Division of Petroleum & Chemical Safety

 

Facility Details

Facility Number: 7044887
Status: Active
Facility Name: SSM Health Good Samaritan Hospital
Address: 1 Good Samaritan Way
Mount Vernon, IL 62864
County: Jefferson
Property Parcel:
Facility Type: Hospital
Owner Type: Private
Green Tag Decal: Z003826
Green Tag Issue Date: 6/4/2024
Green Tag Expiration Date: 12/31/2026

Owner Details

Owner Name: SSM Health Good Samaritan Hospital
Owner Address: 1 Good Samaritan Way
Mount Vernon, IL 62864
Owner Status: Current Owner
Purchase Date: 8/24/2015
Type of Financial Responsibility: Commercial Insurance
Financial Responsibility Reporting Due Date: 7/11/2025

Motor Fuel Dispensing Permits

No MFD Permits Found

Owner Summary

Click for Facility/Tank Ownership history
Owner Number Owner Name Owner Status Purchase Date
U0038414 SSM Health Good Samaritan Hospital Current Owner 8/24/2015
U0036084 St. Mary's Good Samaratin Medical Center 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: 50000 Petroleum Use: Back-up Generator
Product: Diesel Fuel CERCLA Substance:
Status: Currently in use CAS Code:
Regulated Status: Federal Removed Date:
OSFM First Notify Date: 10/9/2012 Abandoned Material:
Current Age: 13 Abandoned Date:
Install Date: 1/9/2012 Red Tag Issue Date:
Last Used Date: Fee Due:
Product Date: 1/10/2012

Equipment

Equipment Type Equipment Last Passing Date Test Expire Date
Corrosion Prot - Piping Fiberglass Non-Corrosive N/A N/A
Corrosion Prot - Tank Composite Non-Corrosive N/A N/A
Leak Detect - Piping American with Sensors/No Test Suction N/A N/A
Leak Detect - Tank Automatic Tank Gauging Veeder Root TLS 300c 4/25/2024 4/25/2025
Leak Detect - Tank Hydrostatic Reservoir Interstitial Monitoring Sensors 4/25/2024 4/25/2025
Manway At Grade Accessible Manway Accessible at Grade N/A N/A
Overfill Prev Device Overfill Drop Tube Valve 5/4/2022 5/4/2025
Piping Fiberglass Double Wall Ameron Dualoy 3000/LCX N/A N/A
Piping Single Wall STP/Tanktop Sump
Leak Detect - Piping Piping Sump Sensors Not Regulated N/A N/A
Spill Contain Device Single Wall Spill Bucket 5/4/2022 5/4/2025
Tank Composite Double Wall Modern Welding Glasteel II 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
Leak Detect - Piping American with Sensors/No Test Suction Functional Pass 4/25/2024

Dispenser Information



MFD Motorfuel Dispensing Forms

No Forms Found