Division of Petroleum & Chemical Safety

Facility Details

Facility Number:	4047542
Status:	Active
Facility Name:	QT #7191
Address:	1320 N Third Street Effingham, IL 62401
County:	Effingham
Property Parcel:	03-11-016-057
Facility Type:	Attended Self-Service Station
Owner Type:	Private
Green Tag Decal:	Y003421
Green Tag Issue Date:	8/30/2023
Green Tag Expiration Date:	12/31/2025

Owner Details

Owner Name:	QuikTrip Corporation
Owner Address:	4705 South 129th East Ave. Tulsa, OK 74134
Owner Status:	Current Owner
Purchase Date:
Type of Financial Responsibility:	Commercial Insurance
Financial Responsibility Reporting Due Date:	4/11/2026

Motor Fuel Dispensing Permits

MFD Permit Type	Issue Date	Expiration Date
Self Service	8/30/2023	12/31/2025

Owner Summary

Click for Facility/Tank Ownership history

Owner Number	Owner Name	Owner Status	Purchase Date
U0034559	QuikTrip Corporation	Current Owner
U0040963	QuikTrip Corporation	Former Owner	2/4/2021
U0040798	Mac's Convenience Stores, 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

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:	8/23/2023	Abandoned Material:
Current Age:	1	Abandoned Date:
Install Date:	2/9/2023	Red Tag Issue Date:
Last Used Date:		Fee Due:	$0.00
Product Date:	8/4/2023

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	8/24/2024	8/24/2025
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 450	8/24/2024	8/24/2025
Leak Detect - Tank	Hydrostatic Reservoir Interstitial Monitoring Sensors with monitor	8/24/2024	8/24/2025
Overfill Prev Device	Overfill Drop Tube Valve	7/26/2023	7/26/2026
Piping	Flexible Double Wall Franklin Fueling Systems UPP	N/A	N/A
Piping	Single Wall STP/Tanktop Sump	6/20/2023	6/20/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	8/24/2024	8/24/2025
Piping	Single Wall Transition Sump	6/20/2023	6/20/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	8/24/2024	8/24/2025
Spill Contain Device	Double Wall Spill Bucket	6/20/2023	6/20/2026
Tank	Fiberglass Brine Filled Double Wall Containment Solutions	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Piping	Flexible Double Wall Franklin Fueling Systems UPP	Precision Test (Piping)	Pass	8/24/2023
Tank	Fiberglass Double Wall Containment Solutions	Precision Test (Tank)	Pass	8/25/2023

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:	8/23/2023	Abandoned Material:
Current Age:	1	Abandoned Date:
Install Date:	2/9/2023	Red Tag Issue Date:
Last Used Date:		Fee Due:	$0.00
Product Date:	8/4/2023

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	8/24/2024	8/24/2025
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 450	8/24/2024	8/24/2025
Leak Detect - Tank	Hydrostatic Reservoir Interstitial Monitoring Sensors with monitor	8/24/2024	8/24/2025
Overfill Prev Device	Overfill Drop Tube Valve	7/26/2023	7/26/2026
Piping	Flexible Double Wall Franklin Fueling Systems UPP	N/A	N/A
Piping	Single Wall STP/Tanktop Sump	6/20/2023	6/20/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	8/24/2024	8/24/2025
Piping	Single Wall Transition Sump	6/20/2023	6/20/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	8/24/2024	8/24/2025
Spill Contain Device	Double Wall Spill Bucket	6/20/2023	6/20/2026
Tank	Fiberglass Brine Filled Double Wall Containment Solutions	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Piping	Flexible Double Wall Franklin Fueling Systems UPP	Precision Test (Piping)	Pass	8/24/2023
Tank	Fiberglass Double Wall Containment Solutions	Precision Test (Tank)	Pass	8/25/2023

Tank Number 3

Capacity:	20000	Petroleum Use:
Product:	Gasoline - Non Ethanol	CERCLA Substance:
Status:	Currently in use	CAS Code:
Regulated Status:	Federal	Removed Date:
OSFM First Notify Date:	8/23/2023	Abandoned Material:
Current Age:	1	Abandoned Date:
Install Date:	2/9/2023	Red Tag Issue Date:
Last Used Date:		Fee Due:	$0.00
Product Date:	8/4/2023

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	8/24/2024	8/24/2025
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 450	8/24/2024	8/24/2025
Leak Detect - Tank	Hydrostatic Reservoir Interstitial Monitoring Sensors with monitor	8/24/2024	8/24/2025
Overfill Prev Device	Overfill Drop Tube Valve	7/26/2023	7/26/2026
Piping	Flexible Double Wall Franklin Fueling Systems UPP	N/A	N/A
Piping	Single Wall STP/Tanktop Sump	6/20/2023	6/20/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	8/24/2024	8/24/2025
Piping	Single Wall Transition Sump	6/20/2023	6/20/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	8/24/2024	8/24/2025
Piping	Single Wall Transition Sump	6/20/2023	6/20/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	8/24/2024	8/24/2025
Spill Contain Device	Double Wall Spill Bucket	6/20/2023	6/20/2026
Tank	Fiberglass Brine Filled Double Wall Containment Solutions	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Piping	Flexible Double Wall Franklin Fueling Systems UPP	Precision Test (Piping)	Pass	8/24/2023
Tank	Fiberglass Double Wall Containment Solutions	Precision Test (Tank)	Pass	8/25/2023

Tank Number 4

Capacity:	20000	Petroleum Use:
Product:	Gasoline - Premium	CERCLA Substance:
Status:	Currently in use	CAS Code:
Regulated Status:	Federal	Removed Date:
OSFM First Notify Date:	8/23/2023	Abandoned Material:
Current Age:	1	Abandoned Date:
Install Date:	2/9/2023	Red Tag Issue Date:
Last Used Date:		Fee Due:	$0.00
Product Date:	8/4/2023

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	8/24/2024	8/24/2025
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 450	8/24/2024	8/24/2025
Leak Detect - Tank	Hydrostatic Reservoir Interstitial Monitoring Sensors with monitor	8/24/2024	8/24/2025
Overfill Prev Device	Overfill Drop Tube Valve	7/26/2023	7/26/2026
Piping	Flexible Double Wall Franklin Fueling Systems UPP	N/A	N/A
Piping	Single Wall STP/Tanktop Sump	6/20/2023	6/20/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	8/24/2024	8/24/2025
Piping	Single Wall Transition Sump	6/20/2023	6/20/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	8/24/2024	8/24/2025
Piping	Single Wall Transition Sump	6/20/2023	6/20/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	8/24/2024	8/24/2025
Spill Contain Device	Double Wall Spill Bucket	6/20/2023	6/20/2026
Tank	Fiberglass Brine Filled Double Wall Containment Solutions	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Piping	Flexible Double Wall Franklin Fueling Systems UPP	Precision Test (Piping)	Pass	8/24/2023
Tank	Fiberglass Double Wall Containment Solutions	Precision Test (Tank)	Pass	8/25/2023

Tank Number 5

Capacity:	18000	Petroleum Use:	None
Product:	B-99	CERCLA Substance:
Status:	Currently in use	CAS Code:
Regulated Status:	Federal	Removed Date:
OSFM First Notify Date:	8/23/2023	Abandoned Material:
Current Age:	1	Abandoned Date:
Install Date:	2/2/2023	Red Tag Issue Date:
Last Used Date:		Fee Due:	$0.00
Product Date:	8/4/2023

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	8/24/2024	8/24/2025
Leak Detect - Piping	Electronic Pressurized Line Leak Detection	8/24/2024	8/24/2025
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 450	8/24/2024	8/24/2025
Leak Detect - Tank	Hydrostatic Reservoir Interstitial Monitoring Sensors with monitor	8/24/2024	8/24/2025
Overfill Prev Device	Overfill Drop Tube Valve	7/26/2023	7/26/2026
Piping	Blending Sump	5/4/2023	5/4/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	8/24/2024	8/24/2025
Piping	Blending Sump	5/4/2023	5/4/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	8/24/2024	8/24/2025
Piping	Blending Sump	5/4/2023	5/4/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	8/24/2024	8/24/2025
Piping	Blending Sump	5/4/2023	5/4/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	8/24/2024	8/24/2025
Piping	Flexible Double Wall Franklin Fueling Systems UPP	N/A	N/A
Piping	Single Wall STP/Tanktop Sump	5/4/2023	5/4/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	8/24/2024	8/24/2025
Piping	Single Wall Transition Sump	6/20/2023	6/20/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	8/24/2024	8/24/2025
Piping	Single Wall Transition Sump	6/20/2023	6/20/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	8/24/2024	8/24/2025
Piping	Single Wall Transition Sump	6/20/2023	6/20/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	8/24/2024	8/24/2025
Spill Contain Device	Double Wall Spill Bucket	5/4/2023	5/4/2026
Tank	Fiberglass Brine Filled Double Wall Containment Solutions	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Piping	Flexible Double Wall Franklin Fueling Systems UPP	Precision Test (Piping)	Pass	8/24/2023
Tank	Fiberglass Double Wall Containment Solutions	Precision Test (Tank)	Pass	8/25/2023

Tank Number 6

Capacity:	30000	Petroleum Use:	None
Product:	Diesel Fuel	CERCLA Substance:
Status:	Currently in use	CAS Code:
Regulated Status:	Federal	Removed Date:
OSFM First Notify Date:	8/23/2023	Abandoned Material:
Current Age:	1	Abandoned Date:
Install Date:	2/2/2023	Red Tag Issue Date:
Last Used Date:		Fee Due:	$0.00
Product Date:	8/4/2023

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	8/24/2024	8/24/2025
Leak Detect - Piping	Electronic Pressurized Line Leak Detection	8/24/2024	8/24/2025
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 450	8/24/2024	8/24/2025
Leak Detect - Tank	Hydrostatic Reservoir Interstitial Monitoring Sensors with monitor	8/24/2024	8/24/2025
Overfill Prev Device	Overfill Drop Tube Valve	7/26/2023	7/26/2026
Piping	Blending Sump	5/4/2023	5/4/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	8/24/2024	8/24/2025
Piping	Flexible Double Wall Franklin Fueling Systems UPP	N/A	N/A
Piping	Single Wall STP/Tanktop Sump	5/4/2023	5/4/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	8/24/2024	8/24/2025
Piping	Single Wall Transition Sump	6/20/2023	6/20/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	8/24/2024	8/24/2025
Piping	Single Wall Transition Sump	5/4/2023	5/4/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	8/24/2024	8/24/2025
Piping	Single Wall Transition Sump	6/20/2023	6/20/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	8/24/2024	8/24/2025
Spill Contain Device	Double Wall Spill Bucket	5/4/2023	5/4/2026
Tank	Fiberglass Brine Filled Double Wall Containment Solutions	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Piping	Flexible Double Wall Franklin Fueling Systems UPP	Precision Test (Piping)	Pass	8/24/2023
Tank	Fiberglass Double Wall Containment Solutions	Precision Test (Tank)	Pass	8/25/2023

Tank Number 7

Capacity:	30000	Petroleum Use:	None
Product:	Diesel Fuel	CERCLA Substance:
Status:	Currently in use	CAS Code:
Regulated Status:	Federal	Removed Date:
OSFM First Notify Date:	8/23/2023	Abandoned Material:
Current Age:	1	Abandoned Date:
Install Date:	2/2/2023	Red Tag Issue Date:
Last Used Date:		Fee Due:	$0.00
Product Date:	8/4/2023

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	8/24/2024	8/24/2025
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 450	8/24/2024	8/24/2025
Leak Detect - Tank	Hydrostatic Reservoir Interstitial Monitoring Sensors with monitor	8/24/2024	8/24/2025
Overfill Prev Device	Overfill Drop Tube Valve	7/26/2023	7/26/2026
Piping	Blending Sump	5/4/2023	5/4/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	8/24/2024	8/24/2025
Piping	Flexible Double Wall Franklin Fueling Systems UPP	N/A	N/A
Piping	Single Wall STP/Tanktop Sump	5/4/2023	5/4/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	8/24/2024	8/24/2025
Spill Contain Device	Double Wall Spill Bucket	5/4/2023	5/4/2026
Tank	Fiberglass Brine Filled Double Wall Containment Solutions	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Piping	Flexible Double Wall Franklin Fueling Systems UPP	Precision Test (Piping)	Pass	8/24/2023
Tank	Fiberglass Double Wall Containment Solutions	Precision Test (Tank)	Pass	8/25/2023

Tank Number 8

Capacity:	30000	Petroleum Use:	None
Product:	Diesel Fuel	CERCLA Substance:
Status:	Currently in use	CAS Code:
Regulated Status:	Federal	Removed Date:
OSFM First Notify Date:	8/23/2023	Abandoned Material:
Current Age:	1	Abandoned Date:
Install Date:	2/2/2023	Red Tag Issue Date:
Last Used Date:		Fee Due:	$0.00
Product Date:	8/4/2023

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	8/24/2024	8/24/2025
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 450	8/24/2024	8/24/2025
Leak Detect - Tank	Hydrostatic Reservoir Interstitial Monitoring Sensors with monitor	8/24/2024	8/24/2025
Overfill Prev Device	Overfill Drop Tube Valve	7/26/2023	7/26/2026
Piping	Blending Sump	5/4/2023	5/4/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	8/24/2024	8/24/2025
Piping	Blending Sump	5/4/2023	5/4/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	8/24/2024	8/24/2025
Piping	Flexible Double Wall Franklin Fueling Systems UPP	N/A	N/A
Piping	Single Wall STP/Tanktop Sump	5/4/2023	5/4/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	8/24/2024	8/24/2025
Spill Contain Device	Double Wall Spill Bucket	5/4/2023	5/4/2026
Tank	Fiberglass Brine Filled Double Wall Containment Solutions	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Piping	Flexible Double Wall Franklin Fueling Systems UPP	Precision Test (Piping)	Pass	8/24/2023
Tank	Fiberglass Double Wall Containment Solutions	Precision Test (Tank)	Pass	8/25/2023

Tank Number 9

Capacity:	30000	Petroleum Use:	None
Product:	Diesel Fuel	CERCLA Substance:
Status:	Currently in use	CAS Code:
Regulated Status:	Federal	Removed Date:
OSFM First Notify Date:	8/23/2023	Abandoned Material:
Current Age:	1	Abandoned Date:
Install Date:	2/2/2023	Red Tag Issue Date:
Last Used Date:		Fee Due:	$0.00
Product Date:	8/4/2023

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 Other Non-vented check valve	N/A	N/A
Leak Detect - Piping	Electronic Pressurized Line Leak Detection	8/24/2024	8/24/2025
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 450	8/24/2024	8/24/2025
Leak Detect - Tank	Hydrostatic Reservoir Interstitial Monitoring Sensors with monitor	8/24/2024	8/24/2025
Overfill Prev Device	Overfill Drop Tube Valve	7/26/2023	7/26/2026
Piping	Blending Sump	5/4/2023	5/4/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	8/24/2024	8/24/2025
Piping	Blending Sump	5/4/2023	5/4/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	8/24/2024	8/24/2025
Piping	Flexible Double Wall Franklin Fueling Systems UPP	N/A	N/A
Piping	Single Wall STP/Tanktop Sump	5/4/2023	5/4/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	8/24/2024	8/24/2025
Spill Contain Device	Double Wall Spill Bucket	5/4/2023	5/4/2026
Tank	Fiberglass Brine Filled Double Wall Containment Solutions	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Piping	Flexible Double Wall Franklin Fueling Systems UPP	Precision Test (Piping)	Pass	8/24/2023
Tank	Fiberglass Double Wall Containment Solutions	Precision Test (Tank)	Pass	8/25/2023

Dispenser Information

Name\ID 1/2

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	6/20/2023	6/20/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	8/24/2024	8/24/2025

Name\ID 1/2 Master

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	5/4/2023	5/4/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	8/24/2024	8/24/2025

Name\ID 11/12

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	6/20/2023	6/20/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	8/24/2024	8/24/2025

Name\ID 13/14

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	6/20/2023	6/20/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	8/24/2024	8/24/2025

Name\ID 15/16

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	6/20/2023	6/20/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	8/24/2024	8/24/2025

Name\ID 17/18

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	6/20/2023	6/20/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	8/24/2024	8/24/2025

Name\ID 19/20

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	6/20/2023	6/20/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	8/24/2024	8/24/2025

Name\ID 2S/3 Master

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	5/4/2023	5/4/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	8/24/2024	8/24/2025

Name\ID 3/4

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	6/20/2023	6/20/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	8/24/2024	8/24/2025

Name\ID 3S/4 Master

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	5/4/2023	5/4/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	8/24/2024	8/24/2025

Name\ID 4S/5 Master

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	5/4/2023	5/4/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	8/24/2024	8/24/2025

Name\ID 5/6

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	6/20/2023	6/20/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	8/24/2024	8/24/2025

Name\ID 5S/6 Master

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	5/4/2023	5/4/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	8/24/2024	8/24/2025

Name\ID 6S/7

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	5/4/2023	5/4/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	8/24/2024	8/24/2025

Name\ID 7/8

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	6/20/2023	6/20/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	8/24/2024	8/24/2025

Name\ID 9/10

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	6/20/2023	6/20/2026
Leak Detect - Piping	Sump Sensor with positive shutdown	8/24/2024	8/24/2025

MFD Motorfuel Dispensing Forms

Facility Number	Name	City	Received Date	Letter
4047542	QT #7191	Effingham	08/29/2023	Letter Form
4047542	QT #7191	Effingham	08/23/2023	Letter Form