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:	7024121
Status:	Closed
Facility Name:	West Salem Country Market
Address:	725 West Church Street West Salem, IL 62476
County:	Edwards
Property Parcel:
Facility Type:	Attended Self-Service Station
Owner Type:	Private
Green Tag Decal:	P002416
Green Tag Issue Date:	8/25/2014
Green Tag Expiration Date:	12/31/2016

Owner Details

Owner Name:	William Koonce
Owner Address:	6530 FM 2609, Lot 10 Nacogdoches, TX 75965
Owner Status:	Current Owner
Purchase Date:	7/31/2017
Type of Financial Responsibility:
Financial Responsibility Reporting Due Date:

Motor Fuel Dispensing Permits

MFD Permit Type	Issue Date	Expiration Date
Self Service	8/25/2014	12/31/2016

Owner Summary

Click for Facility/Tank Ownership history

Owner Number	Owner Name	Owner Status	Purchase Date
U0038881	Koonce, William	Current Owner	7/31/2017
U0029256	West Salem Country Market, Inc.	Former Owner	3/4/2015
U0009963	Mcdowell Ej	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
17-0979	11/29/2017	Removal Log	01378-2017REM
17-0979	11/30/2017	Removal Log	01378-2017REM

LUST Fund Eligibility and Deductibility Determinations

IEMA Number	Status	OSFM Received Date	OSFM Response Date	Deductible	Letter
20170979	Eligible	1/25/2018	1/25/2018	$5,000	Letter

Pay Tank Fees Online

Tank Information

Tank Number 1

Capacity:	10000		Petroleum Use:
Product:	Gasoline		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	11/29/2017
OSFM First Notify Date:	3/30/1987		Abandoned Material:
Current Age:	30		Abandoned Date:
Install Date:	3/26/1987		Red Tag Issue Date:
Last Used Date:	5/2/2016		Fee Due:	$0.00
Product Date:

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Sacrificial Anode Cathodic Protection	7/14/2014	7/14/2017
Corrosion Prot - Piping	Isolation Boots Flex Connector	N/A	N/A
Corrosion Prot - Piping	Fiberglass Non-Corrosive	N/A	N/A
Corrosion Prot - Tank	STIP3 Cathodic Protection with Dielectric Coating	7/14/2014	7/14/2017
Leak Detect - Piping	Mechanical Pressurized Line Leak Detection	7/14/2014	7/14/2015
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 350
Overfill Prev Device	Overfill Drop Tube Valve
Piping	Fiberglass Single Wall Piping	N/A	N/A
Spill Contain Device	Single Wall Spill Bucket
Tank	STIP3 Single 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

Tank Number 2

Capacity:	10000		Petroleum Use:
Product:	Gasoline		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	11/30/2017
OSFM First Notify Date:	3/30/1987		Abandoned Material:
Current Age:	30		Abandoned Date:
Install Date:	3/26/1987		Red Tag Issue Date:
Last Used Date:	5/2/2016		Fee Due:	$0.00
Product Date:

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Sacrificial Anode Cathodic Protection	7/14/2014	7/14/2017
Corrosion Prot - Piping	Isolation Boots Flex Connector	N/A	N/A
Corrosion Prot - Piping	Fiberglass Non-Corrosive	N/A	N/A
Corrosion Prot - Tank	STIP3 Cathodic Protection with Dielectric Coating	7/14/2014	7/14/2017
Leak Detect - Piping	Mechanical Pressurized Line Leak Detection	7/14/2014	7/14/2015
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 350
Overfill Prev Device	Overfill Drop Tube Valve
Piping	Fiberglass Single Wall Piping	N/A	N/A
Spill Contain Device	Single Wall Spill Bucket
Tank	STIP3 Single 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

Dispenser Information

MFD Motorfuel Dispensing Forms

No Forms Found