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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:
6014791
Status:
Closed
Facility Name:
Clifford Polczynski
Address:
384 W. Broadway
4th & Broadway Streets
Dubois, IL 62831
County:
Washington
Property Parcel:
Facility Type:
None
Owner Type:
Private
Green Tag Decal:
Green Tag Issue Date:
Green Tag Expiration Date:
Owner Details
Owner Name:
Clifford Polczynski
Owner Address:
384 W. Broadway
Dubois, IL 62831
Owner Status:
Current Owner
Purchase Date:
1/1/1989
Type of Financial Responsibility:
Letter of Credit
Financial Responsibility Reporting Due Date:
5/25/2008
Motor Fuel Dispensing Permits
No MFD Permits Found
Owner Summary
Click for Facility/Tank Ownership history
Owner Number
Owner Name
Owner Status
Purchase Date
U0034183
Polczynski, Clifford
Current Owner
1/1/1989
U0012017
Polczynski Sr , Dominic
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
IEMA Number
Inspection Date
Inspection Type
Permit Number
07-1613
12/11/2007
Removal Log
01510-2007REM
LUST
Fund Eligibility and Deductibility Determinations
IEMA Number
Status
OSFM Received Date
OSFM Response Date
Deductible
Letter
07-1219
Eligible
10/3/2007
10/23/2007
$10,000
Pay Tank Fees Online
Tank Information
Tank Number 1
Capacity:
1000
Petroleum Use:
Product:
Gasoline
CERCLA Substance:
Status:
Removed
CAS Code:
Regulated Status:
Federal
Removed Date:
12/11/2007
OSFM
First Notify Date:
4/18/1986
Abandoned Material:
Current Age:
25
Abandoned Date:
Install Date:
1/1/1982
Red Tag Issue Date:
Last Used Date:
12/31/1987
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:
560
Petroleum Use:
Product:
Gasoline
CERCLA Substance:
Status:
Removed
CAS Code:
Regulated Status:
Federal
Removed Date:
12/11/2007
OSFM
First Notify Date:
4/18/1986
Abandoned Material:
Current Age:
41
Abandoned Date:
Install Date:
1/1/1966
Red Tag Issue Date:
Last Used Date:
3/1/1983
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
Dispenser Information
MFD
Motorfuel Dispensing Forms
No Forms Found
