Information

JB Pritzker, Governor

James A. Rivera, State Fire Marshal

Division of Petroleum & Chemical Safety

State of Illinois
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Ready Illinois
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Division of Petroleum & Chemical Safety

Facility Details

Facility Number:	4009542
Status:	Active
Facility Name:	Effingham Travel Center
Address:	1702 West Evergreen I-57, I-70 & 32/33, Exit 170 Effingham, IL 62401
County:	Effingham
Property Parcel:	035
Facility Type:	Attended Self-Service Station
Owner Type:	Private
Green Tag Decal:	Z001697
Green Tag Issue Date:	1/2/2024
Green Tag Expiration Date:	12/31/2026

Owner Details

Owner Name:	HPT TA Properties, LLC
Owner Address:	24601 Center Ridge Road Westlake, OH 44145
Owner Status:	Current Owner
Purchase Date:	1/31/2007
Type of Financial Responsibility:	Commercial Insurance
Financial Responsibility Reporting Due Date:	2/12/2026

Motor Fuel Dispensing Permits

MFD Permit Type	Issue Date	Expiration Date
Self Service	1/2/2024	12/31/2026

Owner Summary

Click for Facility/Tank Ownership history

Owner Number	Owner Name	Owner Status	Purchase Date
U0034157	HPT TA Properties, LLC	Current Owner	1/31/2007
U0021229	TA Operating Corporation	Former Owner	10/1/1993
U0014428	Standard Oil Co	Former Owner	12/31/1967
U0026726	TA Operating, LLC	Former Owner

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
92-1403	3/30/1993	Removal Log
98-0862	4/17/1998	Removal Log

LUST Fund Eligibility and Deductibility Determinations

IEMA Number	Status	OSFM Received Date	OSFM Response Date	Deductible	Letter
20210521	Eligible	4/11/2023	4/14/2023	$5,000	Letter

Pay Tank Fees Online

Tank Information

Tank Number 1

Capacity:	12000		Petroleum Use:
Product:	Gasoline - Regular		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	5/2/1986		Abandoned Material:
Current Age:	53		Abandoned Date:
Install Date:	1/1/1972		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	1/1/1972

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Fiberglass Non-Corrosive	N/A	N/A
Corrosion Prot - Tank	Impressed Current Cathodic Protection	4/15/2025	4/15/2026
Leak Detect - Piping	Mechanical Pressurized Line Leak Detection	7/17/2024	7/17/2025
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 350 Plus with CSLD	7/17/2024	7/17/2025
Overfill Prev Device	Overfill Drop Tube Valve	7/17/2024	7/17/2027
Piping	Fiberglass Double Wall	N/A	N/A
Piping	Single Wall STP/Tanktop Sump	9/30/2021	9/30/2024
Leak Detect - Piping	Sump Sensor	7/17/2024	7/17/2025
Spill Contain Device	Single Wall Spill Bucket	7/17/2024	7/17/2027
Tank	Steel Single Wall	N/A	N/A
Vent, Riser, Fill Piping	Steel risers	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Piping	Fiberglass Double Wall	Precision Test (Piping)	Pass	7/17/2024
Tank	Steel Single Wall	Precision Test (Tank)	Pass	8/2/2023
Leak Detect - Tank	Non-Discriminating Interstitial Monitoring Sensors	Sensor Functional	Pass	7/28/2009

Tank Number 2

Capacity:	12000		Petroleum Use:
Product:	Gasoline - Premium		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	5/2/1986		Abandoned Material:
Current Age:	53		Abandoned Date:
Install Date:	1/1/1972		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	1/1/1972

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Fiberglass Non-Corrosive	N/A	N/A
Corrosion Prot - Tank	Impressed Current Cathodic Protection	4/15/2025	4/15/2026
Leak Detect - Piping	Mechanical Pressurized Line Leak Detection	7/17/2024	7/17/2025
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 350 Plus with CSLD	7/17/2024	7/17/2025
Overfill Prev Device	Overfill Drop Tube Valve	7/17/2024	7/17/2027
Piping	Fiberglass Double Wall	N/A	N/A
Piping	Single Wall STP/Tanktop Sump	9/30/2021	9/30/2024
Leak Detect - Piping	Sump Sensor	7/17/2024	7/17/2025
Spill Contain Device	Single Wall Spill Bucket	7/17/2024	7/17/2027
Tank	Steel Single Wall	N/A	N/A
Vent, Riser, Fill Piping	Steel risers	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Piping	Fiberglass Double Wall	Precision Test (Piping)	Pass	7/17/2024
Tank	Steel Single Wall	Precision Test (Tank)	Pass	8/2/2023
Leak Detect - Tank	Non-Discriminating Interstitial Monitoring Sensors	Sensor Functional	Pass	7/28/2009

Tank Number 3

Capacity:	12000		Petroleum Use:
Product:	Gasoline		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	4/17/1998
OSFM First Notify Date:	5/2/1986		Abandoned Material:
Current Age:	26		Abandoned Date:
Install Date:	1/1/1972		Red Tag Issue Date:
Last Used Date:	10/1/1991		Fee Due:	$0.00
Product Date:	1/1/1972

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:	4/17/1998
OSFM First Notify Date:	5/2/1986		Abandoned Material:
Current Age:	26		Abandoned Date:
Install Date:	1/1/1972		Red Tag Issue Date:
Last Used Date:	10/1/1991		Fee Due:	$0.00
Product Date:	1/1/1972

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:	3/30/1993
OSFM First Notify Date:	5/2/1986		Abandoned Material:
Current Age:	21		Abandoned Date:
Install Date:	1/1/1972		Red Tag Issue Date:
Last Used Date:	3/1/1993		Fee Due:	$0.00
Product Date:	1/1/1972

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:	3/30/1993
OSFM First Notify Date:	5/2/1986		Abandoned Material:
Current Age:	21		Abandoned Date:
Install Date:	1/1/1972		Red Tag Issue Date:
Last Used Date:	3/1/1993		Fee Due:	$0.00
Product Date:	1/1/1972

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:	Diesel Fuel		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	3/30/1993
OSFM First Notify Date:	5/2/1986		Abandoned Material:
Current Age:	21		Abandoned Date:
Install Date:	1/1/1972		Red Tag Issue Date:
Last Used Date:	3/1/1993		Fee Due:	$0.00
Product Date:	1/1/1972

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:	Diesel Fuel		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	3/30/1993
OSFM First Notify Date:	5/2/1986		Abandoned Material:
Current Age:	21		Abandoned Date:
Install Date:	1/1/1972		Red Tag Issue Date:
Last Used Date:	3/1/1993		Fee Due:	$0.00
Product Date:	1/1/1972

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:	Diesel Fuel		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	3/30/1993
OSFM First Notify Date:	5/2/1986		Abandoned Material:
Current Age:	21		Abandoned Date:
Install Date:	1/1/1972		Red Tag Issue Date:
Last Used Date:	3/1/1993		Fee Due:	$0.00
Product Date:	1/1/1972

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:	8000		Petroleum Use:
Product:	Lube Oil		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	5/2/1986		Abandoned Material:
Current Age:	39		Abandoned Date:
Install Date:	1/1/1986		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	1/1/1986

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Fiberglass 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 300 with CSLD	7/17/2024	7/17/2025
Overfill Prev Device	Overfill Drop Tube Valve	7/17/2024	7/17/2027
Piping	Fiberglass Double Wall	N/A	N/A
Spill Contain Device	Single Wall Spill Bucket	12/1/2021	7/17/2024
Tank	Fiberglass Single Wall	N/A	N/A
Vent, Riser, Fill Piping	Steel risers	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Piping	Fiberglass Double Wall	Precision Test (Piping)	Pass	8/2/2023
Tank	Fiberglass Single Wall	Precision Test (Tank)	Pass	8/2/2023

Tank Number 11

Capacity:	4000		Petroleum Use:
Product:	Used Oil		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	5/2/1986		Abandoned Material:
Current Age:	39		Abandoned Date:
Install Date:	1/1/1986		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	1/1/1986

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Fiberglass Non-Corrosive	N/A	N/A
Corrosion Prot - Tank	Fiberglass Non-Corrosive	N/A	N/A
Leak Detect - Piping	Gravity Feed	N/A	N/A
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 300 with CSLD	7/17/2024	7/17/2025
Overfill Prev Device	Less than 25 gallon fills	N/A	N/A
Piping	Fiberglass Double Wall	N/A	N/A
Spill Contain Device	Single Wall Spill Bucket	7/17/2024	7/17/2027
Tank	Fiberglass Single Wall	N/A	N/A
Vent, Riser, Fill Piping	Steel risers	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Piping	Fiberglass Double Wall	Precision Test (Piping)	Pass	8/2/2023
Tank	Fiberglass Single Wall	Precision Test (Tank)	Pass	8/2/2023

Tank Number 12

Capacity:	4000		Petroleum Use:
Product:	Diesel Fuel		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	4/1/1993
OSFM First Notify Date:	5/2/1986		Abandoned Material:
Current Age:	21		Abandoned Date:
Install Date:	1/1/1972		Red Tag Issue Date:
Last Used Date:	3/1/1993		Fee Due:	$0.00
Product Date:	1/1/1972

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 13

Capacity:	1000		Petroleum Use:
Product:	Water		CERCLA Substance:
Status:	Unknown		CAS Code:
Regulated Status:	Non-Regulated		Removed Date:
OSFM First Notify Date:	11/13/1992		Abandoned Material:
Current Age:			Abandoned Date:
Install Date:			Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

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:	6/22/1994		Abandoned Material:
Current Age:	32		Abandoned Date:
Install Date:	11/15/1992		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	11/15/1992

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Fiberglass Non-Corrosive	N/A	N/A
Corrosion Prot - Tank	Fiberglass Non-Corrosive	N/A	N/A
Leak Detect - Piping	Mechanical Pressurized Line Leak Detection	7/17/2024	7/17/2025
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 350 Plus with CSLD	7/17/2024	7/17/2025
Overfill Prev Device	Overfill Drop Tube Valve	7/17/2024	7/17/2027
Piping	Fiberglass Double Wall Ameron Dualoy 3000/LCX	N/A	N/A
Piping	Single Wall STP/Tanktop Sump	9/30/2021	9/30/2024
Leak Detect - Piping	Non-Discriminating Sump Sensor with positive shutdown	10/19/2021	10/19/2022
Leak Detect - Piping	Sump Sensor with positive shutdown	7/17/2024	7/17/2025
Leak Detect - Piping	Piping Sump Sensors Not Regulated Not Installed	N/A	N/A
Piping	Single Wall Transition Sump	6/30/2021	6/30/2024
Leak Detect - Piping	Non-Discriminating Sump Sensor	1/10/2019	1/10/2020
Leak Detect - Piping	Non-Discriminating Sump Sensor	12/17/2020	12/17/2021
Leak Detect - Piping	Sump Sensor with positive shutdown	7/17/2024	7/17/2025
Spill Contain Device	Single Wall Spill Bucket	7/17/2024	7/17/2027
Tank	Fiberglass Single Wall	N/A	N/A
Vent, Riser, Fill Piping	Steel risers	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Piping	Fiberglass Double Wall	Precision Test (Piping)	Pass	12/17/2020
Piping	Fiberglass Double Wall Ameron Dualoy 3000/LCX	Precision Test (Piping)	Pass	7/17/2024
Tank	Fiberglass Single Wall	Precision Test (Tank)	Pass	8/2/2023

Tank Number 15

Capacity:	20000		Petroleum Use:
Product:	Diesel Fuel		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	6/22/1994		Abandoned Material:
Current Age:	32		Abandoned Date:
Install Date:	11/15/1992		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	11/15/1992

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Fiberglass Non-Corrosive	N/A	N/A
Corrosion Prot - Tank	Fiberglass Non-Corrosive	N/A	N/A
Leak Detect - Piping	Mechanical Pressurized Line Leak Detection	7/17/2024	7/17/2025
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 350 Plus with CSLD	7/17/2024	7/17/2025
Overfill Prev Device	Overfill Drop Tube Valve	7/17/2024	7/17/2027
Piping	Fiberglass Double Wall Ameron Dualoy 3000/LCX	N/A	N/A
Piping	Single Wall STP/Tanktop Sump	9/30/2021	9/30/2024
Leak Detect - Piping	Non-Discriminating Sump Sensor with positive shutdown	10/19/2021	10/19/2022
Leak Detect - Piping	Sump Sensor with positive shutdown	7/17/2024	7/17/2025
Leak Detect - Piping	Piping Sump Sensors Not Regulated Not Installed	N/A	N/A
Piping	Single Wall Transition Sump	6/30/2021	6/30/2024
Leak Detect - Piping	Non-Discriminating Sump Sensor
Leak Detect - Piping	Non-Discriminating Sump Sensor	12/17/2020	12/17/2021
Leak Detect - Piping	Sump Sensor with positive shutdown	7/17/2024	7/17/2025
Spill Contain Device	Single Wall Spill Bucket	9/30/2021	7/17/2024
Tank	Fiberglass Single Wall	N/A	N/A
Vent, Riser, Fill Piping	Steel risers	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Piping	Fiberglass Double Wall	Precision Test (Piping)	Pass	12/17/2020
Piping	Fiberglass Double Wall Ameron Dualoy 3000/LCX	Precision Test (Piping)	Pass	7/17/2024
Tank	Fiberglass Single Wall	Precision Test (Tank)	Pass	8/2/2023

Tank Number 16

Capacity:	20000		Petroleum Use:
Product:	Diesel Fuel		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	6/22/1994		Abandoned Material:
Current Age:	32		Abandoned Date:
Install Date:	11/15/1992		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	11/15/1992

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Fiberglass Non-Corrosive	N/A	N/A
Corrosion Prot - Tank	Fiberglass Non-Corrosive	N/A	N/A
Leak Detect - Piping	Mechanical Pressurized Line Leak Detection	7/17/2024	7/17/2025
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 350 Plus with CSLD	7/17/2024	7/17/2025
Overfill Prev Device	Overfill Drop Tube Valve	7/17/2024	7/17/2027
Piping	Fiberglass Double Wall Ameron Dualoy 3000/LCX	N/A	N/A
Piping	Single Wall STP/Tanktop Sump	9/30/2021	9/30/2024
Leak Detect - Piping	Non-Discriminating Sump Sensor with positive shutdown	10/19/2021	10/19/2022
Leak Detect - Piping	Sump Sensor with positive shutdown	7/17/2024	7/17/2025
Leak Detect - Piping	Piping Sump Sensors Not Regulated Not Installed	N/A	N/A
Piping	Single Wall Transition Sump	6/30/2021	6/30/2024
Leak Detect - Piping	Non-Discriminating Sump Sensor	1/10/2019	1/10/2020
Leak Detect - Piping	Non-Discriminating Sump Sensor	12/17/2020	12/17/2021
Leak Detect - Piping	Sump Sensor with positive shutdown	7/17/2024	7/17/2025
Spill Contain Device	Single Wall Spill Bucket	9/30/2021	7/17/2024
Tank	Fiberglass Single Wall	N/A	N/A
Vent, Riser, Fill Piping	Steel risers	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Piping	Fiberglass Double Wall	Precision Test (Piping)	Pass	10/7/2021
Piping	Fiberglass Double Wall Ameron Dualoy 3000/LCX	Precision Test (Piping)	Pass	7/17/2024
Piping	Fiberglass Single Wall Piping	Precision Test (Piping)	Pass	8/2/2023
Tank	Fiberglass Single Wall	Precision Test (Tank)	Pass	8/2/2023

Tank Number 17

Capacity:	20000		Petroleum Use:
Product:	Diesel Fuel		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	6/22/1994		Abandoned Material:
Current Age:	32		Abandoned Date:
Install Date:	11/15/1992		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	11/15/1992

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Fiberglass Non-Corrosive	N/A	N/A
Corrosion Prot - Tank	Fiberglass Non-Corrosive	N/A	N/A
Leak Detect - Piping	Mechanical Pressurized Line Leak Detection	7/17/2024	7/17/2025
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 350 Plus with CSLD	7/17/2024	7/17/2025
Overfill Prev Device	Overfill Drop Tube Valve	6/15/2022	7/17/2024
Piping	Fiberglass Double Wall Ameron Dualoy 3000/LCX	N/A	N/A
Piping	Single Wall STP/Tanktop Sump	9/30/2021	9/30/2024
Leak Detect - Piping	Non-Discriminating Sump Sensor with positive shutdown	10/19/2021	10/19/2022
Leak Detect - Piping	Sump Sensor with positive shutdown	7/17/2024	7/17/2025
Leak Detect - Piping	Piping Sump Sensors Not Regulated Not Installed	N/A	N/A
Piping	Single Wall Transition Sump	6/30/2021	6/30/2024
Leak Detect - Piping	Non-Discriminating Sump Sensor	1/10/2019	1/10/2020
Leak Detect - Piping	Non-Discriminating Sump Sensor	12/17/2020	12/17/2021
Leak Detect - Piping	Sump Sensor with positive shutdown	7/17/2024	7/17/2025
Spill Contain Device	Single Wall Spill Bucket	7/17/2024	7/17/2027
Tank	Fiberglass Single Wall	N/A	N/A
Vent, Riser, Fill Piping	Steel risers	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Piping	Fiberglass Double Wall	Precision Test (Piping)	Pass	10/7/2021
Piping	Fiberglass Double Wall Ameron Dualoy 3000/LCX	Precision Test (Piping)	Pass	7/17/2024
Tank	Fiberglass Single Wall	Precision Test (Tank)	Pass	8/2/2023

Tank Number 18

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:	10/12/2021		Abandoned Material:
Current Age:	3		Abandoned Date:
Install Date:	5/26/2021		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	9/13/2021

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Fiberglass Non-Corrosive	N/A	N/A
Corrosion Prot - Tank	Fiberglass Non-Corrosive	N/A	N/A
Leak Detect - Piping	Mechanical Pressurized Line Leak Detection	8/3/2023	7/17/2024
Leak Detect - Piping	Mechanical Pressurized Line Leak Detection	8/3/2023	7/17/2024
Leak Detect - Tank	Non-Discriminating Interstitial Monitoring Sensors With Monitor	7/17/2024	7/17/2025
Overfill Prev Device	Overfill Drop Tube Valve	7/17/2024	7/17/2027
Piping	Blending Sump	6/30/2021	6/30/2024
Leak Detect - Piping	Sump Sensor with positive shutdown	7/17/2024	7/17/2025
Piping	Blending Sump	6/30/2021	6/30/2024
Leak Detect - Piping	Sump Sensor with positive shutdown	7/17/2024	7/17/2025
Piping	Fiberglass Double Wall Ameron Dualoy 3000/LCX	N/A	N/A
Piping	Single Wall STP/Tanktop Sump	6/30/2021	6/30/2024
Leak Detect - Piping	Sump Sensor with positive shutdown	7/17/2024	7/17/2025
Spill Contain Device	Single Wall Spill Bucket	7/17/2024	7/17/2027
Tank	Fiberglass Double Wall Containment Solutions	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Piping	Blending Sump	Precision Test (Piping)	Pass	7/17/2024
Piping	Blending Sump	Precision Test (Piping)	Pass	7/17/2024
Piping	Fiberglass Double Wall Ameron Dualoy 3000/LCX	Precision Test (Piping)	Pass	7/17/2024
Piping	Fiberglass Single Wall Piping Ameron Dualoy 3000/L	Precision Test (Piping)	Pass	8/2/2023
Tank	Fiberglass Double Wall Containment Solutions	Precision Test (Tank)	Pass	8/2/2023

Dispenser Information

Name\ID 1/2

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	9/30/2021	9/30/2024
Leak Detect - Piping	Sump Sensor with positive shutdown	7/17/2024	7/17/2025

Name\ID 1/2S

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	9/30/2021	9/30/2024
Leak Detect - Piping	Sump Sensor with positive shutdown	7/17/2024	7/17/2025

Name\ID 10M/11S

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	9/30/2021	9/30/2024
Leak Detect - Piping	Sump Sensor with positive shutdown	7/17/2024	7/17/2025

Name\ID 11/12

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	9/30/2021	9/30/2024
Leak Detect - Piping	Sump Sensor with positive shutdown	7/17/2024	7/17/2025

Name\ID 11M

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	9/30/2021	9/30/2024
Leak Detect - Piping	Sump Sensor with positive shutdown	7/17/2024	7/17/2025

Name\ID 2M/3S

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	9/30/2021	9/30/2024
Leak Detect - Piping	Sump Sensor with positive shutdown	7/17/2024	7/17/2025

Name\ID 3/4

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	9/30/2021	9/30/2024
Leak Detect - Piping	Sump Sensor with positive shutdown	7/17/2024	7/17/2025

Name\ID 3M/4S

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	9/30/2021	9/30/2024
Leak Detect - Piping	Sump Sensor with positive shutdown	7/17/2024	7/17/2025

Name\ID 4M/5S

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	9/30/2021	9/30/2024
Leak Detect - Piping	Sump Sensor with positive shutdown	7/17/2024	7/17/2025

Name\ID 5/6

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	9/30/2021	9/30/2024
Leak Detect - Piping	Sump Sensor with positive shutdown	7/17/2024	7/17/2025

Name\ID 5M/6S

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	9/30/2021	9/30/2024
Leak Detect - Piping	Sump Sensor with positive shutdown	7/17/2024	7/17/2025

Name\ID 6M

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	9/30/2021	9/30/2024
Leak Detect - Piping	Sump Sensor with positive shutdown	7/17/2024	7/17/2025

Name\ID 7/8

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	9/30/2021	9/30/2024
Leak Detect - Piping	Sump Sensor with positive shutdown	7/17/2024	7/17/2025

Name\ID 7M/8S

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	9/30/2021	9/30/2024
Leak Detect - Piping	Sump Sensor with positive shutdown	7/17/2024	7/17/2025

Name\ID 7S

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	9/30/2021	9/30/2024
Leak Detect - Piping	Sump Sensor with positive shutdown	7/17/2024	7/17/2025

Name\ID 8M/9S

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	9/30/2021	9/30/2024
Leak Detect - Piping	Sump Sensor with positive shutdown	7/17/2024	7/17/2025

Name\ID 9/10

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	9/30/2021	9/30/2024
Leak Detect - Piping	Sump Sensor with positive shutdown	7/17/2024	7/17/2025

Name\ID 9M/10S

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	9/30/2021	9/30/2024
Leak Detect - Piping	Sump Sensor with positive shutdown	7/17/2024	7/17/2025

MFD Motorfuel Dispensing Forms

Facility Number	Name	City	Received Date	Letter
4009542	Effingham Travel Center	Effingham	10/12/2021	Letter Form