Information

JB Pritzker, Governor

Michele L Pankow, State Fire Marshal

Division of Petroleum & Chemical Safety

State of Illinois
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Division of Petroleum & Chemical Safety

Facility Details

Facility Number:	2013075
Status:	Active
Facility Name:	Gottlieb Memorial Hospital
Address:	701 West North Avenue Melrose Park, IL 60160
County:	Cook
Property Parcel:	12-35-302-036-0000
Facility Type:	Hospital
Owner Type:	Private
Green Tag Decal:	Z004103
Green Tag Issue Date:	12/13/2024
Green Tag Expiration Date:	12/31/2026

Owner Details

Owner Name:	Gottlieb Memorial Hospital
Owner Address:	701 West North Avenue Melrose Park, IL 60160
Owner Status:	Current Owner
Purchase Date:
Type of Financial Responsibility:	Commercial Insurance
Financial Responsibility Reporting Due Date:	1/15/2026

Motor Fuel Dispensing Permits

No MFD Permits Found

Owner Summary

Click for Facility/Tank Ownership history

Owner Number	Owner Name	Owner Status	Purchase Date
U0006013	Gottlieb Memorial Hospital	Current Owner

Permits (Unexpired)

Click for permit history

No Active Permits Found

Notice of Violatlions (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:	20000		Petroleum Use:	Consumptive Use on Premises for Heating
Product:	Heating Oil		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	State		Removed Date:	7/10/1990
OSFM First Notify Date:	4/29/1986		Abandoned Material:
Current Age:	37		Abandoned Date:
Install Date:			Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 2

Capacity:	20000		Petroleum Use:
Product:	Fuel Oil		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	State		Removed Date:	7/10/1990
OSFM First Notify Date:	4/29/1986		Abandoned Material:
Current Age:	37		Abandoned Date:
Install Date:			Red Tag Issue Date:
Last Used Date:	6/1/1983		Fee Due:
Product Date:

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 3

Capacity:	1000		Petroleum Use:
Product:	Diesel Fuel		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	7/10/1990
OSFM First Notify Date:	4/29/1986		Abandoned Material:
Current Age:	22		Abandoned Date:
Install Date:			Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 4

Capacity:	10000		Petroleum Use:
Product:	Diesel Fuel		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	9/6/2024
OSFM First Notify Date:	8/26/1996		Abandoned Material:
Current Age:	33		Abandoned Date:
Install Date:	1/1/1991		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	Fiberglass Non-Corrosive	N/A	N/A
Corrosion Prot - Tank	Fiberglass Non-Corrosive	N/A	N/A
Leak Detect - Piping	European with No Test Req Suction	N/A	N/A
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS 300c with CSLD	2/2/2024	2/2/2025
Overfill Prev Device	Overfill Drop Tube Valve	7/10/2023	7/10/2026
Piping	Fiberglass Chase	N/A	N/A
Piping	Steel Single Wall Piping	N/A	N/A
Piping	Not Installed STP/Tanktop Sump	N/A	N/A
Spill Contain Device	Single Wall Spill Bucket	6/23/2023	6/23/2026
Tank	Fiberglass Single Wall	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Piping	Fiberglass Chase	Precision Test (Piping)	Fail	8/11/2023
Piping	Steel Single Wall Piping	Precision Test (Piping)	Fail	8/11/2023
Tank	Fiberglass Single Wall	Precision Test (Tank)	Fail	8/11/2023

Tank Number 5

Capacity:	10000		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:	10/9/2024		Abandoned Material:
Current Age:	0		Abandoned Date:
Install Date:	9/13/2024		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	American with Sensors/No Test Suction	N/A	N/A
Leak Detect - Tank	Automatic Tank Gauging Veeder Root TLS - 4c	12/6/2024	12/6/2025
Leak Detect - Tank	Non-Discriminating Interstitial Monitoring Sensors With Monitor	12/6/2024	12/6/2025
Overfill Prev Device	Overfill Drop Tube Valve	12/6/2024	12/6/2027
Piping	Flexible Double Wall OmegaFlex DoubleTrac	N/A	N/A
Piping	Single Wall STP/Tanktop Sump	10/1/2024	10/1/2027
Leak Detect - Piping	Sump Sensor with positive shutdown	12/6/2024	12/6/2025
Piping	Single Wall STP/Tanktop Sump	10/1/2024	10/1/2027
Leak Detect - Piping	Sump Sensor with positive shutdown	12/6/2024	12/6/2025
Spill Contain Device	Double Wall Spill Bucket	10/1/2024	10/1/2027
Tank	Fiberglass Double Wall KBK Industries	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	12/6/2024
Piping	Flexible Double Wall OmegaFlex DoubleTrac	Precision Test (Piping)	Pass	11/21/2024
Tank	Fiberglass Double Wall KBK Industries	Precision Test (Tank)	Pass	11/21/2024

Dispenser Information

MFD Motorfuel Dispensing Forms

No Forms Found