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:	2014091
Status:	Active
Facility Name:	Sam's Auto Service
Address:	4401 St Charles Road Bellwood, IL 60104
County:	Cook
Property Parcel:	15-08-215-065-0000
Facility Type:	Attended Self-Service Station
Owner Type:	Private
Green Tag Decal:	Z000059
Green Tag Issue Date:	5/29/2024
Green Tag Expire Date:	12/31/2026
MFD Type:	Self Service

Owner Details

Owner Name:	Bassam Shaheen
Owner Address:	4401 St Charles Road Bellwood, IL 60104
Owner Status:	Current Owner
Purchase Date:	12/31/1984
Type of Financial Responsibility:	Commercial Insurance
Financial Responsibility Reporting Due Date:	6/17/2026

Owner Summary

Click for Facility/Tank Ownership history

Owner Number	Owner Name	Owner Status	Purchase Date
U0013806	Shaheen, Bassam	Current Owner	12/31/1984
U0008295	Kayo Oil Co	Former Owner	12/31/1967

Permits (Unexpired)

Click for permit history

No Active Permits Found

Notice of Violatlions (Current)

NOV Number: E0020261021 (Pending) Issue Date: 4/16/2026 Expiration Date: 6/15/2026 View NOV Form

Tanks	Violations
7, 8	Dispensers - hoses cracked, split or worn and require replacement
10	Failed to Empty the Tank to 1" or Less - Tank must be emptied to 1" or less
Facility	Missing copies of 30 day Walkthrough Inspection Report.
Facility	Missing copies of current testing certificates for operator training - Copies must be kept on site
10	Submit Notification Form For Tank Status Change - Tank is no longer used and must be placed out of service. The Notification Form is available at https://webapps.sfm.illinois.gov/USTPortal/NotificationForm

IEMA Numbers Associated with the Facility

IEMA Number	Inspection Date	Inspection Type	Permit Number
94-2131	9/19/1994	Removal Log

LUST Fund Eligibility and Deductibility Determinations

IEMA Number	Status	OSFM Received Date	OSFM Response Date	Deductible	Letter
94-2131	Eligible	9/27/1994	10/13/1994	$15,000

Pay Tank Fees Online

Tank Information

Tank Number 1

Capacity:	8000		Petroleum Use:
Product:	Gasoline		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	9/19/1994
OSFM First Notify Date:	3/31/1986		Abandoned Material:
Current Age:	22		Abandoned Date:
Install Date:	1/1/1972		Red Tag Issue Date:
Last Used Date:	9/19/1994		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:	8000		Petroleum Use:
Product:	Gasoline		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	9/19/1994
OSFM First Notify Date:	3/31/1986		Abandoned Material:
Current Age:	22		Abandoned Date:
Install Date:	1/1/1972		Red Tag Issue Date:
Last Used Date:	9/19/1994		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 3

Capacity:	8000		Petroleum Use:
Product:	Diesel Fuel		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	9/19/1994
OSFM First Notify Date:	3/31/1986		Abandoned Material:
Current Age:	22		Abandoned Date:
Install Date:	1/1/1972		Red Tag Issue Date:
Last Used Date:	9/19/1994		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:	4000		Petroleum Use:
Product:	Gasoline		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	9/19/1994
OSFM First Notify Date:	3/31/1986		Abandoned Material:
Current Age:	22		Abandoned Date:
Install Date:	1/1/1972		Red Tag Issue Date:
Last Used Date:	9/19/1994		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 5

Capacity:	500		Petroleum Use:
Product:	Used Oil		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	9/19/1994
OSFM First Notify Date:	6/28/1994		Abandoned Material:
Current Age:	22		Abandoned Date:
Install Date:	1/1/1972		Red Tag Issue Date:
Last Used Date:	9/19/1994		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 6

Capacity:	500		Petroleum Use:	Consumptive Use on Premises for Heating
Product:	Heating Oil		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	State		Removed Date:	9/19/1994
OSFM First Notify Date:	6/28/1994		Abandoned Material:
Current Age:	22		Abandoned Date:
Install Date:	1/1/1972		Red Tag Issue Date:
Last Used Date:	9/19/1994		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 7

Capacity:	10000		Petroleum Use:
Product:	Gasoline - Regular		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	9/27/1994		Abandoned Material:
Current Age:	31		Abandoned Date:
Install Date:	9/23/1994		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	9/23/1994

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Sacrificial Anode Flex Connector	3/25/2025	3/25/2028
Corrosion Prot - Piping	Flexible Non-Corrosive	N/A	N/A
Corrosion Prot - Tank	Fiberglass Non-Corrosive	N/A	N/A
Leak Detect - Piping	Mechanical Pressurized Line Leak Detection	4/16/2026	4/16/2027
Leak Detect - Tank	Automatic Tank Gauging Veeder Root EMC with CSLD	4/16/2026	4/16/2027
Overfill Prev Device	Overfill Drop Tube Valve	3/27/2024	3/27/2027
Piping	Flexible Double Wall A.P.T. Poly Tech	N/A	N/A
Piping	Single Wall STP/Tanktop Sump
Leak Detect - Piping	Piping Sump Sensors Not Regulated Not Required	N/A	N/A
Spill Contain Device	Single Wall Spill Bucket	3/27/2024	3/27/2027
Tank	Jacketed Steel Double Wall Total Containment	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Piping	Flexible Double Wall	Precision Test (Piping)	Pass	3/25/2025
Piping	Flexible Double Wall A.P.T. Poly Tech	Precision Test (Piping)	Pass	4/16/2026
Tank	Fiberglass Double Wall	Precision Test (Tank)	Pass	7/21/2020

Tank Number 8

Capacity:	6000		Petroleum Use:
Product:	Gasoline - Premium		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	9/27/1994		Abandoned Material:
Current Age:	31		Abandoned Date:
Install Date:	9/23/1994		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	9/23/1994

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Sacrificial Anode Flex Connector	3/25/2025	3/25/2028
Corrosion Prot - Piping	Flexible Non-Corrosive	N/A	N/A
Corrosion Prot - Tank	Fiberglass Non-Corrosive	N/A	N/A
Leak Detect - Piping	Mechanical Pressurized Line Leak Detection	4/16/2026	4/16/2027
Leak Detect - Tank	Automatic Tank Gauging Veeder Root EMC with CSLD	4/16/2026	4/16/2027
Overfill Prev Device	Overfill Drop Tube Valve	3/27/2024	3/27/2027
Piping	Flexible Double Wall A.P.T. Poly Tech	N/A	N/A
Piping	Single Wall STP/Tanktop Sump
Leak Detect - Piping	Piping Sump Sensors Not Regulated Not Required	N/A	N/A
Spill Contain Device	Single Wall Spill Bucket	3/27/2024	3/27/2027
Tank	Jacketed Steel Double Wall Total Containment	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Piping	Flexible Double Wall	Precision Test (Piping)	Pass	3/25/2025
Piping	Flexible Double Wall A.P.T. Poly Tech	Precision Test (Piping)	Pass	4/16/2026
Tank	Fiberglass Double Wall	Precision Test (Tank)	Pass	7/21/2020

Tank Number 9

Capacity:	4000		Petroleum Use:	None
Product:	Diesel Fuel		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	9/27/1994		Abandoned Material:
Current Age:	31		Abandoned Date:
Install Date:	9/23/1994		Red Tag Issue Date:
Last Used Date:			Fee Due:
Product Date:	9/23/1994

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Sacrificial Anode Flex Connector	3/25/2025	3/25/2028
Corrosion Prot - Piping	Flexible Non-Corrosive	N/A	N/A
Corrosion Prot - Tank	Fiberglass Non-Corrosive	N/A	N/A
Leak Detect - Piping	Mechanical Pressurized Line Leak Detection	4/16/2026	4/16/2027
Leak Detect - Tank	Automatic Tank Gauging Veeder Root EMC with CSLD	4/16/2026	4/16/2027
Overfill Prev Device	Overfill Drop Tube Valve	3/27/2024	3/27/2027
Piping	Flexible Double Wall A.P.T. Poly Tech	N/A	N/A
Piping	Single Wall STP/Tanktop Sump
Leak Detect - Piping	Piping Sump Sensors Not Regulated Not Required	N/A	N/A
Spill Contain Device	Single Wall Spill Bucket	3/27/2024	3/27/2027
Tank	Jacketed Steel Double Wall Total Containment	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Piping	Flexible Double Wall	Precision Test (Piping)	Pass	3/25/2025
Piping	Flexible Double Wall A.P.T. Poly Tech	Precision Test (Piping)	Pass	4/16/2026
Tank	Fiberglass Double Wall	Precision Test (Tank)	Pass	7/21/2020

Tank Number 10

Capacity:	500		Petroleum Use:	None
Product:	Used Oil		CERCLA Substance:
Status:	Currently in use		CAS Code:
Regulated Status:	Federal		Removed Date:
OSFM First Notify Date:	9/27/1994		Abandoned Material:
Current Age:	31		Abandoned Date:
Install Date:	9/23/1994		Red Tag Issue Date:
Last Used Date:			Fee Due:	$0.00
Product Date:	9/23/1994

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	Gravity Feed	N/A	N/A
Leak Detect - Tank	110 - 600 gallons Manual Tank Gauging	N/A	N/A
Overfill Prev Device	Less than 25 gallon fills	N/A	N/A
Piping	Fiberglass Single Wall Piping A.O. Smith	N/A	N/A
Spill Contain Device	Single Wall Spill Bucket	3/27/2024	3/27/2027
Tank	Jacketed Steel Double Wall Total Containment	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date
Tank	Fiberglass Double Wall	Precision Test (Tank)	Pass	4/14/2022

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 Required	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 Required	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 Required	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 Required	N/A	N/A

MFD Motorfuel Dispensing Forms

No Forms Found