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Division of Petroleum & Chemical Safety
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Division of Petroleum & Chemical Safety
Facility Details
Facility Number:
4034774
Status:
Active
Facility Name:
Casey's General Store #1903
Address:
1700 W. Main Street
Shelbyville, IL 62565
County:
Shelby
Property Parcel:
1812-12-19-402-009
Facility Type:
Attended Self-Service Station
Owner Type:
Private
Green Tag Decal:
Y000837
Green Tag Issue Date:
3/15/2023
Green Tag Expiration Date:
12/31/2025
Owner Details
Owner Name:
Casey's Retail Company
Owner Address:
3305 SE Delaware Ave.
P.O. Box 3004
Ankeny, IA 50021
Owner Status:
Current Owner
Purchase Date:
6/6/1996
Type of Financial Responsibility:
Self-Insurance
Financial Responsibility Reporting Due Date:
10/27/2025
Motor Fuel Dispensing Permits
MFD Permit Type
Issue Date
Expiration Date
Self Service
3/15/2023
12/31/2025
Owner Summary
Click for Facility/Tank Ownership history
Owner Number
Owner Name
Owner Status
Purchase Date
U0002560
Casey's Retail Company
Current Owner
6/6/1996
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
2022-1017
11/16/2022
Removal Log
01108-2022REM
LUST
Fund Eligibility and Deductibility Determinations
IEMA Number
Status
OSFM Received Date
OSFM Response Date
Deductible
Letter
20221017
Eligible
2/9/2023
2/16/2023
$5,000
Letter
Pay Tank Fees Online
Tank Information
Tank Number 1
Capacity:
10000
Petroleum Use:
None
Product:
Gasoline - Regular
CERCLA Substance:
Status:
Removed
CAS Code:
Regulated Status:
Federal
Removed Date:
11/16/2022
OSFM
First Notify Date:
6/18/1996
Abandoned Material:
Current Age:
26
Abandoned Date:
Install Date:
6/6/1996
Red Tag Issue Date:
Last Used Date:
1/21/2022
Fee Due:
$0.00
Product Date:
6/7/1996
Equipment
Equipment Type
Equipment
Last Passing Date
Test Expire Date
Corrosion Prot - Piping
Sacrificial Anode Flex Connector
6/21/2022
6/21/2025
Corrosion Prot - Piping
Fiberglass Non-Corrosive
N/A
N/A
Corrosion Prot - Tank
Fiberglass Non-Corrosive
N/A
N/A
Leak Detect - Piping
Electronic Pressurized Line Leak Detection
11/2/2021
11/2/2022
Leak Detect - Tank
Automatic Tank Gauging Veeder Root TLS 350 with CSLD
11/2/2021
11/2/2022
Overfill Prev Device
Overfill Drop Tube Valve
11/5/2020
11/5/2023
Piping
Flex Connector Steel
N/A
N/A
Piping
Fiberglass Single Wall Piping
N/A
N/A
Piping
Single Wall STP/Tanktop Sump
Leak Detect - Piping
Piping Sump Sensors Not Regulated Not Installed
N/A
N/A
Spill Contain Device
Single Wall Spill Bucket
7/1/2020
7/1/2023
Tank
Fiberglass Single Wall
N/A
N/A
Additional Tests
Equipment Type
Equipment
Test Type
Test Result
Test Date
Tank Number 2
Capacity:
10000
Petroleum Use:
None
Product:
Diesel Fuel
CERCLA Substance:
Status:
Removed
CAS Code:
Regulated Status:
Federal
Removed Date:
11/16/2022
OSFM
First Notify Date:
6/18/1996
Abandoned Material:
Current Age:
26
Abandoned Date:
Install Date:
6/6/1996
Red Tag Issue Date:
Last Used Date:
1/21/2022
Fee Due:
$0.00
Product Date:
6/7/1996
Equipment
Equipment Type
Equipment
Last Passing Date
Test Expire Date
Corrosion Prot - Piping
Sacrificial Anode Flex Connector
6/21/2022
6/21/2025
Corrosion Prot - Piping
Fiberglass Non-Corrosive
N/A
N/A
Corrosion Prot - Tank
Fiberglass Non-Corrosive
N/A
N/A
Leak Detect - Piping
Electronic Pressurized Line Leak Detection
11/2/2021
11/2/2022
Leak Detect - Tank
Automatic Tank Gauging Veeder Root TLS 350 with CSLD
11/2/2021
11/2/2022
Overfill Prev Device
Overfill Drop Tube Valve
11/5/2020
11/5/2023
Piping
Flex Connector Steel
N/A
N/A
Piping
Fiberglass Single Wall Piping
N/A
N/A
Piping
Single Wall STP/Tanktop Sump
Leak Detect - Piping
Piping Sump Sensors Not Regulated Not Installed
N/A
N/A
Spill Contain Device
Single Wall Spill Bucket
7/1/2020
7/1/2023
Tank
Fiberglass Single Wall
N/A
N/A
Additional Tests
Equipment Type
Equipment
Test Type
Test Result
Test Date
Tank Number 3
Capacity:
14000
Petroleum Use:
Product:
Gasoline - Regular
CERCLA Substance:
Status:
Currently in use
CAS Code:
Regulated Status:
Federal
Removed Date:
OSFM
First Notify Date:
2/1/2023
Abandoned Material:
Current Age:
2
Abandoned Date:
Install Date:
12/1/2022
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
Flexible Non-Corrosive
N/A
N/A
Corrosion Prot - Tank
Fiberglass Non-Corrosive
N/A
N/A
Leak Detect - Piping
Electronic Pressurized Line Leak Detection
2/14/2023
2/14/2024
Leak Detect - Tank
Non-Discriminating Interstitial Monitoring Sensors With Monitor
2/14/2023
2/14/2024
Overfill Prev Device
Overfill Drop Tube Valve
1/11/2023
1/11/2026
Piping
Flexible Double Wall A.P.T. Poly Tech P175SC
N/A
N/A
Piping
Single Wall STP/Tanktop Sump
1/11/2023
1/11/2026
Leak Detect - Piping
Sump Sensor with positive shutdown
2/14/2023
2/14/2024
Spill Contain Device
Single Wall Spill Bucket
1/11/2023
1/11/2026
Tank
Fiberglass Double Wall Containment Solutions
N/A
N/A
Additional Tests
Equipment Type
Equipment
Test Type
Test Result
Test Date
Piping
Flexible Double Wall A.P.T. Poly Tech S175SC
Precision Test (Piping)
Pass
2/14/2023
Tank
Fiberglass Double Wall Containment Solutions
Precision Test (Tank)
Pass
2/14/2023
Tank Number 4
Capacity:
14000
Petroleum Use:
None
Product:
Diesel Fuel
CERCLA Substance:
Status:
Currently in use
CAS Code:
Regulated Status:
Federal
Removed Date:
OSFM
First Notify Date:
2/1/2023
Abandoned Material:
Current Age:
2
Abandoned Date:
Install Date:
12/1/2022
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
Flexible Non-Corrosive
N/A
N/A
Corrosion Prot - Tank
Fiberglass Non-Corrosive
N/A
N/A
Leak Detect - Piping
Electronic Pressurized Line Leak Detection
2/14/2023
2/14/2024
Leak Detect - Tank
Non-Discriminating Interstitial Monitoring Sensors With Monitor
2/14/2023
2/14/2024
Overfill Prev Device
Overfill Drop Tube Valve
1/11/2023
1/11/2026
Piping
Flexible Double Wall A.P.T. Poly Tech S175SC
N/A
N/A
Piping
Single Wall STP/Tanktop Sump
1/11/2023
1/11/2026
Leak Detect - Piping
Sump Sensor with positive shutdown
2/14/2023
2/14/2024
Spill Contain Device
Single Wall Spill Bucket
1/11/2023
1/11/2026
Tank
Fiberglass Double Wall Containment Solutions
N/A
N/A
Additional Tests
Equipment Type
Equipment
Test Type
Test Result
Test Date
Piping
Flexible Double Wall A.P.T. Poly Tech S175SC
Precision Test (Piping)
Pass
2/14/2023
Tank
Fiberglass Double Wall Containment Solutions
Precision Test (Tank)
Pass
2/14/2023
Tank Number 5
Capacity:
8000
Petroleum Use:
Product:
Gasoline - Premium
CERCLA Substance:
Status:
Currently in use
CAS Code:
Regulated Status:
Federal
Removed Date:
OSFM
First Notify Date:
2/1/2023
Abandoned Material:
Current Age:
2
Abandoned Date:
Install Date:
12/1/2022
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
Flexible Non-Corrosive
N/A
N/A
Corrosion Prot - Tank
Fiberglass Non-Corrosive
N/A
N/A
Leak Detect - Piping
Electronic Pressurized Line Leak Detection
2/14/2023
2/14/2024
Leak Detect - Tank
Non-Discriminating Interstitial Monitoring Sensors With Monitor
2/14/2023
2/14/2024
Overfill Prev Device
Overfill Drop Tube Valve
1/11/2023
1/11/2026
Piping
Flexible Double Wall A.P.T. Poly Tech S175SC
N/A
N/A
Piping
Single Wall STP/Tanktop Sump
1/11/2023
1/11/2026
Leak Detect - Piping
Sump Sensor with positive shutdown
2/14/2023
2/14/2024
Spill Contain Device
Single Wall Spill Bucket
1/11/2023
1/11/2026
Tank
Fiberglass Double Wall Containment Solutions
N/A
N/A
Additional Tests
Equipment Type
Equipment
Test Type
Test Result
Test Date
Piping
Flexible Double Wall A.P.T. Poly Tech S175SC
Precision Test (Piping)
Pass
2/14/2023
Tank
Fiberglass Double Wall Containment Solutions
Precision Test (Tank)
Pass
2/14/2023
Tank Number 6
Capacity:
8000
Petroleum Use:
Product:
E15
CERCLA Substance:
Status:
Currently in use
CAS Code:
Regulated Status:
Federal
Removed Date:
OSFM
First Notify Date:
2/1/2023
Abandoned Material:
Current Age:
2
Abandoned Date:
Install Date:
12/1/2022
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
Flexible Non-Corrosive
N/A
N/A
Corrosion Prot - Tank
Fiberglass Non-Corrosive
N/A
N/A
Leak Detect - Piping
Electronic Pressurized Line Leak Detection
2/14/2023
2/14/2024
Leak Detect - Tank
Non-Discriminating Interstitial Monitoring Sensors With Monitor
2/14/2023
2/14/2024
Overfill Prev Device
Overfill Drop Tube Valve
1/11/2023
1/11/2026
Piping
Flexible Double Wall A.P.T. Poly Tech S175SC
N/A
N/A
Piping
Single Wall STP/Tanktop Sump
1/11/2023
1/11/2026
Leak Detect - Piping
Sump Sensor with positive shutdown
2/14/2023
2/14/2024
Spill Contain Device
Single Wall Spill Bucket
1/11/2023
1/11/2026
Tank
Fiberglass Double Wall Containment Solutions
N/A
N/A
Additional Tests
Equipment Type
Equipment
Test Type
Test Result
Test Date
Piping
Flexible Double Wall A.P.T. Poly Tech S175SC
Precision Test (Piping)
Pass
2/14/2023
Tank
Fiberglass Double Wall Containment Solutions
Precision Test (Tank)
Pass
2/14/2023
Dispenser Information
Name\ID 1/2
Status:
Active
Equipment Type
Equipment
Last Passing Date
Test Expire Date
Dispenser
Single Wall UDC Sump
1/11/2023
1/11/2026
Leak Detect - Piping
Sump Sensor with positive shutdown
2/14/2023
2/14/2024
Name\ID 3/4
Status:
Active
Equipment Type
Equipment
Last Passing Date
Test Expire Date
Dispenser
Single Wall UDC Sump
1/11/2023
1/11/2026
Leak Detect - Piping
Sump Sensor with positive shutdown
2/14/2023
2/14/2024
Name\ID 5/6
Status:
Active
Equipment Type
Equipment
Last Passing Date
Test Expire Date
Dispenser
Single Wall UDC Sump
1/11/2023
1/11/2026
Leak Detect - Piping
Sump Sensor with positive shutdown
2/14/2023
2/14/2024
Name\ID 7/8
Status:
Active
Equipment Type
Equipment
Last Passing Date
Test Expire Date
Dispenser
Single Wall UDC Sump
1/11/2023
1/11/2026
Leak Detect - Piping
Sump Sensor with positive shutdown
2/14/2023
2/14/2024
MFD
Motorfuel Dispensing Forms
Facility Number
Name
City
Received Date
Letter
4034774
Casey's General Store #1903
Shelbyville
02/13/2023
Letter
Form
