Division of Petroleum & Chemical Safety

 

Facility Details

Facility Number: 2020667
Status: Active
Facility Name: Lake Bluff Petroleum, Inc.
Address: 218 N. Waukegan Rd.
Lake Bluff, IL 60044
County: Lake
Property Parcel:
Facility Type: Attended Self-Service Station
Owner Type: Private
Green Tag Decal: Y001235
Green Tag Issue Date: 4/3/2023
Green Tag Expiration Date: 12/31/2025

Owner Details

Owner Name: Muhammad Ansari
Owner Address: 218 N. Waukegan Road
Lake Bluff, IL 60044
Owner Status: Current Owner
Purchase Date:
Type of Financial Responsibility: Commercial Insurance
Financial Responsibility Reporting Due Date: 12/20/2024

Motor Fuel Dispensing Permits

MFD Permit Type Issue Date Expiration Date
Self Service 4/3/2023 12/31/2025

Owner Summary

Click for Facility/Tank Ownership history
Owner Number Owner Name Owner Status Purchase Date
U0036922 Ansari, Muhammad Current Owner
U0036558 Lake Bluff Petroleum, Inc. Former Owner 6/13/2012
U0035269 Alliance Oil Corp. Former Owner 3/27/2009
U0034207 A S & K 5, Inc. Former Owner 5/23/2007
U0032773 218 Waukegan, Inc., Former Owner 3/24/2005
U0032209 Combined Real Estate, LLC Former Owner 7/16/2004
U0007721 J & L Oil Co., Inc. Former Owner 9/1/1970

Permits (Unexpired)

Click for permit history

No Active Permits Found

Notice of Violations (Current)

NOV Number: E0020250763 (Pending)    Issue Date: 3/24/2025    Expiration Date: 5/23/2025    View NOV Form

Tanks Violation
4, 5 Dispensers - hoses cracked, split or worn and require replacement - Main hoses cracked
Facility Financial responsibility must be reported yearly - Financial Responsibility shall be declared annually; declaration form can be found at https://webapps.sfm.illinois.gov/USTPortal/forms/FinancialResponsibility. Complete form online and submit electronically.
Facility Missing copies of 30 day Walkthrough Inspection Report. - 30-day Walkthrough Inspection shall be completed, and documentation maintained on site. 30-Day Walkthrough Inspection form available at www.sfm.illinois.gov. The form must be filled out by an A/B Operator, you must, initial each box that applies, date the form each month to ensure it is being done every 30 days, and the A/B operator must print and sign their name at the bottom. If more than one A/B operator fills out the form, then each must print and sign name at the bottom.
Facility Missing copy of emergency instructions or emergency procedures plan - Emergency Procedures plan shall be maintained on site for viewing and reference as necessary (See Operator Training Rules 176.645). The emergency plan template is available on the OSFM website. Update with current owner information.
4, 5 Monthly line interstitial sensor records not available. - Maintain one NORMAL report per LINE, per month, from ATG.
Facility Operations & Maintenance plan missing required frequencies - Adopt and implement a written operations and maintenance plan, signed by both the owner and either a Class A or Class B Operator designated for the UST facility An Operations & Maintenance template is available at www.sfm.illinois.gov to download and complete O & M template and maintain completed form on site. Update with current owner information.
4, 5 Precision line test required. - Precision line test is required due to missing or failed monthly monitoring (Per 41 Ill Admin code 175.640(a)(4))
4, 5 Required monthly tank interstitial sensor records not available. - Maintain one NORMAL report per TANK, per month, from tank monitor.
Facility Submit Notification Form For Ownership Change - Submit OSFM Notification Form showing change in facility ownership, complete and submit the online Notification for Underground Storage Tanks form which can be found at https://webapps.sfm.illinois.gov/USTPortal/NotificationForm Owner St Johns Gas Inc. Contact is Shibu John (708) 955-5972.
4, 5 Tank precision test required. - Precision tank test is required due to missing or failed monthly monitoring (Per 41 Ill Admin code 175.630(c)(2)))

IEMA Numbers Associated with the Facility

IEMA Number Inspection Date Inspection Type Permit Number
13-0392 5/2/2013 Removal Log 00315-2013REM
13-0392 5/3/2013 Removal Log 00315-2013REM

LUST Fund Eligibility and Deductibility Determinations

IEMA Number Status OSFM Received Date OSFM Response Date Deductible Letter
13-0392 Eligible 5/1/2013 6/25/2013 $5,000
Pay Tank Fees Online

Tank Information



Tank Number 1

Capacity: 10000 Petroleum Use:
Product: Gasoline CERCLA Substance:
Status: Removed CAS Code:
Regulated Status: Federal Removed Date: 5/3/2013
OSFM First Notify Date: 4/28/1986 Abandoned Material:
Current Age: 42 Abandoned Date:
Install Date: 9/1/1970 Red Tag Issue Date:
Last Used Date: Fee Due: $0.00
Product Date: 9/1/1970

Equipment

Equipment Type Equipment Last Passing Date Test Expire Date
Corrosion Prot - Piping Cathodic Protection 12/7/2010 12/7/2011
Corrosion Prot - Piping Fiberglass Non-Corrosive N/A N/A
Corrosion Prot - Tank Impressed Current Cathodic Protection 12/7/2010 12/7/2011
Corrosion Prot - Tank Lining Materials Internal 2/28/2008 2/28/2013
Leak Detect - Piping Electronic Pressurized Line Leak Detection 4/30/2010 4/30/2011
Leak Detect - Tank Automatic Tank Gauging Veeder Root TLS 350
Overfill Prev Device Ball Float Vent Valve OPW 53
Overfill Prev Device Overfill Alarm
Piping Fiberglass Double Wall Ameron N/A N/A
Piping Fiberglass Single Wall Piping N/A N/A
Spill Contain Device Single Wall Spill Bucket
Tank Steel Single Wall N/A N/A

Additional Tests

Equipment Type Equipment Test Type Test Result Test Date



Tank Number 2

Capacity: 6000 Petroleum Use:
Product: Gasoline CERCLA Substance:
Status: Removed CAS Code:
Regulated Status: Federal Removed Date: 5/2/2013
OSFM First Notify Date: 4/28/1986 Abandoned Material:
Current Age: 42 Abandoned Date:
Install Date: 9/1/1970 Red Tag Issue Date:
Last Used Date: Fee Due: $0.00
Product Date: 9/1/1970

Equipment

Equipment Type Equipment Last Passing Date Test Expire Date
Corrosion Prot - Piping Cathodic Protection 12/7/2010 12/7/2011
Corrosion Prot - Piping Fiberglass Non-Corrosive N/A N/A
Corrosion Prot - Tank Impressed Current Cathodic Protection 12/7/2010 12/7/2011
Corrosion Prot - Tank Lining Materials Internal 2/28/2008 2/28/2013
Leak Detect - Piping Electronic Pressurized Line Leak Detection 4/30/2010 4/30/2011
Leak Detect - Tank Automatic Tank Gauging Veeder Root TLS 350
Overfill Prev Device Ball Float Vent Valve OPW 53
Overfill Prev Device Overfill Alarm
Piping Fiberglass Double Wall Ameron N/A N/A
Piping Fiberglass Single Wall Piping N/A N/A
Spill Contain Device Single Wall Spill Bucket
Tank Steel Single Wall N/A N/A

Additional Tests

Equipment Type Equipment Test Type Test Result Test Date



Tank Number 3

Capacity: 6000 Petroleum Use:
Product: Gasoline CERCLA Substance:
Status: Removed CAS Code:
Regulated Status: Federal Removed Date: 5/2/2013
OSFM First Notify Date: 4/28/1986 Abandoned Material:
Current Age: 42 Abandoned Date:
Install Date: 9/1/1970 Red Tag Issue Date:
Last Used Date: Fee Due: $0.00
Product Date: 9/1/1970

Equipment

Equipment Type Equipment Last Passing Date Test Expire Date
Corrosion Prot - Piping Cathodic Protection 12/7/2010 12/7/2011
Corrosion Prot - Piping Fiberglass Non-Corrosive N/A N/A
Corrosion Prot - Tank Impressed Current Cathodic Protection 12/7/2010 12/7/2011
Corrosion Prot - Tank Lining Materials Internal 2/28/2008 2/28/2013
Leak Detect - Piping Electronic Pressurized Line Leak Detection 4/30/2010 4/30/2011
Leak Detect - Tank Automatic Tank Gauging Veeder Root TLS 350
Overfill Prev Device Ball Float Vent Valve OPW 53
Overfill Prev Device Overfill Alarm
Piping Fiberglass Double Wall Ameron N/A N/A
Piping Fiberglass Single Wall Piping N/A N/A
Spill Contain Device Single Wall Spill Bucket
Tank Steel Single Wall N/A N/A

Additional Tests

Equipment Type Equipment Test Type Test Result Test Date



Tank Number 4

Capacity: 12000 Petroleum Use:
Product: Gasoline - Regular CERCLA Substance:
Status: Currently in use CAS Code:
Regulated Status: Federal Removed Date:
OSFM First Notify Date: 6/26/2013 Abandoned Material:
Current Age: 12 Abandoned Date:
Install Date: 5/8/2013 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 - Piping Flexible Non-Corrosive N/A N/A
Corrosion Prot - Tank Composite Non-Corrosive N/A N/A
Leak Detect - Piping Mechanical Pressurized Line Leak Detection 12/4/2024 12/4/2025
Leak Detect - Tank Non-Discriminating Interstitial Monitoring Sensors With Monitor 12/4/2024 12/4/2025
Overfill Prev Device Overfill Alarm 8/1/2022 8/1/2025
Overfill Prev Device Overfill Drop Tube Valve 8/1/2022 8/1/2025
Piping Fiberglass Double Wall Ameron N/A N/A
Piping Flexible Double Wall A.P.T. Poly Tech P175SC N/A N/A
Piping Single Wall STP/Tanktop Sump 12/4/2024 12/4/2027
Leak Detect - Piping Non-Discriminating Sump Sensor 10/8/2019 10/8/2020
Leak Detect - Piping Sump Sensor with positive shutdown 12/4/2024 12/4/2025
Piping Single Wall Transition Sump 12/4/2024 12/4/2027
Leak Detect - Piping Sump Sensor with positive shutdown 12/4/2024 12/4/2025
Spill Contain Device Single Wall Spill Bucket 8/1/2022 8/1/2025
Tank Composite Double Wall Lannon N/A N/A

Additional Tests

Equipment Type Equipment Test Type Test Result Test Date
Piping Fiberglass Double Wall Ameron Precision Test (Piping) Pass 12/4/2024
Piping Flexible Double Wall A.P.T. Poly Tech P175SC Precision Test (Piping) Pass 12/4/2024
Tank Composite Double Wall Lannon Precision Test (Tank) Pass 3/9/2023



Tank Number 5

Capacity: 4000 Petroleum Use:
Product: Gasoline - Premium CERCLA Substance:
Status: Currently in use CAS Code:
Regulated Status: Federal Removed Date:
OSFM First Notify Date: 6/26/2013 Abandoned Material:
Current Age: 12 Abandoned Date:
Install Date: 5/8/2013 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 - Piping Flexible Non-Corrosive N/A N/A
Corrosion Prot - Tank Composite Non-Corrosive N/A N/A
Leak Detect - Piping Mechanical Pressurized Line Leak Detection 12/4/2024 12/4/2025
Leak Detect - Tank Non-Discriminating Interstitial Monitoring Sensors With Monitor 12/4/2024 12/4/2025
Overfill Prev Device Overfill Alarm 8/1/2022 8/1/2025
Overfill Prev Device Overfill Drop Tube Valve 8/1/2022 8/1/2025
Piping Fiberglass Double Wall Ameron N/A N/A
Piping Flexible Double Wall A.P.T. Poly Tech P175SC N/A N/A
Piping Single Wall STP/Tanktop Sump 12/4/2024 12/4/2027
Leak Detect - Piping Non-Discriminating Sump Sensor 10/8/2019 10/8/2020
Leak Detect - Piping Sump Sensor with positive shutdown 12/4/2024 12/4/2025
Piping Single Wall Transition Sump 12/4/2024 12/4/2027
Leak Detect - Piping Sump Sensor with positive shutdown 12/4/2024 12/4/2025
Spill Contain Device Single Wall Spill Bucket 8/1/2022 8/1/2025
Tank Composite Double Wall Lannon N/A N/A

Additional Tests

Equipment Type Equipment Test Type Test Result Test Date
Piping Fiberglass Double Wall Ameron Precision Test (Piping) Pass 12/4/2024
Piping Flexible Double Wall A.P.T. Poly Tech P175SC Precision Test (Piping) Pass 12/4/2024
Tank Composite Double Wall Lannon Precision Test (Tank) Pass 3/9/2023

Dispenser Information



Name\ID 1/3

Status: Active
Equipment Type Equipment Last Passing Date Test Expire Date
Dispenser Single Wall UDC Sump 12/4/2024 12/4/2027
Leak Detect - Piping Sump Sensor with positive shutdown 12/4/2024 12/4/2025



Name\ID 2/4

Status: Active
Equipment Type Equipment Last Passing Date Test Expire Date
Dispenser Single Wall UDC Sump 12/4/2024 12/4/2027
Leak Detect - Piping Sump Sensor with positive shutdown 12/4/2024 12/4/2025



Name\ID 5/7

Status: Active
Equipment Type Equipment Last Passing Date Test Expire Date
Dispenser Single Wall UDC Sump 12/4/2024 12/4/2027
Leak Detect - Piping Sump Sensor with positive shutdown 12/4/2024 12/4/2025



Name\ID 6/8

Status: Active
Equipment Type Equipment Last Passing Date Test Expire Date
Dispenser Single Wall UDC Sump 12/4/2024 12/4/2027
Leak Detect - Piping Sump Sensor with positive shutdown 12/4/2024 12/4/2025

MFD Motorfuel Dispensing Forms

No Forms Found