Information

JB Pritzker, Governor

James A. Rivera, State Fire Marshal

Division of Petroleum & Chemical Safety

State of Illinois
Employment Opportunities
Ready Illinois
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Division of Petroleum & Chemical Safety

Facility Details

Facility Number:	2020132
Status:	Active
Facility Name:	Sam's Club #6384
Address:	9500 W. Joliet Rd. Hodgkins, IL 60525
County:	Cook
Property Parcel:	18-16-411-039-0000
Facility Type:	Attended Self-Service Station
Owner Type:	Private
Green Tag Decal:	Z000274
Green Tag Issue Date:	7/2/2024
Green Tag Expiration Date:	12/31/2026

Owner Details

Owner Name:	Sam's West, Inc.
Owner Address:	2101 SE Simple Savings Drive Bentonville, AR 727160745
Owner Status:	Current Owner
Purchase Date:	10/28/2002
Type of Financial Responsibility:	Commercial Insurance
Financial Responsibility Reporting Due Date:	4/29/2026

Motor Fuel Dispensing Permits

MFD Permit Type	Issue Date	Expiration Date
Self Service	7/2/2024	12/31/2026

Owner Summary

Click for Facility/Tank Ownership history

Owner Number	Owner Name	Owner Status	Purchase Date
U0029973	Sam's West, Inc.	Current Owner	10/28/2002
U0006353	Halls Motor Transit Co	Former Owner	12/31/1967
U0006892	Village Of Hodgkins Il Municipal Corp	Former Owner / Operator

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
91-3582	12/11/1991	Removal Log
91-3634	12/17/1991	Removal Log
91-3634	1/9/1992	Removal Log
91-3714	12/23/1991	Removal Log
91-3714	2/5/1992	Removal Log
92-0145	1/16/1992	Removal Log	2106-91
92-0971	4/13/1992	Removal Log
92-0971	4/14/1992	Removal Log
92-0971	4/15/1992	Removal Log

LUST Fund Eligibility and Deductibility Determinations

IEMA Number	Status	OSFM Received Date	OSFM Response Date	Deductible	Letter
91-3582	Eligible	11/9/1994	11/30/1994	$15,000
92-0971	Eligible	11/9/1994	11/30/1994	$15,000
20200674	Eligible	1/8/2021	1/8/2021	$5,000	Letter

Pay Tank Fees Online

Tank Information

Tank Number 1

Capacity:	12000		Petroleum Use:
Product:	Diesel Fuel		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	10/1/1990
OSFM First Notify Date:	5/29/1986		Abandoned Material:
Current Age:	28		Abandoned Date:
Install Date:			Red Tag Issue Date:
Last Used Date:	10/1/1987		Fee Due:	$0.00
Product Date:

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 2

Capacity:	12000		Petroleum Use:
Product:	Diesel Fuel		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	10/1/1990
OSFM First Notify Date:	5/29/1986		Abandoned Material:
Current Age:	28		Abandoned Date:
Install Date:			Red Tag Issue Date:
Last Used Date:	10/1/1987		Fee Due:	$0.00
Product Date:

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 3

Capacity:	12000		Petroleum Use:
Product:	Diesel Fuel		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	10/1/1990
OSFM First Notify Date:	5/29/1986		Abandoned Material:
Current Age:	28		Abandoned Date:
Install Date:			Red Tag Issue Date:
Last Used Date:	10/1/1987		Fee Due:	$0.00
Product Date:

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 4

Capacity:	6000		Petroleum Use:
Product:	Motor Oil		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	10/1/1990
OSFM First Notify Date:	5/29/1986		Abandoned Material:
Current Age:	28		Abandoned Date:
Install Date:			Red Tag Issue Date:
Last Used Date:	10/1/1987		Fee Due:	$0.00
Product Date:

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 5

Capacity:	2000		Petroleum Use:
Product:	Ethylene Glycol		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	10/1/1990
OSFM First Notify Date:	5/29/1986		Abandoned Material:
Current Age:	28		Abandoned Date:
Install Date:			Red Tag Issue Date:
Last Used Date:	10/1/1987		Fee Due:	$0.00
Product Date:

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 6

Capacity:	1000		Petroleum Use:
Product:	Diesel Fuel		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	10/1/1990
OSFM First Notify Date:	5/29/1986		Abandoned Material:
Current Age:	28		Abandoned Date:
Install Date:			Red Tag Issue Date:
Last Used Date:	10/1/1987		Fee Due:	$0.00
Product Date:

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 7

Capacity:	1000		Petroleum Use:
Product:	Gasoline		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	10/1/1990
OSFM First Notify Date:	10/18/1991		Abandoned Material:
Current Age:			Abandoned Date:
Install Date:			Red Tag Issue Date:
Last Used Date:	10/1/1987		Fee Due:	$0.00
Product Date:

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 8

Capacity:	1000		Petroleum Use:
Product:	Gasoline		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	10/1/1990
OSFM First Notify Date:	10/18/1991		Abandoned Material:
Current Age:			Abandoned Date:
Install Date:			Red Tag Issue Date:
Last Used Date:	10/1/1987		Fee Due:	$0.00
Product Date:

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 9

Capacity:	12000		Petroleum Use:
Product:	Diesel Fuel		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	12/24/1991
OSFM First Notify Date:	5/7/1986		Abandoned Material:
Current Age:			Abandoned Date:
Install Date:			Red Tag Issue Date:
Last Used Date:	11/5/1991		Fee Due:	$0.00
Product Date:

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 10

Capacity:	12000		Petroleum Use:
Product:	Diesel Fuel		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	12/24/1991
OSFM First Notify Date:	5/7/1986		Abandoned Material:
Current Age:			Abandoned Date:
Install Date:			Red Tag Issue Date:
Last Used Date:	11/5/1991		Fee Due:	$0.00
Product Date:

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 11

Capacity:	12000		Petroleum Use:
Product:	Diesel Fuel		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	12/24/1991
OSFM First Notify Date:	5/7/1986		Abandoned Material:
Current Age:			Abandoned Date:
Install Date:			Red Tag Issue Date:
Last Used Date:	11/5/1991		Fee Due:	$0.00
Product Date:

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 12

Capacity:	2000		Petroleum Use:
Product:	Used Oil		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	12/23/1991
OSFM First Notify Date:	5/7/1986		Abandoned Material:
Current Age:			Abandoned Date:
Install Date:			Red Tag Issue Date:
Last Used Date:	11/5/1991		Fee Due:	$0.00
Product Date:

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 13

Capacity:	1000		Petroleum Use:
Product:	Used Oil		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	12/23/1991
OSFM First Notify Date:	5/7/1986		Abandoned Material:
Current Age:			Abandoned Date:
Install Date:			Red Tag Issue Date:
Last Used Date:	11/5/1991		Fee Due:	$0.00
Product Date:

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 14

Capacity:	12000		Petroleum Use:
Product:	Gasoline		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	12/24/1991
OSFM First Notify Date:	5/7/1986		Abandoned Material:
Current Age:			Abandoned Date:
Install Date:			Red Tag Issue Date:
Last Used Date:	12/1/1985		Fee Due:	$0.00
Product Date:

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 15

Capacity:	12000		Petroleum Use:
Product:	Diesel Fuel		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	12/23/1991
OSFM First Notify Date:	2/6/1986		Abandoned Material:
Current Age:			Abandoned Date:
Install Date:			Red Tag Issue Date:
Last Used Date:	11/5/1991		Fee Due:	$0.00
Product Date:

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 16

Capacity:	12000		Petroleum Use:
Product:	Diesel Fuel		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	12/17/1991
OSFM First Notify Date:	4/8/1986		Abandoned Material:
Current Age:	11		Abandoned Date:
Install Date:	2/1/1980		Red Tag Issue Date:
Last Used Date:	11/2/1991		Fee Due:	$0.00
Product Date:	2/1/1980

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 17

Capacity:	12000		Petroleum Use:
Product:	Diesel Fuel		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	12/17/1991
OSFM First Notify Date:	4/8/1986		Abandoned Material:
Current Age:	11		Abandoned Date:
Install Date:	2/1/1980		Red Tag Issue Date:
Last Used Date:	11/2/1991		Fee Due:	$0.00
Product Date:	2/1/1980

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 18

Capacity:	150		Petroleum Use:
Product:	Used Oil		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	1/9/1992
OSFM First Notify Date:	12/20/1991		Abandoned Material:
Current Age:	11		Abandoned Date:
Install Date:	2/1/1980		Red Tag Issue Date:
Last Used Date:	11/2/1991		Fee Due:	$0.00
Product Date:	2/1/1980

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 19

Capacity:	10000		Petroleum Use:
Product:	Diesel Fuel		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	12/11/1991
OSFM First Notify Date:	2/3/1986		Abandoned Material:
Current Age:			Abandoned Date:
Install Date:			Red Tag Issue Date:
Last Used Date:	11/2/1991		Fee Due:	$0.00
Product Date:

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 20

Capacity:	6000		Petroleum Use:
Product:	Gasoline		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	12/1/1991
OSFM First Notify Date:	1/30/1986		Abandoned Material:
Current Age:			Abandoned Date:
Install Date:			Red Tag Issue Date:
Last Used Date:	9/1/1991		Fee Due:	$0.00
Product Date:

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 21

Capacity:	4000		Petroleum Use:
Product:	Gasoline		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	12/1/1991
OSFM First Notify Date:	1/30/1986		Abandoned Material:
Current Age:			Abandoned Date:
Install Date:			Red Tag Issue Date:
Last Used Date:	9/1/1991		Fee Due:	$0.00
Product Date:

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 22

Capacity:	5000		Petroleum Use:
Product:	Gasoline		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	12/1/1991
OSFM First Notify Date:	1/30/1986		Abandoned Material:
Current Age:			Abandoned Date:
Install Date:			Red Tag Issue Date:
Last Used Date:	9/1/1991		Fee Due:	$0.00
Product Date:

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 23

Capacity:	4000		Petroleum Use:
Product:	Gasoline		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	12/1/1991
OSFM First Notify Date:	1/30/1986		Abandoned Material:
Current Age:			Abandoned Date:
Install Date:			Red Tag Issue Date:
Last Used Date:	9/1/1991		Fee Due:	$0.00
Product Date:

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 24

Capacity:	550		Petroleum Use:	Consumptive Use on Premises for Heating
Product:	Heating Oil		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Exempt		Removed Date:	1/1/1992
OSFM First Notify Date:	2/14/1992		Abandoned Material:
Current Age:			Abandoned Date:
Install Date:			Red Tag Issue Date:
Last Used Date:	1/1/1970		Fee Due:
Product Date:

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 25

Capacity:	1000		Petroleum Use:
Product:	Gasoline		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Exempt		Removed Date:	2/1/1992
OSFM First Notify Date:	2/14/1992		Abandoned Material:
Current Age:			Abandoned Date:
Install Date:			Red Tag Issue Date:
Last Used Date:	1/1/1970		Fee Due:
Product Date:

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 26

Capacity:	1000		Petroleum Use:
Product:	Gasoline		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	1/16/1992
OSFM First Notify Date:	4/5/1991		Abandoned Material:
Current Age:			Abandoned Date:
Install Date:			Red Tag Issue Date:
Last Used Date:	1/10/1992		Fee Due:	$0.00
Product Date:

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 27

Capacity:	4000		Petroleum Use:
Product:	Diesel Fuel		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	4/13/1992
OSFM First Notify Date:	4/23/1986		Abandoned Material:
Current Age:	25		Abandoned Date:
Install Date:	1/1/1967		Red Tag Issue Date:
Last Used Date:	10/15/1991		Fee Due:	$0.00
Product Date:	1/1/1967

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 28

Capacity:	12000		Petroleum Use:
Product:	Diesel Fuel		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	4/13/1992
OSFM First Notify Date:	4/23/1986		Abandoned Material:
Current Age:	25		Abandoned Date:
Install Date:	1/1/1967		Red Tag Issue Date:
Last Used Date:	10/15/1991		Fee Due:	$0.00
Product Date:	1/1/1967

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 29

Capacity:	12000		Petroleum Use:
Product:	Diesel Fuel		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	4/13/1992
OSFM First Notify Date:	4/23/1986		Abandoned Material:
Current Age:	25		Abandoned Date:
Install Date:	1/1/1967		Red Tag Issue Date:
Last Used Date:	10/15/1991		Fee Due:	$0.00
Product Date:	1/1/1967

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 30

Capacity:	12000		Petroleum Use:
Product:	Diesel Fuel		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	4/14/1992
OSFM First Notify Date:	1/1/1995		Abandoned Material:
Current Age:	25		Abandoned Date:
Install Date:	1/1/1967		Red Tag Issue Date:
Last Used Date:	10/15/1991		Fee Due:	$0.00
Product Date:	1/1/1967

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 31

Capacity:	12000		Petroleum Use:	Consumptive Use on Premises for Heating
Product:	Heating Oil		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	State		Removed Date:	4/15/1992
OSFM First Notify Date:	9/17/1991		Abandoned Material:
Current Age:	25		Abandoned Date:
Install Date:	1/1/1967		Red Tag Issue Date:
Last Used Date:	10/15/1991		Fee Due:	$0.00
Product Date:	1/1/1967

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 32

Capacity:	12000		Petroleum Use:	Consumptive Use on Premises for Heating
Product:	Heating Oil		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	State		Removed Date:	4/15/1992
OSFM First Notify Date:	9/17/1991		Abandoned Material:
Current Age:	25		Abandoned Date:
Install Date:	1/1/1967		Red Tag Issue Date:
Last Used Date:	10/15/1991		Fee Due:	$0.00
Product Date:	1/1/1967

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 33

Capacity:	4000		Petroleum Use:
Product:	Used Oil		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	4/15/1992
OSFM First Notify Date:	9/17/1991		Abandoned Material:
Current Age:	25		Abandoned Date:
Install Date:	1/1/1967		Red Tag Issue Date:
Last Used Date:	10/15/1991		Fee Due:	$0.00
Product Date:	1/1/1967

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 34

Capacity:	4000		Petroleum Use:
Product:	Motor Oil		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	4/14/1992
OSFM First Notify Date:	9/17/1991		Abandoned Material:
Current Age:	35		Abandoned Date:
Install Date:	1/1/1957		Red Tag Issue Date:
Last Used Date:	10/15/1991		Fee Due:	$0.00
Product Date:	1/1/1957

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 35

Capacity:	4000		Petroleum Use:
Product:	Motor Oil		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	4/14/1992
OSFM First Notify Date:	9/17/1991		Abandoned Material:
Current Age:	25		Abandoned Date:
Install Date:	1/1/1967		Red Tag Issue Date:
Last Used Date:	10/15/1991		Fee Due:	$0.00
Product Date:	1/1/1967

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 36

Capacity:	12000		Petroleum Use:
Product:	Diesel Fuel		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	4/15/1992
OSFM First Notify Date:	9/17/1991		Abandoned Material:
Current Age:	35		Abandoned Date:
Install Date:	1/1/1957		Red Tag Issue Date:
Last Used Date:	10/15/1991		Fee Due:	$0.00
Product Date:	1/1/1957

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 37

Capacity:	2000		Petroleum Use:
Product:	Heating Oil		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	State		Removed Date:	4/14/1992
OSFM First Notify Date:	5/7/1992		Abandoned Material:
Current Age:	25		Abandoned Date:
Install Date:	1/1/1967		Red Tag Issue Date:
Last Used Date:	10/15/1991		Fee Due:
Product Date:	1/1/1967

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 38

Capacity:	20000		Petroleum Use:
Product:	Gasoline - Regular		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	1/29/2003		Abandoned Material:
Current Age:	22		Abandoned Date:
Install Date:	12/5/2002		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	Flexible Non-Corrosive	N/A	N/A
Corrosion Prot - Tank	Fiberglass Non-Corrosive	N/A	N/A
Leak Detect - Piping	Mechanical Pressurized Line Leak Detection	7/2/2024	7/2/2025
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 450 Plus with CSLD	7/2/2024	7/2/2025
Leak Detect - Tank	Non-Discriminating Interstitial Monitoring Sensors	7/2/2024	7/2/2025
Overfill Prev Device	Overfill Drop Tube Valve	7/25/2023	7/25/2026
Piping	Flexible Double Wall Environ Geo Flex	N/A	N/A
Piping	Single Wall STP/Tanktop Sump	7/17/2023	7/17/2026
Leak Detect - Piping	Non-Discriminating Sump Sensor	9/8/2021	9/8/2022
Leak Detect - Piping	Sump Sensor with positive shutdown	7/2/2024	7/2/2025
Spill Contain Device	Single Wall Spill Bucket	7/2/2024	7/2/2027
Tank	Fiberglass Double Wall	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Piping	Fiberglass Single Wall Piping Ameron	Precision Test (Piping)	Pass	12/18/2019
Piping	Flexible Double Wall Environ Geo Flex	Precision Test (Piping)	Pass	7/2/2024
Tank	Fiberglass Double Wall	Precision Test (Tank)	Pass	9/15/2020

Tank Number 39

Capacity:	20000		Petroleum Use:
Product:	Gasoline - Regular		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	1/29/2003		Abandoned Material:
Current Age:	22		Abandoned Date:
Install Date:	12/5/2002		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	Flexible Non-Corrosive	N/A	N/A
Corrosion Prot - Tank	Fiberglass Non-Corrosive	N/A	N/A
Leak Detect - Piping	Mechanical Pressurized Line Leak Detection	3/24/2025	3/24/2026
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 450 Plus with CSLD	7/2/2024	7/2/2025
Leak Detect - Tank	Non-Discriminating Interstitial Monitoring Sensors	7/2/2024	7/2/2025
Overfill Prev Device	Overfill Drop Tube Valve	7/25/2023	7/25/2026
Piping	Flexible Double Wall Environ Geo Flex	N/A	N/A
Piping	Single Wall STP/Tanktop Sump	7/17/2023	7/17/2026
Leak Detect - Piping	Non-Discriminating Sump Sensor	9/8/2021	9/8/2022
Leak Detect - Piping	Sump Sensor with positive shutdown	7/2/2024	7/2/2025
Spill Contain Device	Single Wall Spill Bucket	7/2/2024	7/2/2027
Tank	Fiberglass Double Wall	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Piping	Fiberglass Single Wall Piping Ameron	Precision Test (Piping)	Pass	12/18/2019
Piping	Flexible Double Wall Environ Geo Flex	Precision Test (Piping)	Pass	7/2/2024
Tank	Fiberglass Double Wall	Precision Test (Tank)	Pass	9/15/2020

Tank Number 40

Capacity:	20000		Petroleum Use:
Product:	Gasoline - Premium		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	1/29/2003		Abandoned Material:
Current Age:	22		Abandoned Date:
Install Date:	12/5/2002		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	Flexible Non-Corrosive	N/A	N/A
Corrosion Prot - Tank	Fiberglass Non-Corrosive	N/A	N/A
Leak Detect - Piping	Mechanical Pressurized Line Leak Detection	7/2/2024	7/2/2025
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 450 Plus with CSLD	7/2/2024	7/2/2025
Leak Detect - Tank	Non-Discriminating Interstitial Monitoring Sensors	7/2/2024	7/2/2025
Overfill Prev Device	Overfill Drop Tube Valve	7/25/2023	7/25/2026
Piping	Flexible Double Wall Environ Geo Flex	N/A	N/A
Piping	Single Wall STP/Tanktop Sump	7/17/2023	7/17/2026
Leak Detect - Piping	Non-Discriminating Sump Sensor	9/8/2021	9/8/2022
Leak Detect - Piping	Sump Sensor with positive shutdown	7/2/2024	7/2/2025
Spill Contain Device	Single Wall Spill Bucket	7/2/2024	7/2/2027
Tank	Fiberglass Double Wall	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Piping	Fiberglass Single Wall Piping Ameron	Precision Test (Piping)	Pass	12/18/2019
Piping	Flexible Double Wall Environ Geo Flex	Precision Test (Piping)	Pass	7/2/2024
Tank	Fiberglass Double Wall	Precision Test (Tank)	Pass	9/15/2020

Dispenser Information

Name\ID 1/2

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	7/17/2023	7/17/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	7/2/2024	7/2/2025

Name\ID 11/12

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	7/17/2023	7/17/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	7/2/2024	7/2/2025

Name\ID 13/14

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	7/17/2023	7/17/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	7/2/2024	7/2/2025

Name\ID 15/16

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	7/17/2023	7/17/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	7/2/2024	7/2/2025

Name\ID 3/4

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	7/17/2023	7/17/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	7/2/2024	7/2/2025

Name\ID 5/6

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	7/17/2023	7/17/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	7/2/2024	7/2/2025

Name\ID 7/8

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	7/17/2023	7/17/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	7/2/2024	7/2/2025

Name\ID 9/10

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	7/17/2023	7/17/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	7/2/2024	7/2/2025

MFD Motorfuel Dispensing Forms

No Forms Found