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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:
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:
Y002602
Green Tag Issue Date:
5/26/2023
Green Tag Expiration Date:
12/31/2025
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:
4/26/2025
Motor Fuel Dispensing Permits
MFD Permit Type
Issue Date
Expiration Date
Self Service
4/27/2023
12/31/2025
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
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
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:
43
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:
43
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
6/16/2020
6/16/2025
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
7/12/2021
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:
36
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
