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:	2045315
Status:	Closed
Facility Name:	Sam's Club #6237
Address:	460 South Weber Road Romeoville, IL 60544
County:	Will
Property Parcel:
Facility Type:	Attended Self-Service Station
Owner Type:	Private
Green Tag Decal:	S000528
Green Tag Issue Date:	5/25/2017
Green Tag Expiration Date:	12/31/2019

Owner Details

Owner Name:	Sam's West, Inc.
Owner Address:	2101 SE Simple Savings Drive Bentonville, AR 727160745
Owner Status:	Current Owner
Purchase Date:	10/3/2013
Type of Financial Responsibility:	Commercial Insurance
Financial Responsibility Reporting Due Date:	5/3/2019

Motor Fuel Dispensing Permits

MFD Permit Type	Issue Date	Expiration Date
Self Service	5/25/2017	12/31/2019

Owner Summary

Click for Facility/Tank Ownership history

Owner Number	Owner Name	Owner Status	Purchase Date
U0029973	Sam's West, Inc.	Current Owner	10/3/2013

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	3/12/2019	Removal Log	01339-2018REM
N/A	3/11/2019	Removal Log	01339-2018REM

LUST Fund Eligibility and Deductibility Determinations

IEMA Number	Status	OSFM Received Date	OSFM Response Date	Deductible	Letter
20190261	Eligible	8/7/2020	8/10/2020	$5,000	Letter

Pay Tank Fees Online

Tank Information

Tank Number 1

Capacity:	20000		Petroleum Use:
Product:	Gasoline		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	3/12/2019
OSFM First Notify Date:	10/3/2013		Abandoned Material:
Current Age:	5		Abandoned Date:
Install Date:	4/22/2013		Red Tag Issue Date:
Last Used Date:	1/26/2018		Fee Due:	$0.00
Product Date:	10/3/2013

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	4/24/2017	4/24/2018
Leak Detect - Piping	Siphon Bar	N/A	N/A
Leak Detect - Piping	Sump Sensor	4/24/2017	4/24/2018
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 450
Leak Detect - Tank	Non-Discriminating Interstitial Monitoring Sensors	4/24/2017	4/24/2018
Overfill Prev Device	Overfill Drop Tube Valve
Piping	Flexible Double Wall OPW Flexworks	N/A	N/A
Spill Contain Device	Double Wall Spill Bucket
Tank	Fiberglass Double Wall XERXES	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 2

Capacity:	20000		Petroleum Use:
Product:	Gasoline		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	3/11/2019
OSFM First Notify Date:	10/3/2013		Abandoned Material:
Current Age:	5		Abandoned Date:
Install Date:	4/22/2013		Red Tag Issue Date:
Last Used Date:	1/26/2018		Fee Due:	$0.00
Product Date:	10/3/2013

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	4/24/2017	4/24/2018
Leak Detect - Piping	Siphon Bar	N/A	N/A
Leak Detect - Piping	Sump Sensor	4/24/2017	4/24/2018
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 450
Leak Detect - Tank	Non-Discriminating Interstitial Monitoring Sensors	4/24/2017	4/24/2018
Overfill Prev Device	Overfill Drop Tube Valve
Piping	Flexible Double Wall OPW Flexworks	N/A	N/A
Spill Contain Device	Double Wall Spill Bucket
Tank	Fiberglass Double Wall XERXES	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 3

Capacity:	12000		Petroleum Use:
Product:	Gasoline		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	3/11/2019
OSFM First Notify Date:	10/3/2013		Abandoned Material:
Current Age:	5		Abandoned Date:
Install Date:	4/22/2013		Red Tag Issue Date:
Last Used Date:	1/26/2018		Fee Due:	$0.00
Product Date:	10/3/2013

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	4/24/2017	4/24/2018
Leak Detect - Piping	Sump Sensor	4/24/2017	4/24/2018
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 450
Leak Detect - Tank	Non-Discriminating Interstitial Monitoring Sensors	4/24/2017	4/24/2018
Overfill Prev Device	Overfill Drop Tube Valve
Piping	Flexible Double Wall OPW Flexworks	N/A	N/A
Spill Contain Device	Double Wall Spill Bucket
Tank	Fiberglass Double Wall XERXES	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 4

Capacity:	8000		Petroleum Use:
Product:	Diesel Fuel		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	3/11/2019
OSFM First Notify Date:	10/3/2013		Abandoned Material:
Current Age:	5		Abandoned Date:
Install Date:	4/22/2013		Red Tag Issue Date:
Last Used Date:	1/26/2018		Fee Due:	$0.00
Product Date:	10/3/2013

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	4/24/2017	4/24/2018
Leak Detect - Piping	Sump Sensor	4/24/2017	4/24/2018
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 450
Leak Detect - Tank	Non-Discriminating Interstitial Monitoring Sensors	4/24/2017	4/24/2018
Overfill Prev Device	Overfill Drop Tube Valve
Piping	Flexible Double Wall OPW Flexworks	N/A	N/A
Spill Contain Device	Double Wall Spill Bucket
Tank	Fiberglass Double Wall XERXES	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Dispenser Information

MFD Motorfuel Dispensing Forms

No Forms Found