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:	1010992
Status:	Active
Facility Name:	IL0104
Address:	4545 Sandy Hollow Road Rockford, IL 61109
County:	Winnebago
Property Parcel:	16-08-201-001
Facility Type:	Attended Self-Service Station
Owner Type:	Private
Green Tag Decal:	Y001110
Green Tag Issue Date:	4/27/2023
Green Tag Expiration Date:	12/31/2025

Owner Details

Owner Name:	Three Angels, LLC
Owner Address:	4545 Sandy Hollow Road Rockford, IL 61109
Owner Status:	Current Owner
Purchase Date:	3/22/2018
Type of Financial Responsibility:	Commercial Insurance
Financial Responsibility Reporting Due Date:	8/4/2024

Motor Fuel Dispensing Permits

MFD Permit Type	Issue Date	Expiration Date
Self Service	4/27/2023	12/31/2025

Owner Summary

Click for Facility/Tank Ownership history

Owner Number	Owner Name	Owner Status	Purchase Date
U0040346	Three Angels, LLC	Current Owner	3/22/2018
U0037337	Lehigh Gas Wholesale Services	Former Owner	9/27/2016
U0025164	BAPA, LLC & PT, LLC	Former Owner	10/17/2006
U0012999	Rockford Oil Company	Former Owner	4/11/1999

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 - Mid-grade		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	11/19/1987		Abandoned Material:
Current Age:	36		Abandoned Date:
Install Date:	11/19/1987		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	11/19/1987

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Fiberglass Non-Corrosive	N/A	N/A
Corrosion Prot - Tank	Fiberglass Non-Corrosive	N/A	N/A
Leak Detect - Piping	Mechanical Pressurized Line Leak Detection	9/5/2023	9/5/2024
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 350 with CSLD	9/5/2023	9/5/2024
Overfill Prev Device	Overfill Alarm	9/5/2023	9/5/2026
Piping	Fiberglass Single Wall Piping	N/A	N/A
Piping	Not Installed STP/Tanktop Sump	N/A	N/A
Spill Contain Device	Single Wall Spill Bucket	10/15/2021	10/15/2024
Tank	Fiberglass Single Wall	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 2

Capacity:	12000		Petroleum Use:
Product:	Gasoline - Regular		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	11/19/1987		Abandoned Material:
Current Age:	36		Abandoned Date:
Install Date:	11/19/1987		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	11/19/1987

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Fiberglass Non-Corrosive	N/A	N/A
Corrosion Prot - Tank	Fiberglass Non-Corrosive	N/A	N/A
Leak Detect - Piping	Mechanical Pressurized Line Leak Detection	9/5/2023	9/5/2024
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 350 with CSLD	9/5/2023	9/5/2024
Overfill Prev Device	Overfill Alarm	9/5/2023	9/5/2026
Piping	Fiberglass Single Wall Piping	N/A	N/A
Piping	Fiberglass Single Wall Piping Ameron Dualoy 3000/L	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	10/15/2021	10/15/2024
Tank	Fiberglass Single Wall	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Piping	Fiberglass Single Wall Piping	Precision Test	Pass	9/5/2023
Piping	Fiberglass Single Wall Piping Ameron Dualoy 3000/L	Precision Test	Pass	10/27/2021

Tank Number 3

Capacity:	12000		Petroleum Use:
Product:	Gasoline - Premium		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	11/19/1987		Abandoned Material:
Current Age:	36		Abandoned Date:
Install Date:	11/19/1987		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	11/19/1987

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Fiberglass Non-Corrosive	N/A	N/A
Corrosion Prot - Tank	Fiberglass Non-Corrosive	N/A	N/A
Leak Detect - Piping	Mechanical Pressurized Line Leak Detection	9/5/2023	9/5/2024
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 350 with CSLD	9/5/2023	9/5/2024
Overfill Prev Device	Overfill Alarm	9/5/2023	9/5/2026
Piping	Fiberglass Single Wall Piping	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	10/15/2021	10/15/2024
Tank	Fiberglass Single Wall	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Piping	Fiberglass Single Wall Piping	Precision Test	Pass	9/5/2023

Tank Number 4

Capacity:	12000		Petroleum Use:
Product:	Diesel Fuel		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	11/19/1987		Abandoned Material:
Current Age:	36		Abandoned Date:
Install Date:	11/19/1987		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	11/19/1987

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Fiberglass Non-Corrosive	N/A	N/A
Corrosion Prot - Tank	Fiberglass Non-Corrosive	N/A	N/A
Leak Detect - Piping	Mechanical Pressurized Line Leak Detection	9/5/2023	9/5/2024
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 350 with CSLD	9/5/2023	9/5/2024
Overfill Prev Device	Overfill Alarm	9/5/2023	9/5/2026
Piping	Fiberglass Single Wall Piping	N/A	N/A
Piping	Not Installed STP/Tanktop Sump	N/A	N/A
Spill Contain Device	Single Wall Spill Bucket	10/15/2021	10/15/2024
Tank	Fiberglass Single Wall	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 5

Capacity:	10000		Petroleum Use:
Product:	E85		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	10/29/1998		Abandoned Material:
Current Age:	26		Abandoned Date:
Install Date:	11/14/1997		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	2/4/1998

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Sacrificial Anode Cathodic Protection	9/8/2020	9/8/2023
Corrosion Prot - Piping	Fiberglass Non-Corrosive	N/A	N/A
Corrosion Prot - Tank	Fiberglass Non-Corrosive	N/A	N/A
Leak Detect - Piping	Mechanical Pressurized Line Leak Detection	9/5/2023	9/5/2024
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 350 with CSLD	9/5/2023	9/5/2024
Overfill Prev Device	Overfill Alarm	9/5/2023	9/5/2026
Overfill Prev Device	Overfill Drop Tube Valve	9/5/2023	9/5/2026
Piping	Fiberglass Double Wall	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	10/15/2021	10/15/2024
Tank	Fiberglass Double Wall XERXES	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Piping	Fiberglass Double Wall	Precision Test	Pass	9/5/2023

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 11/12

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 13/14

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 15/16

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 17/18

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

Name\ID 9/10

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