Division of Petroleum & Chemical Safety

Facility Details

Facility Number:	7002499
Status:	Closed
Facility Name:	Good Samaritan Regional Health Center
Address:	605 N. 12th Street Mount Vernon, IL 62864
County:	Jefferson
Property Parcel:
Facility Type:	None
Owner Type:
Green Tag Decal:
Green Tag Issue Date:
Green Tag Expire Date:
MFD Type:	N/A

Owner Details

Owner Name:	Good Samaritan Regional Health Center
Owner Address:	1 Good Samaritan Way Mount Vernon, IL 62864
Owner Status:	Current Owner
Purchase Date:	2/29/1996
Type of Financial Responsibility:
Financial Responsibility Reporting Due Date:

Owner Summary

Click for Facility/Tank Ownership history

Owner Number	Owner Name	Owner Status	Purchase Date
U0005979	Good Samaritan Regional Health Center	Current Owner	2/29/1996

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
14-0343	4/10/2014	Removal Log	00258-2014REM
14-0343	4/8/2014	Removal Log	00258-2014REM
14-0343	4/9/2014	Removal Log	00258-2014REM

LUST Fund Eligibility and Deductibility Determinations

IEMA Number	Status	OSFM Received Date	OSFM Response Date	Deductible	Letter
14-0343	Partial Eligible	7/23/2014	7/23/2014	$5,000

Pay Tank Fees Online

Tank Information

Tank Number 1

Capacity:	2000	Petroleum Use:
Product:	Diesel Fuel	CERCLA Substance:
Status:	Removed	CAS Code:
Regulated Status:	Federal	Removed Date:	4/8/2014
OSFM First Notify Date:	3/17/1986	Abandoned Material:	Water
Current Age:	28	Abandoned Date:	12/11/1998
Install Date:		Red Tag Issue Date:
Last Used Date:	12/11/1998	Fee Due:	$0.00
Product Date:

Equipment Information

No Equipment Listed

Additional Tests

No Tests Listed

Tank Number 2

Capacity:	5000	Petroleum Use:
Product:	Diesel Fuel	CERCLA Substance:
Status:	Removed	CAS Code:
Regulated Status:	Federal	Removed Date:	4/8/2014
OSFM First Notify Date:	3/17/1986	Abandoned Material:	Inert material mixed with portland cement
Current Age:	37	Abandoned Date:	12/1/1990
Install Date:		Red Tag Issue Date:
Last Used Date:	1/1/1975	Fee Due:	$0.00
Product Date:

Equipment Information

No Equipment Listed

Additional Tests

No Tests Listed

Tank Number 3

Capacity:	5000	Petroleum Use:	Consumptive Use on Premises for Heating
Product:	Diesel Fuel	CERCLA Substance:
Status:	Removed	CAS Code:
Regulated Status:	State	Removed Date:	4/8/2014
OSFM First Notify Date:	3/17/1986	Abandoned Material:	Inert material mixed with portland cement
Current Age:	37	Abandoned Date:	12/1/1990
Install Date:		Red Tag Issue Date:
Last Used Date:	1/1/1975	Fee Due:	$0.00
Product Date:

Equipment Information

No Equipment Listed

Additional Tests

No Tests Listed

Tank Number 4

Capacity:	15000	Petroleum Use:	Consumptive Use on Premises for Heating
Product:	Heating Oil	CERCLA Substance:
Status:	Removed	CAS Code:
Regulated Status:	State	Removed Date:	4/9/2014
OSFM First Notify Date:	4/17/1990	Abandoned Material:	Inert material mixed with portland cement
Current Age:		Abandoned Date:	4/12/1990
Install Date:		Red Tag Issue Date:
Last Used Date:	7/1/1980	Fee Due:
Product Date:

Equipment Information

No Equipment Listed

Additional Tests

No Tests Listed

Tank Number 5

Capacity:	12000	Petroleum Use:	Consumptive Use on Premises for Heating
Product:	Heating Oil	CERCLA Substance:
Status:	Removed	CAS Code:
Regulated Status:	State	Removed Date:	4/10/2014
OSFM First Notify Date:	4/17/1990	Abandoned Material:	Inert material mixed with portland cement
Current Age:		Abandoned Date:	4/12/1990
Install Date:		Red Tag Issue Date:
Last Used Date:	7/1/1980	Fee Due:
Product Date:

Equipment Information

No Equipment Listed

Additional Tests

No Tests Listed

Failed test = the latest test has failed.

Not applicable = a test does not apply to this equipment type or configuration.

No passing test found = a passing test is expected but was not found from the source data.

Dispenser Information

Failed test = the latest test has failed.

Not applicable = a test does not apply to this equipment type or configuration.

No passing test found = a passing test is expected but was not found from the source data.

MFD Motorfuel Dispensing Forms

No Forms Found