Information
JB Pritzker, Governor

James A. Rivera, State Fire Marshal

Division of Petroleum & Chemical Safety
State of Illinois
Employment Opportunities
Ready Illinois
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Division of Petroleum & Chemical Safety

 

Facility Details

Facility Number: 4002378
Status: Active
Facility Name: Flying J Travel Plaza #643
Address: 1701 W. Evergreen Ave.
Effingham, IL 62401
County: Effingham
Property Parcel: 03-11-019-123
Facility Type: Attended Self-Service Station
Owner Type: Private
Green Tag Decal: Z001790
Green Tag Issue Date: 9/9/2024
Green Tag Expiration Date: 12/31/2026

Owner Details

Owner Name: Pilot Travel Centers, LLC
Owner Address: 5508 Lonas Rd.
Knoxville, TN 37909
Owner Status: Current Owner
Purchase Date: 7/1/2010
Type of Financial Responsibility: Commercial Insurance
Financial Responsibility Reporting Due Date: 8/28/2025

Motor Fuel Dispensing Permits

MFD Permit Type Issue Date Expiration Date
Self Service 9/9/2024 12/31/2026

Owner Summary

Click for Facility/Tank Ownership history
Owner Number Owner Name Owner Status Purchase Date
U0011913 Pilot Travel Centers, LLC Current Owner 7/1/2010
U0030842 AFS, LLC Former Owner 11/6/2003
U0016401 Wilcox, Inc. Former Owner

Permits (Unexpired)

Click for permit history
Permit Number Type Status OSFM Receive Date Issue Date Expiration Date Documents
00546-2025UPG Upgrade Approved / Issued 5/6/2025 5/6/2025 11/6/2025 Documents

Notice of Violations (Current)

No Notice of Violations Found

IEMA Numbers Associated with the Facility

IEMA Number Inspection Date Inspection Type Permit Number
03-1711 11/20/2003 Removal Log 03807-2003REM
03-1712 11/20/2003 Removal Log 03807-2003REM
04-0067 11/20/2003 Removal Log 03807-2003REM
04-0625 5/4/2004 Removal Log 03807-2003REM

LUST Fund Eligibility and Deductibility Determinations

IEMA Number Status OSFM Received Date OSFM Response Date Deductible Letter
92-3467 Eligible 6/13/2001 6/28/2001 $10,000
01-1342 Eligible 10/29/2001 10/30/2001 $10,000
01-1342 Eligible 7/9/2002 7/31/2002 $10,000
92-3467 Eligible 7/9/2002 7/31/2002 $10,000
20040058 Eligible 4/19/2018 4/25/2018 $10,000 Letter
20040625 Eligible 4/19/2018 4/25/2018 $10,000 Letter
20031711 Eligible 4/19/2018 4/25/2018 $10,000 Letter
20011342 Eligible 4/19/2018 4/25/2018 $10,000 Letter
19923467 Eligible 4/19/2018 4/25/2018 $10,000 Letter
20040067 Eligible 5/17/2018 5/17/2018 $10,000 Letter
Pay Tank Fees Online

Tank Information



Tank Number 1

Capacity: 12000 Petroleum Use:
Product: Diesel Fuel CERCLA Substance:
Status: Removed CAS Code:
Regulated Status: Federal Removed Date: 1/16/2004
OSFM First Notify Date: 3/18/1986 Abandoned Material:
Current Age: 36 Abandoned Date:
Install Date: 1/1/1968 Red Tag Issue Date:
Last Used Date: 1/14/2004 Fee Due: $0.00
Product Date: 1/1/1968

Equipment

Equipment Type Equipment Last Passing Date Test Expire Date

Additional Tests

Equipment Type Equipment Test Type Test Result Test Date



Tank Number 2

Capacity: 12000 Petroleum Use:
Product: Diesel Fuel CERCLA Substance:
Status: Removed CAS Code:
Regulated Status: Federal Removed Date: 1/16/2004
OSFM First Notify Date: 3/18/1986 Abandoned Material:
Current Age: 36 Abandoned Date:
Install Date: 1/1/1968 Red Tag Issue Date:
Last Used Date: 1/14/2004 Fee Due: $0.00
Product Date: 1/1/1968

Equipment

Equipment Type Equipment Last Passing Date Test Expire Date

Additional Tests

Equipment Type Equipment Test Type Test Result Test Date



Tank Number 3

Capacity: 12000 Petroleum Use:
Product: Diesel Fuel CERCLA Substance:
Status: Removed CAS Code:
Regulated Status: Federal Removed Date: 1/16/2004
OSFM First Notify Date: 3/18/1986 Abandoned Material:
Current Age: 36 Abandoned Date:
Install Date: 1/1/1968 Red Tag Issue Date:
Last Used Date: 1/14/2004 Fee Due: $0.00
Product Date: 1/1/1968

Equipment

Equipment Type Equipment Last Passing Date Test Expire Date

Additional Tests

Equipment Type Equipment Test Type Test Result Test Date



Tank Number 4

Capacity: 12000 Petroleum Use:
Product: Diesel Fuel CERCLA Substance:
Status: Removed CAS Code:
Regulated Status: Federal Removed Date: 1/16/2004
OSFM First Notify Date: 3/18/1986 Abandoned Material:
Current Age: 36 Abandoned Date:
Install Date: 1/1/1968 Red Tag Issue Date:
Last Used Date: 1/14/2004 Fee Due: $0.00
Product Date: 1/1/1968

Equipment

Equipment Type Equipment Last Passing Date Test Expire Date

Additional Tests

Equipment Type Equipment Test Type Test Result Test Date



Tank Number 5

Capacity: 12000 Petroleum Use:
Product: Diesel Fuel CERCLA Substance:
Status: Removed CAS Code:
Regulated Status: Federal Removed Date: 1/16/2004
OSFM First Notify Date: 3/18/1986 Abandoned Material:
Current Age: 36 Abandoned Date:
Install Date: 1/1/1968 Red Tag Issue Date:
Last Used Date: 1/14/2004 Fee Due: $0.00
Product Date: 1/1/1968

Equipment

Equipment Type Equipment Last Passing Date Test Expire Date

Additional Tests

Equipment Type Equipment Test Type Test Result Test Date



Tank Number 6

Capacity: 12000 Petroleum Use:
Product: Diesel Fuel CERCLA Substance:
Status: Removed CAS Code:
Regulated Status: Federal Removed Date: 11/20/2003
OSFM First Notify Date: 3/18/1986 Abandoned Material:
Current Age: 35 Abandoned Date:
Install Date: 1/1/1968 Red Tag Issue Date:
Last Used Date: 11/18/2003 Fee Due: $0.00
Product Date: 1/1/1968

Equipment

Equipment Type Equipment Last Passing Date Test Expire Date

Additional Tests

Equipment Type Equipment Test Type Test Result Test Date



Tank Number 7

Capacity: 12000 Petroleum Use:
Product: Gasoline CERCLA Substance:
Status: Removed CAS Code:
Regulated Status: Federal Removed Date: 1/20/2004
OSFM First Notify Date: 3/18/1986 Abandoned Material:
Current Age: 36 Abandoned Date:
Install Date: 1/1/1968 Red Tag Issue Date:
Last Used Date: 1/16/2004 Fee Due: $0.00
Product Date: 1/1/1968

Equipment

Equipment Type Equipment Last Passing Date Test Expire Date

Additional Tests

Equipment Type Equipment Test Type Test Result Test Date



Tank Number 8

Capacity: 12000 Petroleum Use:
Product: Gasoline CERCLA Substance:
Status: Removed CAS Code:
Regulated Status: Federal Removed Date: 1/20/2004
OSFM First Notify Date: 3/18/1986 Abandoned Material:
Current Age: 36 Abandoned Date:
Install Date: 1/1/1968 Red Tag Issue Date:
Last Used Date: 1/16/2004 Fee Due: $0.00
Product Date: 1/1/1968

Equipment

Equipment Type Equipment Last Passing Date Test Expire Date

Additional Tests

Equipment Type Equipment Test Type Test Result Test Date



Tank Number 9

Capacity: 12000 Petroleum Use:
Product: Gasoline CERCLA Substance:
Status: Removed CAS Code:
Regulated Status: Federal Removed Date: 1/20/2004
OSFM First Notify Date: 3/18/1986 Abandoned Material:
Current Age: 36 Abandoned Date:
Install Date: 1/1/1968 Red Tag Issue Date:
Last Used Date: 1/16/2004 Fee Due: $0.00
Product Date: 1/1/1968

Equipment

Equipment Type Equipment Last Passing Date Test Expire Date

Additional Tests

Equipment Type Equipment Test Type Test Result Test Date



Tank Number 10

Capacity: 10000 Petroleum Use: Consumptive Use on Premises for Heating
Product: Diesel Fuel CERCLA Substance:
Status: Removed CAS Code:
Regulated Status: State Removed Date: 5/4/2004
OSFM First Notify Date: 3/18/1986 Abandoned Material:
Current Age: 36 Abandoned Date:
Install Date: 1/1/1968 Red Tag Issue Date:
Last Used Date: Fee Due: $0.00
Product Date: 1/1/1968

Equipment

Equipment Type Equipment Last Passing Date Test Expire Date

Additional Tests

Equipment Type Equipment Test Type Test Result Test Date



Tank Number 11

Capacity: 2000 Petroleum Use:
Product: Used Oil CERCLA Substance:
Status: Removed CAS Code:
Regulated Status: Federal Removed Date: 11/20/2003
OSFM First Notify Date: 3/18/1986 Abandoned Material:
Current Age: 29 Abandoned Date:
Install Date: 1/1/1974 Red Tag Issue Date:
Last Used Date: 11/18/2003 Fee Due: $0.00
Product Date: 1/1/1974

Equipment

Equipment Type Equipment Last Passing Date Test Expire Date

Additional Tests

Equipment Type Equipment Test Type Test Result Test Date



Tank Number 12

Capacity: 20000 Petroleum Use: None
Product: B-99 CERCLA Substance:
Status: Currently in use CAS Code:
Regulated Status: Federal Removed Date:
OSFM First Notify Date: 1/16/2004 Abandoned Material:
Current Age: 21 Abandoned Date:
Install Date: 11/6/2003 Red Tag Issue Date:
Last Used Date: Fee Due: $0.00
Product Date: 12/16/2003

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 350 Plus with CSLD 11/25/2024 11/25/2025
Leak Detect - Tank Non-Discriminating Interstitial Monitoring Sensors 11/25/2024 11/25/2025
Overfill Prev Device Overfill Drop Tube Valve 11/28/2023 11/28/2026
Piping Blending Sump 4/7/2025 4/7/2028
Leak Detect - Piping Sump Sensor 11/25/2024 11/25/2025
Piping Flexible Double Wall N/A N/A
Piping Single Wall STP/Tanktop Sump 4/7/2025 4/7/2028
Leak Detect - Piping Piping Sump Sensors Not Regulated N/A N/A
Piping Single Wall Transition Sump 4/7/2025 4/7/2028
Leak Detect - Piping Sump Sensor 11/25/2024 11/25/2025
Spill Contain Device Single Wall Spill Bucket 5/8/2022 4/25/2025
Tank Fiberglass Double Wall XERXES N/A N/A

Additional Tests

Equipment Type Equipment Test Type Test Result Test Date
Piping Flexible Double Wall Precision Test (Piping) Pass 4/7/2020
Tank Fiberglass Double Wall XERXES Precision Test (Tank) Pass 9/30/2020
Leak Detect - Tank Non-Discriminating Interstitial Monitoring Sensors Sensor Functional Pass 8/18/2009



Tank Number 13

Capacity: 20000 Petroleum Use:
Product: Diesel Fuel CERCLA Substance:
Status: Currently in use CAS Code:
Regulated Status: Federal Removed Date:
OSFM First Notify Date: 1/16/2004 Abandoned Material:
Current Age: 21 Abandoned Date:
Install Date: 11/6/2003 Red Tag Issue Date:
Last Used Date: Fee Due: $0.00
Product Date: 12/16/2003

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 11/25/2024 11/25/2025
Leak Detect - Tank Automatic Tank Gauging Veeder Root TLS 350 Plus with CSLD 11/25/2024 11/25/2025
Leak Detect - Tank Non-Discriminating Interstitial Monitoring Sensors 11/25/2024 11/25/2025
Overfill Prev Device Overfill Drop Tube Valve 5/15/2025 5/15/2028
Piping Blending Sump 4/7/2025 4/7/2028
Leak Detect - Piping Sump Sensor 11/25/2024 11/25/2025
Piping Flexible Double Wall N/A N/A
Piping Single Wall STP/Tanktop Sump 4/7/2025 4/7/2028
Leak Detect - Piping Non-Discriminating Sump Sensor 3/3/2021 3/3/2022
Leak Detect - Piping Sump Sensor with positive shutdown 11/25/2024 11/25/2025
Piping Single Wall Transition Sump 4/7/2025 4/7/2028
Leak Detect - Piping Sump Sensor 11/25/2024 11/25/2025
Spill Contain Device Double Wall Spill Bucket 5/15/2025 5/15/2028
Tank Fiberglass Double Wall XERXES N/A N/A

Additional Tests

Equipment Type Equipment Test Type Test Result Test Date
Piping Flexible Double Wall Precision Test (Piping) Pass 11/25/2024
Tank Fiberglass Double Wall XERXES Precision Test (Tank) Pass 9/30/2020
Leak Detect - Tank Non-Discriminating Interstitial Monitoring Sensors Sensor Functional Pass 8/18/2009



Tank Number 14

Capacity: 20000 Petroleum Use:
Product: Diesel Fuel CERCLA Substance:
Status: Currently in use CAS Code:
Regulated Status: Federal Removed Date:
OSFM First Notify Date: 1/16/2004 Abandoned Material:
Current Age: 21 Abandoned Date:
Install Date: 11/6/2003 Red Tag Issue Date:
Last Used Date: Fee Due: $0.00
Product Date: 12/16/2003

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 11/25/2024 11/25/2025
Leak Detect - Tank Automatic Tank Gauging Veeder Root TLS 350 Plus with CSLD 11/25/2024 11/25/2025
Leak Detect - Tank Non-Discriminating Interstitial Monitoring Sensors 11/25/2024 11/25/2025
Overfill Prev Device Overfill Drop Tube Valve 5/15/2025 5/15/2028
Piping Blending Sump 4/7/2025 4/7/2028
Leak Detect - Piping Sump Sensor 11/25/2024 11/25/2025
Piping Flexible Double Wall N/A N/A
Piping Single Wall STP/Tanktop Sump 4/7/2025 4/7/2028
Leak Detect - Piping Sump Sensor 11/25/2024 11/25/2025
Piping Single Wall Transition Sump 4/7/2025 4/7/2028
Leak Detect - Piping Sump Sensor 11/25/2024 11/25/2025
Spill Contain Device Double Wall Spill Bucket 5/15/2025 5/15/2028
Tank Fiberglass Double Wall XERXES N/A N/A

Additional Tests

Equipment Type Equipment Test Type Test Result Test Date
Piping Flexible Double Wall Precision Test (Piping) Pass 11/25/2024
Piping Steel Single Wall Piping Precision Test (Piping) Pass 3/13/2020
Tank Fiberglass Double Wall XERXES Precision Test (Tank) Pass 9/30/2020
Leak Detect - Tank Non-Discriminating Interstitial Monitoring Sensors Sensor Functional Pass 8/18/2009



Tank Number 15

Capacity: 20000 Petroleum Use:
Product: Gasoline - Regular CERCLA Substance:
Status: Currently in use CAS Code:
Regulated Status: Federal Removed Date:
OSFM First Notify Date: 1/16/2004 Abandoned Material:
Current Age: 21 Abandoned Date:
Install Date: 11/6/2003 Red Tag Issue Date:
Last Used Date: Fee Due: $0.00
Product Date: 12/16/2003

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 11/25/2024 11/25/2025
Leak Detect - Tank Automatic Tank Gauging Veeder Root TLS 350 Plus with CSLD 11/25/2024 11/25/2025
Leak Detect - Tank Non-Discriminating Interstitial Monitoring Sensors 11/25/2024 11/25/2025
Overfill Prev Device Overfill Drop Tube Valve 11/28/2023 11/28/2026
Piping Flexible Double Wall N/A N/A
Piping Single Wall STP/Tanktop Sump 4/7/2025 4/7/2028
Leak Detect - Piping Sump Sensor 11/25/2024 11/25/2025
Spill Contain Device Single Wall Spill Bucket 4/25/2025 4/25/2028
Tank Fiberglass Double Wall XERXES N/A N/A

Additional Tests

Equipment Type Equipment Test Type Test Result Test Date
Piping Flexible Double Wall Precision Test (Piping) Pass 11/25/2024
Tank Fiberglass Double Wall XERXES Precision Test (Tank) Pass 9/30/2020
Leak Detect - Tank Non-Discriminating Interstitial Monitoring Sensors Sensor Functional Pass 8/18/2009



Tank Number 16

Capacity: 12000 Petroleum Use:
Product: Gasoline - Premium CERCLA Substance:
Status: Currently in use CAS Code:
Regulated Status: Federal Removed Date:
OSFM First Notify Date: 1/16/2004 Abandoned Material:
Current Age: 21 Abandoned Date:
Install Date: 11/6/2003 Red Tag Issue Date:
Last Used Date: Fee Due: $0.00
Product Date: 12/16/2003

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 11/25/2024 11/25/2025
Leak Detect - Tank Automatic Tank Gauging Veeder Root TLS 350 Plus with CSLD 11/25/2024 11/25/2025
Leak Detect - Tank Non-Discriminating Interstitial Monitoring Sensors 11/25/2024 11/25/2025
Overfill Prev Device Overfill Drop Tube Valve 11/28/2023 11/28/2026
Piping Flexible Double Wall N/A N/A
Piping Single Wall STP/Tanktop Sump 4/7/2025 4/7/2028
Leak Detect - Piping Sump Sensor 11/25/2024 11/25/2025
Spill Contain Device Single Wall Spill Bucket 4/25/2025 4/25/2028
Tank Fiberglass Double Wall XERXES N/A N/A

Additional Tests

Equipment Type Equipment Test Type Test Result Test Date
Piping Flexible Double Wall Precision Test (Piping) Pass 11/25/2024
Tank Fiberglass Double Wall XERXES Precision Test (Tank) Pass 9/30/2020
Leak Detect - Tank Non-Discriminating Interstitial Monitoring Sensors Sensor Functional Pass 8/18/2009

Dispenser Information



Name\ID 1/2

Status: Active
Equipment Type Equipment Last Passing Date Test Expire Date
Dispenser Single Wall UDC Sump 4/7/2025 4/7/2028
Leak Detect - Piping Sump Sensor 11/25/2024 11/25/2025



Name\ID 11/12

Status: Active
Equipment Type Equipment Last Passing Date Test Expire Date
Dispenser Single Wall UDC Sump 4/7/2025 4/7/2028
Leak Detect - Piping Sump Sensor 11/25/2024 11/25/2025



Name\ID 13

Status: Active
Equipment Type Equipment Last Passing Date Test Expire Date
Dispenser Single Wall UDC Sump 4/7/2025 4/7/2028
Leak Detect - Piping Sump Sensor 11/25/2024 11/25/2025



Name\ID 14/15

Status: Active
Equipment Type Equipment Last Passing Date Test Expire Date
Dispenser Single Wall UDC Sump 4/7/2025 4/7/2028
Leak Detect - Piping Sump Sensor 11/25/2024 11/25/2025



Name\ID 16

Status: Active
Equipment Type Equipment Last Passing Date Test Expire Date
Dispenser Single Wall UDC Sump 4/7/2025 4/7/2028
Leak Detect - Piping Sump Sensor 11/25/2024 11/25/2025



Name\ID 17

Status: Active
Equipment Type Equipment Last Passing Date Test Expire Date
Dispenser Single Wall UDC Sump 4/7/2025 4/7/2028
Leak Detect - Piping Sump Sensor 11/25/2024 11/25/2025



Name\ID 18

Status: Active
Equipment Type Equipment Last Passing Date Test Expire Date
Dispenser Single Wall UDC Sump 4/7/2025 4/7/2028
Leak Detect - Piping Sump Sensor 11/25/2024 11/25/2025



Name\ID 19

Status: Active
Equipment Type Equipment Last Passing Date Test Expire Date
Dispenser Single Wall UDC Sump 4/7/2025 4/7/2028
Leak Detect - Piping Sump Sensor 11/25/2024 11/25/2025



Name\ID 20

Status: Active
Equipment Type Equipment Last Passing Date Test Expire Date
Dispenser Single Wall UDC Sump 4/7/2025 4/7/2028
Leak Detect - Piping Sump Sensor 11/25/2024 11/25/2025



Name\ID 21

Status: Active
Equipment Type Equipment Last Passing Date Test Expire Date
Dispenser Single Wall UDC Sump 4/7/2025 4/7/2028
Leak Detect - Piping Sump Sensor 11/25/2024 11/25/2025



Name\ID 22 m

Status: Active
Equipment Type Equipment Last Passing Date Test Expire Date
Dispenser Single Wall UDC Sump 4/7/2025 4/7/2028
Leak Detect - Piping Sump Sensor 11/25/2024 11/25/2025



Name\ID 22 sat

Status: Active
Equipment Type Equipment Last Passing Date Test Expire Date
Dispenser Single Wall UDC Sump 4/7/2025 4/7/2028
Leak Detect - Piping Sump Sensor 11/25/2024 11/25/2025



Name\ID 23

Status: Active
Equipment Type Equipment Last Passing Date Test Expire Date
Dispenser Single Wall UDC Sump 4/7/2025 4/7/2028
Leak Detect - Piping Sump Sensor 11/25/2024 11/25/2025



Name\ID 24

Status: Active
Equipment Type Equipment Last Passing Date Test Expire Date
Dispenser Single Wall UDC Sump 4/7/2025 4/7/2028
Leak Detect - Piping Sump Sensor 11/25/2024 11/25/2025



Name\ID 25

Status: Active
Equipment Type Equipment Last Passing Date Test Expire Date
Dispenser Single Wall UDC Sump 4/7/2025 4/7/2028
Leak Detect - Piping Sump Sensor 11/25/2024 11/25/2025



Name\ID 26

Status: Active
Equipment Type Equipment Last Passing Date Test Expire Date
Dispenser Single Wall UDC Sump 4/7/2025 4/7/2028
Leak Detect - Piping Sump Sensor 11/25/2024 11/25/2025



Name\ID 27

Status: Active
Equipment Type Equipment Last Passing Date Test Expire Date
Dispenser Single Wall UDC Sump 4/7/2025 4/7/2028
Leak Detect - Piping Sump Sensor 11/25/2024 11/25/2025



Name\ID 28 m

Status: Active
Equipment Type Equipment Last Passing Date Test Expire Date
Dispenser Single Wall UDC Sump 4/7/2025 4/7/2028
Leak Detect - Piping Sump Sensor 11/25/2024 11/25/2025



Name\ID 28 sat

Status: Active
Equipment Type Equipment Last Passing Date Test Expire Date
Dispenser Single Wall UDC Sump 4/7/2025 4/7/2028
Leak Detect - Piping Sump Sensor 11/25/2024 11/25/2025



Name\ID 3/4

Status: Active
Equipment Type Equipment Last Passing Date Test Expire Date
Dispenser Single Wall UDC Sump 4/7/2025 4/7/2028
Leak Detect - Piping Sump Sensor 11/25/2024 11/25/2025



Name\ID 5/6

Status: Active
Equipment Type Equipment Last Passing Date Test Expire Date
Dispenser Single Wall UDC Sump 4/7/2025 4/7/2028
Leak Detect - Piping Sump Sensor 11/25/2024 11/25/2025



Name\ID 7/8

Status: Active
Equipment Type Equipment Last Passing Date Test Expire Date
Dispenser Single Wall UDC Sump 4/7/2025 4/7/2028
Leak Detect - Piping Sump Sensor 11/25/2024 11/25/2025



Name\ID 9/10

Status: Active
Equipment Type Equipment Last Passing Date Test Expire Date
Dispenser Single Wall UDC Sump 4/7/2025 4/7/2028
Leak Detect - Piping Sump Sensor 11/25/2024 11/25/2025

MFD Motorfuel Dispensing Forms

No Forms Found

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