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:	4040312
Status:	Active
Facility Name:	Sam's Club #8197
Address:	915 W. Marketview Dr. Champaign, IL 61822
County:	Champaign
Property Parcel:	41-20-02-203-012
Facility Type:	Attended Self-Service Station
Owner Type:	Private
Green Tag Decal:	Y001571
Green Tag Issue Date:	6/27/2023
Green Tag Expiration Date:	12/31/2025

Owner Details

Owner Name:	Sam's West, Inc.
Owner Address:	2101 SE Simple Savings Drive Bentonville, AR 727160745
Owner Status:	Current Owner
Purchase Date:	3/29/2001
Type of Financial Responsibility:	Commercial Insurance
Financial Responsibility Reporting Due Date:	4/29/2026

Motor Fuel Dispensing Permits

MFD Permit Type	Issue Date	Expiration Date
Self Service	6/27/2023	12/31/2025

Owner Summary

Click for Facility/Tank Ownership history

Owner Number	Owner Name	Owner Status	Purchase Date
U0029973	Sam's West, Inc.	Current Owner	3/29/2001

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

No IEMA Numbers Found

LUST Fund Eligibility and Deductibility Determinations

No Applications Found

Pay Tank Fees Online

Tank Information

Tank Number 1

Capacity:	20000		Petroleum Use:
Product:	Gasoline - Regular		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	6/29/2001		Abandoned Material:
Current Age:	24		Abandoned Date:
Install Date:	3/30/2001		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	4/3/2001

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	4/23/2025	4/23/2026
Leak Detect - Piping	Siphon Bar	N/A	N/A
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 450 Plus with CSLD	4/23/2025	4/23/2026
Leak Detect - Tank	Non-Discriminating Interstitial Monitoring Sensors	4/23/2025	4/23/2026
Overfill Prev Device	Overfill Drop Tube Valve	4/3/2025	4/3/2028
Piping	Flexible Double Wall	N/A	N/A
Piping	Single Wall STP/Tanktop Sump	8/19/2024	8/19/2027
Leak Detect - Piping	Sump Sensor	5/2/2024	5/2/2025
Leak Detect - Piping	Sump Sensor with positive shutdown	4/23/2025	4/23/2026
Spill Contain Device	Double Wall Spill Bucket	4/23/2025	4/23/2028
Tank	Fiberglass Double Wall	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Leak Detect - Piping	Siphon Bar	Functional	Pass	5/18/2023
Piping	Flexible Double Wall	Precision Test (Piping)	Pass	4/23/2025
Tank	Fiberglass Double Wall	Precision Test (Tank)	Pass	4/23/2025

Tank Number 2

Capacity:	20000		Petroleum Use:
Product:	Gasoline - Regular		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	6/29/2001		Abandoned Material:
Current Age:	24		Abandoned Date:
Install Date:	3/30/2001		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	4/3/2001

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	4/23/2025	4/23/2026
Leak Detect - Piping	Siphon Bar	N/A	N/A
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 450 Plus with CSLD	4/23/2025	4/23/2026
Leak Detect - Tank	Non-Discriminating Interstitial Monitoring Sensors	4/23/2025	4/23/2026
Overfill Prev Device	Overfill Drop Tube Valve	6/15/2023	6/15/2026
Piping	Flexible Double Wall	N/A	N/A
Piping	Single Wall STP/Tanktop Sump	8/19/2024	8/19/2027
Leak Detect - Piping	Sump Sensor	5/18/2023	5/2/2024
Leak Detect - Piping	Sump Sensor with positive shutdown	4/23/2025	4/23/2026
Spill Contain Device	Double Wall Spill Bucket	4/23/2025	4/23/2028
Tank	Fiberglass Double Wall	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Leak Detect - Piping	Siphon Bar	Functional	Pass	5/18/2023
Piping	Flexible Double Wall	Precision Test (Piping)	Pass	4/23/2025
Tank	Fiberglass Double Wall	Precision Test (Tank)	Pass	4/23/2025

Tank Number 3

Capacity:	20000		Petroleum Use:
Product:	Gasoline - Premium		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	6/29/2001		Abandoned Material:
Current Age:	24		Abandoned Date:
Install Date:	3/30/2001		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	4/3/2001

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	4/23/2025	4/23/2026
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 450 Plus with CSLD	4/23/2025	4/23/2026
Leak Detect - Tank	Non-Discriminating Interstitial Monitoring Sensors	4/23/2025	4/23/2026
Overfill Prev Device	Overfill Drop Tube Valve	5/18/2023	5/18/2026
Piping	Flexible Double Wall	N/A	N/A
Piping	Single Wall STP/Tanktop Sump	8/19/2024	8/19/2027
Leak Detect - Piping	Sump Sensor	5/2/2024	5/2/2025
Leak Detect - Piping	Sump Sensor with positive shutdown	4/23/2025	4/23/2026
Spill Contain Device	Double Wall Spill Bucket	4/23/2025	4/23/2028
Tank	Fiberglass Double Wall	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Piping	Flexible Double Wall	Precision Test (Piping)	Pass	4/23/2025
Tank	Fiberglass Double Wall	Precision Test (Tank)	Pass	4/23/2025

Dispenser Information

Name\ID 1/2

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump
Leak Detect - Piping	Piping Sump Sensors Not Regulated Not Installed	N/A	N/A

Name\ID 11/12

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump
Leak Detect - Piping	Piping Sump Sensors Not Regulated Not Installed	N/A	N/A

Name\ID 13/14

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump
Leak Detect - Piping	Piping Sump Sensors Not Regulated Not Installed	N/A	N/A

Name\ID 15/16

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump
Leak Detect - Piping	Piping Sump Sensors Not Regulated Not Installed	N/A	N/A

Name\ID 3/4

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump
Leak Detect - Piping	Piping Sump Sensors Not Regulated Not Installed	N/A	N/A

Name\ID 5/6

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump
Leak Detect - Piping	Piping Sump Sensors Not Regulated Not Installed	N/A	N/A

Name\ID 7/8

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump
Leak Detect - Piping	Piping Sump Sensors Not Regulated Not Installed	N/A	N/A

Name\ID 9/10

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump
Leak Detect - Piping	Piping Sump Sensors Not Regulated Not Installed	N/A	N/A

MFD Motorfuel Dispensing Forms

No Forms Found