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:	5033083
Status:	Active
Facility Name:	Clark
Address:	654 North Main White Hall, IL 62092
County:	Greene
Property Parcel:
Facility Type:	Attended Self-Service Station
Owner Type:	Private
Green Tag Decal:	Y000792
Green Tag Issue Date:	6/20/2023
Green Tag Expiration Date:	12/31/2025

Owner Details

Owner Name:	Jagjita Corp.
Owner Address:	654 North Main Street White Hall, IL 62092
Owner Status:	Current Owner
Purchase Date:	6/20/2006
Type of Financial Responsibility:	Commercial Insurance
Financial Responsibility Reporting Due Date:	12/18/2024

Motor Fuel Dispensing Permits

MFD Permit Type	Issue Date	Expiration Date
Self Service	6/20/2023	12/31/2025

Owner Summary

Click for Facility/Tank Ownership history

Owner Number	Owner Name	Owner Status	Purchase Date
U0033584	Jagjita Corp.	Current Owner	6/20/2006
U0020686	A-Jay Enterprises	Former Owner	5/1/1994

Permits (Unexpired)

Click for permit history

No Active Permits Found

Deficiencies (Current)

No Deficiencies 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:	12000		Petroleum Use:
Product:	Gasoline - Regular		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	10/12/1994		Abandoned Material:
Current Age:	29		Abandoned Date:
Install Date:	6/1/1994		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	6/1/1994

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	6/2/2023	6/2/2024
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 350 Plus with CSLD	6/2/2023	6/2/2024
Overfill Prev Device	Ball Float Vent Valve	5/20/2021	5/20/2024
Piping	Flexible Double Wall	N/A	N/A
Piping	Flex Connector Steel	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	5/20/2021	5/20/2024
Tank	Fiberglass Double 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	Flexible Double Wall	Precision Test	Pass	6/2/2023

Tank Number 2

Capacity:	10000		Petroleum Use:
Product:	Gasoline - Mid-grade		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	10/12/1994		Abandoned Material:
Current Age:	29		Abandoned Date:
Install Date:	6/1/1994		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	6/1/1994

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	6/2/2023	6/2/2024
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 350 Plus with CSLD	6/2/2023	6/2/2024
Overfill Prev Device	Ball Float Vent Valve	5/20/2021	5/20/2024
Piping	Flexible Double Wall	N/A	N/A
Piping	Flex Connector Steel	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	5/20/2021	5/20/2024
Tank	Fiberglass Double 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	Flexible Double Wall	Precision Test	Pass	6/2/2023

Tank Number 3

Capacity:	10000		Petroleum Use:
Product:	Gasoline - Premium		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	10/12/1994		Abandoned Material:
Current Age:	29		Abandoned Date:
Install Date:	6/1/1994		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	6/1/1994

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	6/2/2023	6/2/2024
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 350 Plus with CSLD	6/2/2023	6/2/2024
Overfill Prev Device	Ball Float Vent Valve	5/20/2021	5/20/2024
Piping	Flexible Double Wall	N/A	N/A
Piping	Flex Connector Steel	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	5/20/2021	5/20/2024
Tank	Fiberglass Double 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	Flexible Double Wall	Precision Test	Pass	6/2/2023

Tank Number 4

Capacity:	10000		Petroleum Use:
Product:	Diesel Fuel		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	10/12/1994		Abandoned Material:
Current Age:	29		Abandoned Date:
Install Date:	6/1/1994		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	6/1/1994

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	6/2/2023	6/2/2024
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 350 Plus with CSLD	6/2/2023	6/2/2024
Overfill Prev Device	Ball Float Vent Valve	5/20/2021	5/20/2024
Piping	Flexible Double Wall	N/A	N/A
Piping	Flex Connector Steel	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	5/20/2021	5/20/2024
Tank	Fiberglass Double 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	Flexible Double Wall	Precision Test	Pass	6/2/2023

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 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

MFD Motorfuel Dispensing Forms

No Forms Found