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:	1031212
Status:	Active
Facility Name:	Sandy Hollow Mobil
Address:	1621 Sandy Hollow Road Rockford, IL 61109
County:	Winnebago
Property Parcel:
Facility Type:	Attended Self-Service Station
Owner Type:	Private
Green Tag Decal:	Y001145
Green Tag Issue Date:	7/26/2023
Green Tag Expiration Date:	12/31/2025

Owner Details

Owner Name:	Kelley Williamson Company
Owner Address:	1132 Harrison Avenue Rockford, IL 61104
Owner Status:	Current Owner
Purchase Date:
Type of Financial Responsibility:	Commercial Insurance
Financial Responsibility Reporting Due Date:	3/15/2025

Motor Fuel Dispensing Permits

MFD Permit Type	Issue Date	Expiration Date
Self Service	7/26/2023	12/31/2025

Owner Summary

Click for Facility/Tank Ownership history

Owner Number	Owner Name	Owner Status	Purchase Date
U0008336	Kelley Williamson Company	Current Owner
U0020520	Opsahl Oil Co	Former Owner	1/29/1993

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 - Regular		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	2/18/1993		Abandoned Material:
Current Age:	31		Abandoned Date:
Install Date:	10/1/1992		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	1/23/1993

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Flexible Non-Corrosive	N/A	N/A
Corrosion Prot - Tank	Fiberglass Non-Corrosive	N/A	N/A
Leak Detect - Piping	Electronic Pressurized Line Leak Detection	4/4/2024	4/4/2025
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 350 with CSLD	4/4/2024	4/4/2025
Overfill Prev Device	Overfill Alarm	4/4/2024	4/4/2027
Piping	Flexible Double Wall A.P.T. Poly Tech	N/A	N/A
Piping	Single Wall STP/Tanktop Sump	4/4/2024	4/4/2027
Leak Detect - Piping	Sump Sensor	4/4/2024	4/4/2025
Spill Contain Device	Single Wall Spill Bucket	4/4/2024	4/4/2027
Tank	Fiberglass 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
Piping	Flexible Double Wall A.P.T. Poly Tech	Precision Test	Pass	3/26/2021

Tank Number 2

Capacity:	8000		Petroleum Use:
Product:	Gasoline - Mid-grade		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	2/18/1993		Abandoned Material:
Current Age:	31		Abandoned Date:
Install Date:	10/1/1992		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	1/23/1993

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Flexible Non-Corrosive	N/A	N/A
Corrosion Prot - Tank	Fiberglass Non-Corrosive	N/A	N/A
Leak Detect - Piping	Electronic Pressurized Line Leak Detection	4/4/2024	4/4/2025
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 350 with CSLD	4/4/2024	4/4/2025
Overfill Prev Device	Overfill Alarm	4/4/2024	4/4/2027
Piping	Flexible Double Wall A.P.T. Poly Tech	N/A	N/A
Piping	Single Wall STP/Tanktop Sump	4/4/2024	4/4/2027
Leak Detect - Piping	Sump Sensor	4/4/2024	4/4/2025
Spill Contain Device	Single Wall Spill Bucket	4/4/2024	4/4/2027
Tank	Fiberglass 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
Piping	Flexible Double Wall A.P.T. Poly Tech	Precision Test	Pass	3/26/2021

Tank Number 3

Capacity:	8000		Petroleum Use:
Product:	Gasoline - Premium		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	2/18/1993		Abandoned Material:
Current Age:	31		Abandoned Date:
Install Date:	10/1/1992		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	1/23/1993

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Flexible Non-Corrosive	N/A	N/A
Corrosion Prot - Tank	Fiberglass Non-Corrosive	N/A	N/A
Leak Detect - Piping	Electronic Pressurized Line Leak Detection	4/4/2024	4/4/2025
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 350 with CSLD	4/4/2024	4/4/2025
Overfill Prev Device	Overfill Alarm	4/4/2024	4/4/2027
Piping	Flexible Double Wall A.P.T. Poly Tech	N/A	N/A
Piping	Single Wall STP/Tanktop Sump	4/4/2024	4/4/2027
Leak Detect - Piping	Sump Sensor	4/4/2024	4/4/2025
Spill Contain Device	Single Wall Spill Bucket	4/4/2024	4/4/2027
Tank	Fiberglass 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
Piping	Flexible Double Wall A.P.T. Poly Tech	Precision Test	Pass	3/26/2021

Tank Number 4

Capacity:	8000		Petroleum Use:
Product:	Diesel Fuel		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	2/23/2015		Abandoned Material:
Current Age:	11		Abandoned Date:
Install Date:	9/3/2012		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Flexible Non-Corrosive	N/A	N/A
Corrosion Prot - Tank	Fiberglass Non-Corrosive	N/A	N/A
Leak Detect - Piping	Electronic Pressurized Line Leak Detection	4/4/2024	4/4/2025
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 350	4/3/2023	4/3/2024
Leak Detect - Tank	Non-Discriminating Interstitial Monitoring Sensors	4/3/2023	4/3/2024
Overfill Prev Device	Overfill Alarm	4/4/2024	4/4/2027
Piping	Flexible Double Wall A.P.T. Poly Tech	N/A	N/A
Piping	Single Wall STP/Tanktop Sump	4/4/2024	4/4/2027
Leak Detect - Piping	Sump Sensor with positive shutdown	4/4/2024	4/4/2025
Spill Contain Device	Single Wall Spill Bucket	4/4/2024	4/4/2027
Tank	Fiberglass Double Wall XERXES	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
Piping	Flexible Double Wall A.P.T. Poly Tech	Precision Test	Pass	3/26/2021

Dispenser Information

Name\ID 1/2

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	4/4/2024	4/4/2027
Leak Detect - Piping	Sump Sensor	4/3/2023	4/3/2024

Name\ID 11/12

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	4/4/2024	4/4/2027
Leak Detect - Piping	Sump Sensor	4/3/2023	4/3/2024

Name\ID 3/4

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	4/4/2024	4/4/2027
Leak Detect - Piping	Sump Sensor	4/3/2023	4/3/2024

Name\ID 5/6

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	4/4/2024	4/4/2027
Leak Detect - Piping	Sump Sensor	4/3/2023	4/3/2024

Name\ID 7/8

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	4/4/2024	4/4/2027
Leak Detect - Piping	Sump Sensor	4/3/2023	4/3/2024

Name\ID 9/10

Status:	Active

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Dispenser	Single Wall UDC Sump	4/4/2024	4/4/2027
Leak Detect - Piping	Sump Sensor	4/3/2023	4/3/2024

MFD Motorfuel Dispensing Forms

No Forms Found