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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

Pay Tank Fees Online Print Detail Page Export to Excel

Facility Details

Facility Number:	2030399
Status:	Active
Facility Name:	Sam's Club #6358
Address:	141 West North Ave. Northlake, IL 60164
County:	Cook
Property Parcel:	15-06-201-060-0000
Facility Type:	Attended Self-Service Station
Owner Type:	Private
Green Tag Decal:	Z000030
Green Tag Issue Date:	4/19/2024
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:	3/14/2002
Type of Financial Responsibility:	Commercial Insurance
Financial Responsibility Reporting Due Date:	4/29/2025

Motor Fuel Dispensing Permits

MFD Permit Type	Issue Date	Expiration Date
Self Service	4/19/2024	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	3/14/2002
U0019919	DO NOT USE THIS NUMBER, former Wal-mart	Former Owner	4/11/1999

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
92-1640	7/28/1992	Removal Log

LUST Fund Eligibility and Deductibility Determinations

No Applications Found

Pay Tank Fees Online

Tank Information

Tank Number	Capacity	Product	Status	Regulated Status	Red Tag Issued	Fee Due	Abandon/Removal Date
1	5000	Heating Oil	Removed	State		$0.00	07/28/1992 - REM
2	20000	Gasoline - Regular	Currently in use	Federal		$0.00
3	20000	Gasoline - Regular	Currently in use	Federal		$0.00
4	20000	Gasoline - Premium	Currently in use	Federal		$0.00

Dispenser Information

Name\ID	Status
1/2	Active
3/4	Active
5/6	Active
7/8	Active
9/10	Active
11/12	Active

MFD Motorfuel Dispensing Forms

No Forms Found