025
2/23/2026
Documents
Notice of Violatlions (Current)
No Notice of Violations Found
IEMA Numbers Associated with the Facility
IEMA Number
Inspection Date
Inspection Type
Permit Number
N/A
4/13/2023
Abandonment Log
00335-2023ABN
LUST
Fund Eligibility and Deductibility Determinations
IEMA Number
Status
OSFM Received Date
OSFM Response Date
Deductible
Letter
20230171
Eligible
1/10/2024
1/18/2024
$5,000
Letter
Pay Tank Fees Online
Tank Information
Tank Number 1
Capacity:
12000
Petroleum Use:
Product:
Gasoline - Regular
CERCLA Substance:
Status:
Abandoned in place
CAS Code:
Regulated Status:
Federal
Removed Date:
OSFM
First Notify Date:
5/10/1990
Abandoned Material:
Inert material mixed with portland cement
Current Age:
44
Abandoned Date:
4/13/2023
Install Date:
5/10/1981
Red Tag Issue Date:
Last Used Date:
Fee Due:
$0.00
Product Date:
Equipment
Equipment Type
Equipment
Last Passing Date
Test Expire Date
Corrosion Prot - Piping
Sacrificial Anode Cathodic Protection
7/12/2021
7/12/2024
Corrosion Prot - Piping
Fiberglass Non-Corrosive
N/A
N/A
Corrosion Prot - Tank
Lining Materials Internal
6/16/2020
6/16/2025
Leak Detect - Piping
Electronic Pressurized Line Leak Detection
9/26/2022
9/26/2023
Leak Detect - Tank
Automatic Tank Gauging Veeder Root TLS 350j with CSLD
9/26/2022
9/26/2023
Overfill Prev Device
Overfill Drop Tube Valve
7/12/2021
7/12/2024
Piping
Fiberglass Single Wall Piping Ameron
N/A
N/A
Piping
Not Installed STP/Tanktop Sump
N/A
N/A
Spill Contain Device
Single Wall Spill Bucket
5/31/2019
5/31/2022
Tank
Steel Single Wall
N/A
N/A
Additional Tests
Equipment Type
Equipment
Test Type
Test Result
Test Date
Piping
Fiberglass Double Wall
Precision Test (Piping)
Pass
5/31/2019
Piping
Fiberglass Single Wall Piping Ameron
Precision Test (Piping)
Pass
6/17/2020
Tank
Steel Single Wall
Precision Test (Tank)
Fail
1/5/2023
Tank Number 2
Capacity:
10000
Petroleum Use:
Product:
Gasoline - Premium
CERCLA Substance:
Status:
Currently in use
CAS Code:
Regulated Status:
Federal
Removed Date:
OSFM
First Notify Date:
5/10/1990
Abandoned Material:
Current Age:
44
Abandoned Date:
Install Date:
5/10/1981
Red Tag Issue Date:
Last Used Date:
Fee Due:
$0.00
Product Date:
Equipment
Equipment Type
Equipment
Last Passing Date
Test Expire Date
Corrosion Prot - Piping
Sacrificial Anode Flex Connector
8/16/2024
8/16/2027
Corrosion Prot - Piping
Fiberglass Non-Corrosive
N/A
N/A
Corrosion Prot - Tank
Lining Materials Internal
9/17/2025
9/17/2030
Leak Detect - Piping
Electronic Pressurized Line Leak Detection
2/24/2025
2/24/2026
Leak Detect - Tank
Automatic Tank Gauging Veeder Root TLS 350j with CSLD
2/24/2025
2/24/2026
Overfill Prev Device
Overfill Drop Tube Valve
8/24/2024
8/24/2027
Piping
Fiberglass Single Wall Piping Ameron
N/A
N/A
Piping
Not Installed STP/Tanktop Sump
N/A
N/A
Spill Contain Device
Single Wall Spill Bucket
9/26/2022
9/26/2025
Tank
Steel Single Wall
N/A
N/A
Additional Tests
Equipment Type
Equipment
Test Type
Test Result
Test Date
Piping
Fiberglass Double Wall
Precision Test (Piping)
Pass
5/31/2019
Piping
Fiberglass Single Wall Piping Ameron
Precision Test (Piping)
Pass
4/20/2023
Tank
Steel Single Wall
Precision Test (Tank)
Pass
9/18/2025
Tank Number 3
Capacity:
10000
Petroleum Use:
Product:
Gasoline - Regular
CERCLA Substance:
Status:
Currently in use
CAS Code:
Regulated Status:
Federal
Removed Date:
OSFM
First Notify Date:
5/10/1990
Abandoned Material:
Current Age:
37
Abandoned Date:
Install Date:
6/28/1988
Red Tag Issue Date:
Last Used Date:
Fee Due:
$0.00
Product Date:
6/28/1988
Equipment
Equipment Type
Equipment
Last Passing Date
Test Expire Date
Corrosion Prot - Piping
Sacrificial Anode Flex Connector
8/16/2024
8/16/2027
Corrosion Prot - Piping
Fiberglass Non-Corrosive
N/A
N/A
Corrosion Prot - Tank
Fiberglass Non-Corrosive
N/A
N/A
Leak Detect - Piping
Electronic Pressurized Line Leak Detection
2/24/2025
2/24/2026
Leak Detect - Tank
Automatic Tank Gauging Veeder Root TLS 350j with CSLD
2/24/2025
2/24/2026
Overfill Prev Device
Overfill Drop Tube Valve
8/24/2024
8/24/2027
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
9/26/2022
9/26/2025
Tank
Fiberglass Single Wall
N/A
N/A
Additional Tests
Equipment Type
Equipment
Test Type
Test Result
Test Date
Piping
Fiberglass Double Wall
Precision Test (Piping)
Pass
5/31/2019
Piping
Fiberglass Single Wall Piping
Precision Test (Piping)
Pass
4/20/2023
Piping
Fiberglass Single Wall Piping Ameron
Precision Test (Piping)
Pass
5/8/2020
Tank
Fiberglass Single Wall
Precision Test (Tank)
Pass
4/14/2023
Dispenser Information
Name\ID 1/2
Status:
Active
Equipment Type
Equipment
Last Passing Date
Test Expire Date
Dispenser
Single Wall UDC Sump
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
Name\ID 7/8
Status:
Active
Equipment Type
Equipment
Last Passing Date
Test Expire Date
Dispenser
Not Installed UDC Sump
N/A
N/A
Name\ID 9/10
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
