Information

JB Pritzker, Governor

Michele L Pankow, State Fire Marshal

Division of Petroleum & Chemical Safety

State of Illinois
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Division of Petroleum & Chemical Safety

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Facility Details

Facility Number:	2040091
Status:	Active
Facility Name:	Costco Gasoline #380
Address:	2746 N. Clybourn Avenue Chicago, IL 60614
County:	Cook
Property Parcel:
Facility Type:	Attended Self-Service Station
Owner Type:	Private
Green Tag Decal:	Y001521
Green Tag Issue Date:	10/13/2023
Green Tag Expiration Date:	12/31/2025

Owner Details

Owner Name:	Costco Wholesale Corporation
Owner Address:	P.O. Box 35005 Seattle, WA 98124
Owner Status:	Current Owner
Purchase Date:	5/13/2011
Type of Financial Responsibility:	Commercial Insurance
Financial Responsibility Reporting Due Date:	6/3/2026

Motor Fuel Dispensing Permits

MFD Permit Type	Issue Date	Expiration Date
Self Service	10/13/2023	12/31/2025

Owner Summary

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Owner Number	Owner Name	Owner Status	Purchase Date
U0029489	Costco Wholesale Corporation	Current Owner	5/13/2011

Permits (Unexpired)

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Permit Number	Type	Status	OSFM Receive Date	Issue Date	Expiration Date	Documents
00438-2025REM	Removal	Approved / Issued	4/11/2025	4/11/2025	10/14/2025	Documents
00432-2025INS	Install	Approved / Issued	3/26/2025	4/10/2025	10/10/2025	Documents
00462-2025UPG	Upgrade	Approved / Issued	4/11/2025	4/21/2025	10/21/2025	Documents

Notice of Violatlions (Current)

No Notice of Violations Found

IEMA Numbers Associated with the Facility

IEMA Number	Inspection Date	Inspection Type	Permit Number
00-0918	5/15/2000	Removal Log	105610

LUST Fund Eligibility and Deductibility Determinations

No Applications Found

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Tank Information

Tank Number	Capacity	Product	Status	Regulated Status	Red Tag Issued	Fee Due	Abandon/Removal Date
1	3000	Fuel Oil	Removed	State			05/15/2000 - REM
2	1500	Ultrazol - Fuel Additive	Currently in use	Federal		$0.00
3	20000	Gasoline - Regular	Currently in use	Federal		$0.00
4	20000	Gasoline - Regular	Currently in use	Federal		$0.00
5	20000	Gasoline - Premium	Currently in use	Federal		$0.00
6	30000	Gasoline - Premium	Not Installed	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

Facility Number	Name	City	Received Date	Letter
2040091	Costco Gasoline #380	Chicago	04/07/2025	Letter Form
2040091	Costco Gasoline #380	Chicago	09/22/2020	Letter Form
2040091	Costco Gasoline #380	Chicago	02/12/2020	Letter Form