Information

JB Pritzker, Governor

James A. Rivera, State Fire Marshal

Division of Petroleum & Chemical Safety

State of Illinois
Employment Opportunities
Ready Illinois
Find us on Facebook

Division of Petroleum & Chemical Safety

Facility Details

Facility Number:	4012122
Status:	Active
Facility Name:	F S Farmtown
Address:	1808 Morrissey Bloomington, IL 61704
County:	McLean
Property Parcel:	21-15-276-013
Facility Type:	Unattended Self-Service Station
Owner Type:	Private
Green Tag Decal:	Y002321
Green Tag Issue Date:	7/25/2023
Green Tag Expiration Date:	12/31/2025

Owner Details

Owner Name:	Evergreen FS, Inc.
Owner Address:	P.O. Box 1367 Bloomington, IL 61702
Owner Status:	Current Owner
Purchase Date:	6/17/1975
Type of Financial Responsibility:	Self-Insurance
Financial Responsibility Reporting Due Date:	2/27/2026

Motor Fuel Dispensing Permits

MFD Permit Type	Issue Date	Expiration Date
Unattended Self Service	7/25/2023	12/31/2025
Self Service	1/7/2020	12/31/2021

Owner Summary

Click for Facility/Tank Ownership history

Owner Number	Owner Name	Owner Status	Purchase Date
U0027569	Evergreen FS, Inc.	Current Owner	6/17/1975
U0010025	Evergreen F S	Former Owner	10/13/1998

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
98-2996	12/7/1998	Removal Log	3262-98

LUST Fund Eligibility and Deductibility Determinations

No Applications Found

Pay Tank Fees Online

Tank Information

Tank Number 1

Capacity:	6000		Petroleum Use:
Product:	Gasoline		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	12/7/1998
OSFM First Notify Date:	5/6/1986		Abandoned Material:
Current Age:	19		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 2

Capacity:	6000		Petroleum Use:
Product:	Diesel Fuel		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	12/7/1998
OSFM First Notify Date:	5/6/1986		Abandoned Material:
Current Age:	19		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 3

Capacity:	2000		Petroleum Use:
Product:	Gasoline		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	12/7/1998
OSFM First Notify Date:	5/6/1986		Abandoned Material:
Current Age:	19		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 4

Capacity:	2000		Petroleum Use:
Product:	Kerosene		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	12/7/1998
OSFM First Notify Date:	5/6/1986		Abandoned Material:
Current Age:	19		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 5

Capacity:	3000		Petroleum Use:
Product:	Gasoline		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	11/29/1988
OSFM First Notify Date:	5/6/1986		Abandoned Material:
Current Age:	-18		Abandoned Date:
Install Date:	11/8/2006		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	11/8/2006

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:	10000		Petroleum Use:
Product:	Diesel Fuel		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	12/15/1998		Abandoned Material:
Current Age:	26		Abandoned Date:
Install Date:	10/13/1998		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	10/14/1998

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Sacrificial Anode Flex Connector	6/14/2023	6/14/2026
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	6/14/2024	6/14/2025
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 300c with CSLD	6/13/2024	6/13/2025
Overfill Prev Device	Overfill Drop Tube Valve	6/27/2023	6/27/2026
Piping	Flexible Double Wall A.P.T. Poly Tech	N/A	N/A
Piping	Single Wall STP/Tanktop Sump	6/14/2023	6/14/2026
Leak Detect - Piping	Sump Sensor	6/13/2024	6/13/2025
Piping	Single Wall Transition Sump	6/14/2023	6/14/2026
Leak Detect - Piping	Sump Sensor	6/13/2024	6/13/2025
Spill Contain Device	Single Wall Spill Bucket	6/14/2023	6/14/2026
Tank	Fiberglass Single Wall	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Piping	Flexible Double Wall A.P.T. Poly Tech	Precision Test (Piping)	Pass	6/13/2024

Tank Number 7

Capacity:	10000		Petroleum Use:
Product:	Gasoline - Regular		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	12/15/1998		Abandoned Material:
Current Age:	26		Abandoned Date:
Install Date:	10/13/1998		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	10/14/1998

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Sacrificial Anode Flex Connector	6/14/2023	6/14/2026
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	6/13/2024	6/13/2025
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 300c with CSLD	6/13/2024	6/13/2025
Overfill Prev Device	Overfill Drop Tube Valve	6/14/2023	6/14/2026
Piping	Flexible Double Wall A.P.T. Poly Tech	N/A	N/A
Piping	Single Wall STP/Tanktop Sump	6/14/2023	6/14/2026
Leak Detect - Piping	Sump Sensor	6/13/2024	6/13/2025
Spill Contain Device	Double Wall Spill Bucket	7/18/2023	7/18/2026
Tank	Fiberglass Single Wall	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Piping	Flexible Double Wall A.P.T. Poly Tech	Precision Test (Piping)	Pass	6/13/2024

Tank Number 8

Capacity:	8000		Petroleum Use:
Product:	Gasoline - Premium		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	12/15/1998		Abandoned Material:
Current Age:	26		Abandoned Date:
Install Date:	10/13/1998		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	10/14/1998

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Sacrificial Anode Flex Connector	6/14/2023	6/14/2026
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	6/13/2024	6/13/2025
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 300c with CSLD	6/13/2024	6/13/2025
Overfill Prev Device	Overfill Drop Tube Valve	7/18/2023	7/18/2026
Piping	Flexible Double Wall A.P.T. Poly Tech	N/A	N/A
Piping	Single Wall STP/Tanktop Sump	6/14/2023	6/14/2026
Leak Detect - Piping	Sump Sensor	6/13/2024	6/13/2025
Spill Contain Device	Single Wall Spill Bucket	6/14/2023	6/14/2026
Tank	Fiberglass Single Wall	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Piping	Flexible Double Wall A.P.T. Poly Tech	Precision Test (Piping)	Pass	6/13/2024

Tank Number 9

Capacity:	30000		Petroleum Use:
Product:	Gasoline - Regular		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	4/9/2007		Abandoned Material:
Current Age:	18		Abandoned Date:
Install Date:	11/8/2006		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	11/8/2006

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Other Aboveground Piping	N/A	N/A
Corrosion Prot - Tank	Fiberglass Non-Corrosive	N/A	N/A
Leak Detect - Piping	Aboveground	N/A	N/A
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 350 with CSLD	6/13/2024	6/13/2025
Overfill Prev Device	Overfill Alarm	6/14/2023	6/14/2026
Piping	Aboveground	N/A	N/A
Spill Contain Device	Single Wall Spill Bucket	6/14/2023	6/14/2026
Tank	Fiberglass Single Wall Containment Solutions	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 10

Capacity:	30000		Petroleum Use:
Product:	Dyed Diesel		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	4/9/2007		Abandoned Material:
Current Age:	18		Abandoned Date:
Install Date:	11/8/2006		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	11/8/2006

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Other Aboveground Piping	N/A	N/A
Corrosion Prot - Tank	Fiberglass Non-Corrosive	N/A	N/A
Leak Detect - Piping	Aboveground	N/A	N/A
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 350 with CSLD	6/13/2024	6/13/2025
Overfill Prev Device	Overfill Alarm	6/14/2023	6/14/2026
Piping	Aboveground	N/A	N/A
Spill Contain Device	Single Wall Spill Bucket	6/14/2023	6/14/2026
Tank	Fiberglass Single Wall Containment Solutions	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 11

Capacity:	30000		Petroleum Use:
Product:	Dyed Diesel		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	4/9/2007		Abandoned Material:
Current Age:	18		Abandoned Date:
Install Date:	11/8/2006		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	11/8/2006

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Other Aboveground Piping	N/A	N/A
Corrosion Prot - Tank	Fiberglass Non-Corrosive	N/A	N/A
Leak Detect - Piping	Aboveground	N/A	N/A
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 350 with CSLD	6/13/2024	6/13/2025
Overfill Prev Device	Overfill Alarm	6/14/2023	6/14/2026
Piping	Aboveground	N/A	N/A
Spill Contain Device	Single Wall Spill Bucket	6/14/2023	6/14/2026
Tank	Fiberglass Single Wall Containment Solutions	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 12

Capacity:	30000		Petroleum Use:
Product:	Dyed Diesel		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	4/9/2007		Abandoned Material:
Current Age:	18		Abandoned Date:
Install Date:	11/8/2006		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	11/8/2006

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Other Aboveground Piping	N/A	N/A
Corrosion Prot - Tank	Fiberglass Non-Corrosive	N/A	N/A
Leak Detect - Piping	Aboveground	N/A	N/A
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 350 with CSLD	6/13/2024	6/13/2025
Overfill Prev Device	Overfill Alarm	6/14/2023	6/14/2026
Piping	Aboveground	N/A	N/A
Spill Contain Device	Single Wall Spill Bucket	6/14/2023	6/14/2026
Tank	Fiberglass Single Wall Containment Solutions	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 13

Capacity:	30000		Petroleum Use:
Product:	Diesel Fuel		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	4/9/2007		Abandoned Material:
Current Age:	18		Abandoned Date:
Install Date:	11/8/2006		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	11/8/2006

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Other Aboveground Piping	N/A	N/A
Corrosion Prot - Tank	Fiberglass Non-Corrosive	N/A	N/A
Leak Detect - Piping	Aboveground	N/A	N/A
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 350 with CSLD	6/13/2024	6/13/2025
Overfill Prev Device	Overfill Alarm	6/14/2023	6/14/2026
Piping	Aboveground	N/A	N/A
Spill Contain Device	Single Wall Spill Bucket	6/14/2023	6/14/2026
Tank	Fiberglass Single Wall Containment Solutions	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 14

Capacity:	30000		Petroleum Use:
Product:	B-99		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	4/9/2007		Abandoned Material:
Current Age:	18		Abandoned Date:
Install Date:	11/8/2006		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	11/8/2006

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Other Aboveground Piping	N/A	N/A
Corrosion Prot - Tank	Fiberglass Non-Corrosive	N/A	N/A
Leak Detect - Piping	Aboveground	N/A	N/A
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 350 with CSLD	6/13/2024	6/13/2025
Overfill Prev Device	Overfill Alarm	6/14/2023	6/14/2026
Piping	Aboveground	N/A	N/A
Spill Contain Device	Single Wall Spill Bucket	6/14/2023	6/14/2026
Tank	Fiberglass Single Wall Containment Solutions	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 15

Capacity:	30000		Petroleum Use:
Product:	Diesel Fuel		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	4/9/2007		Abandoned Material:
Current Age:	18		Abandoned Date:
Install Date:	11/8/2006		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	11/8/2006

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Other Aboveground Piping	N/A	N/A
Corrosion Prot - Tank	Fiberglass Non-Corrosive	N/A	N/A
Leak Detect - Piping	Aboveground	N/A	N/A
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 350 with CSLD	6/13/2024	6/13/2025
Overfill Prev Device	Overfill Alarm	6/14/2023	6/14/2026
Piping	Aboveground	N/A	N/A
Spill Contain Device	Single Wall Spill Bucket	6/14/2023	6/14/2026
Tank	Fiberglass Single Wall Containment Solutions	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 16

Capacity:	30000		Petroleum Use:
Product:	Diesel Fuel		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	4/9/2007		Abandoned Material:
Current Age:	18		Abandoned Date:
Install Date:	11/8/2006		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	11/8/2006

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Other Aboveground Piping	N/A	N/A
Corrosion Prot - Tank	Fiberglass Non-Corrosive	N/A	N/A
Leak Detect - Piping	Aboveground	N/A	N/A
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 350 with CSLD	2/17/2025	2/17/2026
Overfill Prev Device	Overfill Alarm	6/14/2023	6/14/2026
Piping	Aboveground	N/A	N/A
Spill Contain Device	Single Wall Spill Bucket	6/14/2023	6/14/2026
Tank	Fiberglass Single Wall Containment Solutions	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 17

Capacity:	15000		Petroleum Use:
Product:	Gasoline - Mid-grade		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	4/9/2007		Abandoned Material:
Current Age:	18		Abandoned Date:
Install Date:	11/8/2006		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	11/8/2006

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Other Aboveground Piping	N/A	N/A
Corrosion Prot - Tank	Fiberglass Non-Corrosive	N/A	N/A
Leak Detect - Piping	Aboveground	N/A	N/A
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 350 with CSLD	6/13/2024	6/13/2025
Overfill Prev Device	Overfill Alarm	6/14/2023	6/14/2026
Piping	Aboveground	N/A	N/A
Spill Contain Device	Single Wall Spill Bucket	6/14/2023	6/14/2026
Tank	Fiberglass Single Wall Containment Solutions	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 18

Capacity:	15000		Petroleum Use:
Product:	Dyed Diesel		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	4/9/2007		Abandoned Material:
Current Age:	18		Abandoned Date:
Install Date:	11/8/2006		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	11/8/2006

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Other Aboveground Piping	N/A	N/A
Corrosion Prot - Tank	Fiberglass Non-Corrosive	N/A	N/A
Leak Detect - Piping	Aboveground	N/A	N/A
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 350 with CSLD	6/13/2024	6/13/2025
Overfill Prev Device	Overfill Alarm	6/14/2023	6/14/2026
Piping	Aboveground	N/A	N/A
Spill Contain Device	Single Wall Spill Bucket	6/14/2023	6/14/2026
Tank	Fiberglass Single Wall Containment Solutions	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 19

Capacity:	15000		Petroleum Use:
Product:	Dyed Diesel		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	4/9/2007		Abandoned Material:
Current Age:	18		Abandoned Date:
Install Date:	11/8/2006		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	11/8/2006

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Other Aboveground Piping	N/A	N/A
Corrosion Prot - Tank	Fiberglass Non-Corrosive	N/A	N/A
Leak Detect - Piping	Aboveground	N/A	N/A
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 350 with CSLD	6/13/2024	6/13/2025
Overfill Prev Device	Overfill Alarm	6/14/2023	6/14/2026
Piping	Aboveground	N/A	N/A
Spill Contain Device	Single Wall Spill Bucket	6/14/2023	6/14/2026
Tank	Fiberglass Single Wall Containment Solutions	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 20

Capacity:	15000		Petroleum Use:
Product:	Diesel Fuel		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	4/9/2007		Abandoned Material:
Current Age:	18		Abandoned Date:
Install Date:	11/8/2006		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	11/8/2006

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Other Aboveground Piping	N/A	N/A
Corrosion Prot - Tank	Fiberglass Non-Corrosive	N/A	N/A
Leak Detect - Piping	Aboveground	N/A	N/A
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 350 with CSLD	6/13/2024	6/13/2025
Overfill Prev Device	Overfill Alarm	6/14/2023	6/14/2026
Piping	Aboveground	N/A	N/A
Spill Contain Device	Single Wall Spill Bucket	6/14/2023	6/14/2026
Tank	Fiberglass Single Wall Containment Solutions	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 21

Capacity:	10000		Petroleum Use:
Product:	Gasoline - Regular		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	11/15/2022		Abandoned Material:
Current Age:	2		Abandoned Date:
Install Date:	11/10/2022		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	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	6/13/2024	6/13/2025
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 350 with CSLD	6/13/2024	6/13/2025
Leak Detect - Tank	Non-Discriminating Interstitial Monitoring Sensors	6/13/2024	6/13/2025
Overfill Prev Device	Overfill Drop Tube Valve	12/13/2022	12/13/2025
Piping	Fiberglass Double Wall Ameron Dualoy 3000/LCX	N/A	N/A
Piping	Single Wall STP/Tanktop Sump	11/15/2022	11/15/2025
Leak Detect - Piping	Sump Sensor with positive shutdown	6/13/2024	6/13/2025
Spill Contain Device	Single Wall Spill Bucket	11/15/2022	11/15/2025
Tank	Fiberglass Double Wall	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Piping	Fiberglass Double Wall Ameron Dualoy 3000/LCX	Precision Test (Piping)	Pass	6/13/2024
Tank	Fiberglass Double Wall	Precision Test (Tank)	Pass	12/16/2022

Dispenser Information

Name\ID 1/2

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	6/14/2023	6/14/2026
Leak Detect - Piping	Sump Sensor	6/13/2024	6/13/2025

Name\ID 3/4

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	6/14/2023	6/14/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	6/28/2024	6/28/2025

Name\ID 5/6M

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	6/14/2023	6/14/2026
Leak Detect - Piping	Sump Sensor	6/13/2024	6/13/2025

Name\ID 6S

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	6/14/2023	6/14/2026
Leak Detect - Piping	Sump Sensor	6/13/2024	6/13/2025

Name\ID 7/8

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	11/17/2022	11/17/2025
Leak Detect - Piping	Sump Sensor with positive shutdown	6/13/2024	6/13/2025

Name\ID 9/10

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	11/17/2022	11/17/2025
Leak Detect - Piping	Sump Sensor with positive shutdown	6/13/2024	6/13/2025

MFD Motorfuel Dispensing Forms

Facility Number	Name	City	Received Date	Letter
4012122	F S Farmtown	Bloomington	12/14/2022	Letter Form
4012122	F S Farmtown	Bloomington	12/14/2022	Letter Form