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:	2029564
Status:	Active
Facility Name:	Good Samaritan Hospital
Address:	3815 Highland Ave Downers Grove, IL 60515
County:	Du Page
Property Parcel:
Facility Type:	Hospital
Owner Type:	Private
Green Tag Decal:	Z004323
Green Tag Issue Date:	9/19/2024
Green Tag Expiration Date:	12/31/2026

Owner Details

Owner Name:	Advocate Healthcare
Owner Address:	2025 Windsor Drive Oak Brook, IL 605231586
Owner Status:	Current Owner
Purchase Date:
Type of Financial Responsibility:	Commercial Insurance
Financial Responsibility Reporting Due Date:	9/19/2025

Motor Fuel Dispensing Permits

No MFD Permits Found

Owner Summary

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Owner Number	Owner Name	Owner Status	Purchase Date
U0018941	Advocate Healthcare	Current Owner

Permits (Unexpired)

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No Active Permits Found

Notice of Violations (Current)

No Notice of Violations Found

IEMA Numbers Associated with the Facility

No IEMA Numbers Found

LUST Fund Eligibility and Deductibility Determinations

No Applications Found

Pay Tank Fees Online

Tank Information

Tank Number 1

Capacity:	20000		Petroleum Use:	Back-up Generator
Product:	Diesel Fuel		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	State		Removed Date:
OSFM First Notify Date:	3/9/1992		Abandoned Material:
Current Age:	48		Abandoned Date:
Install Date:	1/1/1975		Red Tag Issue Date:
Last Used Date:			Fee Due:
Product Date:	9/1/1976

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	European with No Test Req Suction	N/A	N/A
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 300 with CSLD	5/13/2024	5/13/2025
Overfill Prev Device	Overfill Alarm	7/1/2022	7/1/2025
Piping	Flexible Double Wall Environ Geo Flex	N/A	N/A
Piping	Single Wall STP/Tanktop Sump
Leak Detect - Piping	Piping Sump Sensors Not Regulated	N/A	N/A
Spill Contain Device	Single Wall Spill Bucket	7/1/2022	7/1/2025
Tank	Fiberglass Single Wall	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Piping	Flexible Double Wall Environ Geo Flex	Precision Test (Piping)	Pass	6/1/2022
Tank	Fiberglass Single Wall	Precision Test (Tank)	Pass	6/1/2022

Tank Number 2

Capacity:	4000		Petroleum Use:	Back-up Generator
Product:	Diesel Fuel		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	3/9/1992		Abandoned Material:
Current Age:	48		Abandoned Date:
Install Date:	1/1/1975		Red Tag Issue Date:
Last Used Date:			Fee Due:
Product Date:	9/1/1976

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	European with No Test Req Suction	N/A	N/A
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 300 with CSLD	5/13/2024	5/13/2025
Overfill Prev Device	Overfill Alarm	7/1/2022	7/1/2025
Overfill Prev Device	Overfill Drop Tube Valve	7/1/2022	7/1/2025
Piping	Polyethylene Chase	N/A	N/A
Piping	Flexible Double Wall A.P.T. Poly Tech P200SC	N/A	N/A
Piping	Single Wall STP/Tanktop Sump
Leak Detect - Piping	Piping Sump Sensors Not Regulated	N/A	N/A
Spill Contain Device	Single Wall Spill Bucket	6/1/2022	6/1/2025
Tank	Fiberglass Single Wall	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Piping	Chase Secondary Containment A.P.T. Poly Tech DCT-400	Precision Test (Piping)	Pass	7/6/2020
Piping	Flexible Double Wall A.P.T. Poly Tech P200SC	Precision Test (Piping)	Pass	6/1/2022
Piping	Polyethylene Chase	Precision Test (Piping)	Pass	6/1/2022
Tank	Fiberglass Single Wall	Precision Test (Tank)	Pass	6/1/2022
Leak Detect - Piping	Non-Discriminating Sump Sensor	Sensor Functional	Pass	1/1/2009

Dispenser Information

MFD Motorfuel Dispensing Forms

No Forms Found