Information

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:	2011720
Status:	Closed
Facility Name:	Jacobsen Excavating, Inc.
Address:	22381 W. Rt. 173 Antioch, IL 60002
County:	Lake
Property Parcel:	92-16-400-010
Facility Type:	Construction
Owner Type:	Private
Green Tag Decal:	W001841
Green Tag Issue Date:	4/4/2022
Green Tag Expiration Date:	10/17/2023

Owner Details

Owner Name:	Jacobsen Excavating, Inc.
Owner Address:	22381 W. Rt. 173 Antioch, IL 60002
Owner Status:	Current Owner
Purchase Date:
Type of Financial Responsibility:	Letter of Credit
Financial Responsibility Reporting Due Date:	4/6/2024

Motor Fuel Dispensing Permits

MFD Permit Type	Issue Date	Expiration Date
Fleet	4/6/2023	12/31/2025

Owner Summary

Click for Facility/Tank Ownership history

Owner Number	Owner Name	Owner Status	Purchase Date
U0007759	Jacobsen Excavating, Inc.	Current Owner

Permits (Unexpired)

Click for permit history

No Active Permits Found

Notice of Violations (Current)

No Notice of Violations Found

IEMA Numbers Associated with the Facility

IEMA Number	Inspection Date	Inspection Type	Permit Number
N/A	10/17/2023	Removal Log	01031-2023REM

LUST Fund Eligibility and Deductibility Determinations

No Applications Found

Pay Tank Fees Online

Tank Information

Tank Number 1

Capacity:	1000		Petroleum Use:
Product:	Gasoline - Regular		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	10/17/2023
OSFM First Notify Date:	6/10/1987		Abandoned Material:
Current Age:	35		Abandoned Date:
Install Date:	12/16/1987		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	Fiberglass Non-Corrosive	N/A	N/A
Corrosion Prot - Tank	Sacrificial Anode Cathodic Protection	12/27/2021	12/27/2024
Leak Detect - Piping	European with No Test Req Suction	N/A	N/A
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 300j	1/16/2023	1/16/2024
Overfill Prev Device	Overfill Alarm	7/29/2022	7/29/2025
Piping	Fiberglass Single Wall Piping Ameron	N/A	N/A
Piping	Not Installed STP/Tanktop Sump	N/A	N/A
Leak Detect - Piping	Piping Sump Sensors Not Regulated Not Installed	N/A	N/A
Spill Contain Device	Single Wall Spill Bucket	7/29/2022	7/29/2025
Tank	Steel Single Wall	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Tank	Steel Single Wall	Precision Test (Tank)	Pass	12/27/2021

Tank Number 2

Capacity:	4000		Petroleum Use:	None
Product:	Dyed Diesel		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	10/17/2023
OSFM First Notify Date:	6/10/1987		Abandoned Material:
Current Age:	35		Abandoned Date:
Install Date:	12/16/1987		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	Fiberglass Non-Corrosive	N/A	N/A
Corrosion Prot - Tank	Sacrificial Anode Cathodic Protection	12/27/2021	12/27/2024
Leak Detect - Piping	European with No Test Req Suction	N/A	N/A
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 300j	1/16/2023	1/16/2024
Overfill Prev Device	Overfill Alarm	7/29/2022	7/29/2025
Piping	Fiberglass Single Wall Piping Ameron	N/A	N/A
Piping	Not Installed STP/Tanktop Sump	N/A	N/A
Leak Detect - Piping	Piping Sump Sensors Not Regulated Not Installed	N/A	N/A
Spill Contain Device	Single Wall Spill Bucket	7/29/2022	7/29/2025
Tank	Steel Single Wall	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Tank	Steel Single Wall	Precision Test (Tank)	Pass	12/27/2021

Tank Number 3

Capacity:	4000		Petroleum Use:	None
Product:	Diesel Fuel		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	10/17/2023
OSFM First Notify Date:	6/10/1987		Abandoned Material:
Current Age:	35		Abandoned Date:
Install Date:	12/16/1987		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	Fiberglass Non-Corrosive	N/A	N/A
Corrosion Prot - Tank	Sacrificial Anode Cathodic Protection	12/27/2021	12/27/2024
Leak Detect - Piping	European with No Test Req Suction	N/A	N/A
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 300j	1/16/2023	1/16/2024
Overfill Prev Device	Overfill Alarm	7/29/2022	7/29/2025
Piping	Fiberglass Single Wall Piping Ameron	N/A	N/A
Piping	Not Installed STP/Tanktop Sump	N/A	N/A
Leak Detect - Piping	Piping Sump Sensors Not Regulated Not Installed	N/A	N/A
Spill Contain Device	Single Wall Spill Bucket	7/29/2022	7/29/2025
Tank	Steel Single Wall	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Tank	Steel Single Wall	Precision Test (Tank)	Pass	12/27/2021

Dispenser Information

Name\ID 1

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Not Installed UDC Sump	N/A	N/A
Leak Detect - Piping	Piping Sump Sensors Not Regulated Not Installed	N/A	N/A

Name\ID 2

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Not Installed UDC Sump	N/A	N/A
Leak Detect - Piping	Piping Sump Sensors Not Regulated Not Installed	N/A	N/A

Name\ID 3

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Not Installed UDC Sump	N/A	N/A
Leak Detect - Piping	Piping Sump Sensors Not Regulated Not Installed	N/A	N/A

MFD Motorfuel Dispensing Forms

No Forms Found