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:	2014412
Status:	Closed
Facility Name:	Formula Auto Repair, Ltd.
Address:	310 W. Northwest Hwy. Mount Prospect, IL 60056
County:	Cook
Property Parcel:
Facility Type:	Attended Self-Service Station
Owner Type:	Private
Green Tag Decal:	N000806
Green Tag Issue Date:	4/26/2012
Green Tag Expiration Date:	12/31/2014

Owner Details

Owner Name:	Formula Auto Repair, Ltd.
Owner Address:	310 W. Northwest Hwy Mount Prospect, IL 60056
Owner Status:	Current Owner
Purchase Date:	6/1/1994
Type of Financial Responsibility:
Financial Responsibility Reporting Due Date:

Motor Fuel Dispensing Permits

MFD Permit Type	Issue Date	Expiration Date
Self Service	4/26/2012	12/31/2014

Owner Summary

Click for Facility/Tank Ownership history

Owner Number	Owner Name	Owner Status	Purchase Date
U0036514	Formula Auto Repair, Ltd.	Current Owner	6/1/1994
U0028686	Formula Auto Corporation,	Former Owner	6/1/1994
U0016521	Winkelmann Douglas	Former Owner	1/1/1950

Permits (Unexpired)

Click for permit history

No Active Permits Found

Notice of Violations (Current)

No Notice of Violations Found

IEMA Numbers Associated with the Facility

IEMA Number	Inspection Date	Inspection Type	Permit Number
00-2263	11/28/2000	Removal Log	01868-2000REM
14-0459	5/29/2014	Removal Log	00367-2014REM
14-0459	5/30/2014	Removal Log	00367-2014REM
14-0459	5/28/2014	Removal Log	00367-2014REM

LUST Fund Eligibility and Deductibility Determinations

IEMA Number	Status	OSFM Received Date	OSFM Response Date	Deductible	Letter
00-2263	Eligible	2/14/2001	3/12/2001	$10,000
14-0459	Eligible	5/14/2014	4/16/2018	$5,000

Pay Tank Fees Online

Tank Information

Tank Number 1

Capacity:	3000		Petroleum Use:
Product:	Diesel Fuel		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	5/28/2014
OSFM First Notify Date:	4/20/1986		Abandoned Material:
Current Age:	47		Abandoned Date:
Install Date:	1/1/1967		Red Tag Issue Date:
Last Used Date:	5/1/2014		Fee Due:	$0.00
Product Date:	1/1/1967

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Sacrificial Anode Cathodic Protection	3/5/2010	3/5/2013
Corrosion Prot - Tank	Lining Materials Internal	9/18/2008	9/18/2013
Leak Detect - Piping	Mechanical Pressurized Line Leak Detection	7/20/2012	7/20/2013
Leak Detect - Tank	Automatic Tank Gauging Petro Vend Site Sentinel Model III
Overfill Prev Device	Ball Float Vent Valve
Piping	Fiberglass Single Wall Piping	N/A	N/A
Spill Contain Device	Single Wall Spill Bucket
Tank	Steel Single Wall	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 2

Capacity:	4000		Petroleum Use:
Product:	Gasoline		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	5/29/2014
OSFM First Notify Date:	4/20/1986		Abandoned Material:
Current Age:	64		Abandoned Date:
Install Date:	1/1/1950		Red Tag Issue Date:
Last Used Date:	4/1/2011		Fee Due:	$0.00
Product Date:	1/1/1950

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Sacrificial Anode Cathodic Protection	3/5/2010	3/5/2013
Corrosion Prot - Tank	Lining Materials Internal	9/18/2008	9/18/2013
Leak Detect - Piping	Mechanical Pressurized Line Leak Detection	7/20/2012	7/20/2013
Leak Detect - Tank	Automatic Tank Gauging Petro Vend Site Sentinel Model III
Overfill Prev Device	Ball Float Vent Valve
Piping	Fiberglass Single Wall Piping	N/A	N/A
Spill Contain Device	Single Wall Spill Bucket
Tank	Steel Single Wall	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 3

Capacity:	4000		Petroleum Use:
Product:	Gasoline		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	5/29/2014
OSFM First Notify Date:	4/20/1986		Abandoned Material:
Current Age:	64		Abandoned Date:
Install Date:	1/1/1950		Red Tag Issue Date:
Last Used Date:	5/1/2014		Fee Due:	$0.00
Product Date:	1/1/1950

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Sacrificial Anode Cathodic Protection	3/5/2010	3/5/2013
Corrosion Prot - Tank	Lining Materials Internal	9/18/2008	9/18/2013
Leak Detect - Piping	Mechanical Pressurized Line Leak Detection	7/20/2012	7/20/2013
Leak Detect - Tank	Automatic Tank Gauging Petro Vend Site Sentinel Model III
Overfill Prev Device	Ball Float Vent Valve
Piping	Fiberglass Single Wall Piping	N/A	N/A
Spill Contain Device	Single Wall Spill Bucket
Tank	Steel Single Wall	N/A	N/A

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:	5/30/2014
OSFM First Notify Date:	4/20/1986		Abandoned Material:
Current Age:	64		Abandoned Date:
Install Date:	1/1/1950		Red Tag Issue Date:
Last Used Date:	5/1/2014		Fee Due:	$0.00
Product Date:	1/1/1950

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Sacrificial Anode Cathodic Protection	3/5/2010	3/5/2013
Corrosion Prot - Tank	Lining Materials Internal	9/18/2008	9/18/2013
Leak Detect - Piping	Mechanical Pressurized Line Leak Detection	7/20/2012	7/20/2013
Leak Detect - Tank	Automatic Tank Gauging Petro Vend Site Sentinel Model III
Overfill Prev Device	Ball Float Vent Valve
Spill Contain Device	Single Wall Spill Bucket
Tank	Steel Single Wall	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Tank Number 5

Capacity:	300		Petroleum Use:
Product:	Used Oil		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	11/28/2000
OSFM First Notify Date:	4/20/1986		Abandoned Material:
Current Age:	15		Abandoned Date:
Install Date:			Red Tag Issue Date:
Last Used Date:	5/1/1994		Fee Due:	$0.00
Product Date:	1/1/1985

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:	6000		Petroleum Use:
Product:	E85		CERCLA Substance:
Status:	Removed		CAS Code:
Regulated Status:	Federal		Removed Date:	5/30/2014
OSFM First Notify Date:	9/10/1999		Abandoned Material:
Current Age:	14		Abandoned Date:
Install Date:	8/2/1999		Red Tag Issue Date:
Last Used Date:	5/1/2014		Fee Due:	$0.00
Product Date:	8/2/1999

Equipment

Equipment Type	Equipment	Last Passing Date	Test Expire Date
Corrosion Prot - Piping	Sacrificial Anode Cathodic Protection	3/5/2010	3/5/2013
Corrosion Prot - Tank	Composite Non-Corrosive	N/A	N/A
Leak Detect - Piping	Mechanical Pressurized Line Leak Detection	7/20/2012	7/20/2013
Leak Detect - Tank	Automatic Tank Gauging Petro Vend Site Sentinel Model III
Overfill Prev Device	Ball Float Vent Valve
Piping	Fiberglass Single Wall Piping	N/A	N/A
Spill Contain Device	Single Wall Spill Bucket
Tank	Composite Single Wall ACT 100	N/A	N/A

Additional Tests

Equipment Type	Equipment	Test Type	Test Result	Test Date

Dispenser Information

MFD Motorfuel Dispensing Forms

No Forms Found