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:	2009892
Status:	Closed
Facility Name:	Clark
Address:	1295 N. Rand Road Palatine, IL 60067
County:	Cook
Property Parcel:
Facility Type:	Attended Self-Service Station
Owner Type:	Private
Green Tag Decal:	H000434
Green Tag Issue Date:	4/10/2006
Green Tag Expiration Date:	12/31/2009

Owner Details

Owner Name:	LaSalle 115 Holdings, LLC - Series 8 Rand Meadows
Owner Address:	111 W. Monroe / 11W Chicago, IL 60603
Owner Status:	Current Owner
Purchase Date:	4/14/2010
Type of Financial Responsibility:	Commercial Insurance
Financial Responsibility Reporting Due Date:	6/15/2011

Motor Fuel Dispensing Permits

MFD Permit Type	Issue Date	Expiration Date
Self Service	1/2/2004	1/1/2005

Owner Summary

Click for Facility/Tank Ownership history

Owner Number	Owner Name	Owner Status	Purchase Date
U0035814	LaSalle 115 Holdings, LLC - Series 8 Rand Meadows	Current Owner	4/14/2010
U0032664	Patel, Vipul	Former Owner	10/7/2004
U0031557	Toor, Surjit	Former Owner	8/20/2003
U0003073	Clark Retail Enterprises, Inc.	Former Owner	11/22/1988
U0029789	Clark Retail Enterprises, Inc.	Former Owner
U0028787	Clark Retail Enterprises, Inc.,	Former Owner

Permits (Unexpired)

Click for permit history

No Active Permits Found

Notice of Violatlions (Current)

No Notice of Violations Found

IEMA Numbers Associated with the Facility

IEMA Number	Inspection Date	Inspection Type	Permit Number
11-0280	3/30/2011	Removal Log	00112-2011REM
11-2080	3/30/2011	Removal Log	00112-2011REM

LUST Fund Eligibility and Deductibility Determinations

IEMA Number	Status	OSFM Received Date	OSFM Response Date	Deductible	Letter
92-1804	Eligible	7/28/2010	9/7/2010	$10,000

Pay Tank Fees Online

Tank Information

Tank Number 1

Capacity:	7500		Petroleum Use:
Product:	Gasoline		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	3/30/2011
OSFM First Notify Date:	5/2/1986		Abandoned Material:
Current Age:	33		Abandoned Date:
Install Date:	1/1/1978		Red Tag Issue Date:
Last Used Date:	6/16/2006		Fee Due:	$0.00
Product Date:	1/1/1978

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Fiberglass Non-Corrosive	N/A	N/A
Corrosion Prot - Tank	Impressed Current Cathodic Protection
Leak Detect - Piping	Mechanical Pressurized Line Leak Detection
Leak Detect - Tank	Automatic Tank Gauging
Overfill Prev Device	Ball Float Vent Valve
Overfill Prev Device	Overfill Drop Tube Valve
Piping	Fiberglass Double Wall	N/A	N/A
Spill Contain Device	Manhole Field Constructed
Tank	Steel Single Wall	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 2

Capacity:	7500		Petroleum Use:
Product:	Gasoline		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	3/30/2011
OSFM First Notify Date:	5/2/1986		Abandoned Material:
Current Age:	33		Abandoned Date:
Install Date:	1/1/1978		Red Tag Issue Date:
Last Used Date:	6/16/2006		Fee Due:	$0.00
Product Date:	1/1/1978

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Fiberglass Non-Corrosive	N/A	N/A
Corrosion Prot - Tank	Impressed Current Cathodic Protection
Leak Detect - Tank	Automatic Tank Gauging
Piping	Fiberglass Double Wall	N/A	N/A
Tank	Steel Single Wall	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Dispenser Information

MFD Motorfuel Dispensing Forms

No Forms Found