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:	3041637
Status:	Active
Facility Name:	Hy-Vee Gas
Address:	4218 Avenue of the Cities Moline, IL 61265
County:	Rock Island
Property Parcel:
Facility Type:	Attended Self-Service/Unattended Self-Service
Owner Type:	Private
Green Tag Decal:	Y001620
Green Tag Issue Date:	12/27/2023
Green Tag Expiration Date:	12/31/2025

Owner Details

Owner Name:	Hy-Vee, Inc.
Owner Address:	5820 Westown Parkway West Des Moines, IA 50266
Owner Status:	Current Owner
Purchase Date:	1/8/2004
Type of Financial Responsibility:	Letter of Credit
Financial Responsibility Reporting Due Date:	10/23/2024

Motor Fuel Dispensing Permits

MFD Permit Type	Issue Date	Expiration Date
Self Service	12/27/2023	12/31/2025
Unattended Self Service	4/29/2021	12/31/2023

Owner Summary

Click for Facility/Tank Ownership history

Owner Number	Owner Name	Owner Status	Purchase Date
U0030721	Hy-Vee, Inc.	Current Owner	1/8/2004

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:	20000		Petroleum Use:
Product:	Gasoline - Non Ethanol		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	3/24/2004		Abandoned Material:
Current Age:	20		Abandoned Date:
Install Date:	1/8/2004		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	1/8/2004

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	5/7/2024	5/7/2025
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 350 Plus with CSLD	5/7/2024	5/7/2025
Overfill Prev Device	Overfill Drop Tube Valve	5/7/2024	5/7/2027
Piping	Flexible Double Wall A.P.T. Poly Tech	N/A	N/A
Piping	Single Wall STP/Tanktop Sump	5/7/2024	5/7/2027
Leak Detect - Piping	Sump Sensor	5/7/2024	5/7/2025
Spill Contain Device	Single Wall Spill Bucket	5/7/2024	5/7/2027
Tank	Fiberglass Double Wall XERXES	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 2

Capacity:	20000		Petroleum Use:
Product:	Gasoline - Regular		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	3/24/2004		Abandoned Material:
Current Age:	20		Abandoned Date:
Install Date:	1/8/2004		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	1/8/2004

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	5/7/2024	5/7/2025
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 350 Plus with CSLD	5/7/2024	5/7/2025
Overfill Prev Device	Overfill Drop Tube Valve	5/7/2024	5/7/2027
Piping	Flexible Double Wall A.P.T. Poly Tech	N/A	N/A
Piping	Single Wall STP/Tanktop Sump	5/7/2024	5/7/2027
Leak Detect - Piping	Sump Sensor	5/7/2024	5/7/2025
Spill Contain Device	Single Wall Spill Bucket	5/7/2024	5/7/2027
Tank	Fiberglass Double Wall XERXES	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 3

Capacity:	14000		Petroleum Use:
Product:	Gasoline - Regular		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	3/24/2004		Abandoned Material:
Current Age:	20		Abandoned Date:
Install Date:	1/8/2004		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	1/8/2004

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	5/7/2024	5/7/2025
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 350 Plus with CSLD	5/7/2024	5/7/2025
Overfill Prev Device	Overfill Drop Tube Valve	5/7/2024	5/7/2027
Piping	Flexible Double Wall A.P.T. Poly Tech	N/A	N/A
Piping	Single Wall STP/Tanktop Sump	5/7/2024	5/7/2027
Leak Detect - Piping	Sump Sensor	5/7/2024	5/7/2025
Spill Contain Device	Single Wall Spill Bucket	5/7/2024	5/7/2027
Tank	Fiberglass Double Wall XERXES	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 4

Capacity:	6000		Petroleum Use:
Product:	Gasoline - Premium		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	3/24/2004		Abandoned Material:
Current Age:	20		Abandoned Date:
Install Date:	1/8/2004		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	1/8/2004

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	5/7/2024	5/7/2025
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 350 Plus with CSLD	5/7/2024	5/7/2025
Overfill Prev Device	Overfill Drop Tube Valve	5/7/2024	5/7/2027
Piping	Flexible Double Wall A.P.T. Poly Tech	N/A	N/A
Piping	Single Wall STP/Tanktop Sump	5/7/2024	5/7/2027
Leak Detect - Piping	Sump Sensor	5/7/2024	5/7/2025
Spill Contain Device	Single Wall Spill Bucket	5/7/2024	5/7/2027
Tank	Fiberglass Double Wall XERXES	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

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 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