Division of Petroleum & Chemical Safety

Facility Details

Facility Number:	2040790
Status:	Active
Facility Name:	Sam's Club #6464
Address:	101 West Oakton St. Des Plaines, IL 60018
County:	Cook
Property Parcel:	08-25-204-003-0000
Facility Type:	Attended Self-Service Station
Owner Type:	Private
Green Tag Decal:	Y001452
Green Tag Issue Date:	1/17/2023
Green Tag Expiration Date:	12/31/2025

Owner Details

Owner Name:	Sam's West, Inc.
Owner Address:	2101 SE Simple Savings Drive Bentonville, AR 727160745
Owner Status:	Current Owner
Purchase Date:
Type of Financial Responsibility:	Commercial Insurance
Financial Responsibility Reporting Due Date:	4/29/2026

Motor Fuel Dispensing Permits

MFD Permit Type	Issue Date	Expiration Date
Self Service	1/17/2023	12/31/2025

Owner Summary

Click for Facility/Tank Ownership history

Owner Number	Owner Name	Owner Status	Purchase Date
U0029973	Sam's West, Inc.	Current Owner
U0017352	Walmart Stores, Inc.	Former Owner	4/12/2002

Permits (Unexpired)

Click for permit history

No Active Permits Found

Notice of Violations (Current)

NOV Number: E0020251199 (Pending) Issue Date: 5/7/2025 Expiration Date: 7/6/2025 View NOV Form

Tanks	Violation
Facility	Annual Emergency Stop Inspection not completed or inspection report not available. - Inspection report missing from facility paperwork
1, 3	Drop tube valve or overfill alarm failed inspection. Repair or replace equipment.
Facility	Missing copies of Annual Walkthrough Inspection Report.
Facility	Missing copies of current testing certificates for operator training - Certificates of all C operators must be with facility paperwork
1, 2, 3	Shear valve inspection report not completed (Required during Annual Walkthrough Inspection). - Report missing from facility paperwork
1, 2, 3	Verify and test piping sump sensor for positive shutdown - Sensors only shutting down dispenser, must shut down entire system

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:
Product:	Gasoline - Regular	CERCLA Substance:
Status:	Currently in use	CAS Code:
Regulated Status:	Federal	Removed Date:
OSFM First Notify Date:	5/28/2002	Abandoned Material:
Current Age:	23	Abandoned Date:
Install Date:	4/18/2002	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	Flexible Non-Corrosive	N/A	N/A
Corrosion Prot - Tank	Fiberglass Non-Corrosive	N/A	N/A
Leak Detect - Piping	Mechanical Pressurized Line Leak Detection	4/16/2025	4/16/2026
Leak Detect - Tank	Non-Discriminating Interstitial Monitoring Sensors With Monitor	4/16/2025	4/16/2026
Overfill Prev Device	Overfill Drop Tube Valve	5/19/2025	5/19/2028
Piping	Flexible Double Wall OPW Pisces	N/A	N/A
Piping	Single Wall STP/Tanktop Sump	1/16/2023	1/16/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	4/16/2025	4/16/2026
Spill Contain Device	Double Wall Spill Bucket	4/16/2025	4/16/2028
Tank	Fiberglass Double Wall XERXES	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Piping	Flexible Double Wall OPW Pisces	Precision Test (Piping)	Pass	4/16/2025
Tank	Fiberglass Double Wall XERXES	Precision Test (Tank)	Pass	5/7/2024

Tank Number 2

Capacity:	20000	Petroleum Use:
Product:	Gasoline - Regular	CERCLA Substance:
Status:	Currently in use	CAS Code:
Regulated Status:	Federal	Removed Date:
OSFM First Notify Date:	5/28/2002	Abandoned Material:
Current Age:	23	Abandoned Date:
Install Date:	4/18/2002	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	Flexible Non-Corrosive	N/A	N/A
Corrosion Prot - Tank	Fiberglass Non-Corrosive	N/A	N/A
Leak Detect - Piping	Mechanical Pressurized Line Leak Detection	4/16/2025	4/16/2026
Leak Detect - Tank	Non-Discriminating Interstitial Monitoring Sensors With Monitor	4/16/2025	4/16/2026
Overfill Prev Device	Overfill Drop Tube Valve	4/16/2025	4/16/2028
Piping	Flexible Double Wall OPW Pisces	N/A	N/A
Piping	Single Wall STP/Tanktop Sump	1/16/2023	1/16/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	4/16/2025	4/16/2026
Spill Contain Device	Double Wall Spill Bucket	4/16/2025	4/16/2028
Tank	Fiberglass Double Wall XERXES	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Piping	Flexible Double Wall OPW Pisces	Precision Test (Piping)	Pass	4/16/2025
Tank	Fiberglass Double Wall XERXES	Precision Test (Tank)	Pass	5/7/2024

Tank Number 3

Capacity:	20000	Petroleum Use:
Product:	Gasoline - Premium	CERCLA Substance:
Status:	Currently in use	CAS Code:
Regulated Status:	Federal	Removed Date:
OSFM First Notify Date:	5/28/2002	Abandoned Material:
Current Age:	23	Abandoned Date:
Install Date:	4/18/2002	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	Flexible Non-Corrosive	N/A	N/A
Corrosion Prot - Tank	Fiberglass Non-Corrosive	N/A	N/A
Leak Detect - Piping	Mechanical Pressurized Line Leak Detection	4/16/2025	4/16/2026
Leak Detect - Tank	Non-Discriminating Interstitial Monitoring Sensors With Monitor	4/16/2025	4/16/2026
Overfill Prev Device	Overfill Drop Tube Valve	5/19/2025	5/19/2028
Piping	Flexible Double Wall OPW Pisces	N/A	N/A
Piping	Single Wall STP/Tanktop Sump	1/16/2023	1/16/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	4/16/2025	4/16/2026
Spill Contain Device	Double Wall Spill Bucket	4/16/2025	4/16/2028
Tank	Fiberglass Double Wall XERXES	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Piping	Flexible Double Wall OPW Pisces	Precision Test (Piping)	Pass	4/16/2025
Tank	Fiberglass Double Wall XERXES	Precision Test (Tank)	Pass	5/7/2024

Dispenser Information

Name\ID 1/2

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	1/16/2023	1/16/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	4/16/2025	4/16/2026

Name\ID 11/12

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	1/16/2023	1/16/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	4/16/2025	4/16/2026

Name\ID 3/4

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	1/16/2023	1/16/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	4/16/2025	4/16/2026

Name\ID 5/6

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	1/16/2023	1/16/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	4/16/2025	4/16/2026

Name\ID 7/8

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	1/16/2023	1/16/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	4/16/2025	4/16/2026

Name\ID 9/10

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	1/16/2023	1/16/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	4/16/2025	4/16/2026

MFD Motorfuel Dispensing Forms

No Forms Found