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AST SP001 ANNUAL INSPECTION Received on 10/29/20' SJC EHD - CR General Inspection Information: (36 months from inspection Inspection Date: 6/1&2019 Retain Until Date. 6/1&2022 date) Prior Inspection Date: Unavailable Inspector Name. S.La.n Tacks Inspected(OMs):Mew Antifiee ANTIFREEZE Inspection Guidance: For equipment not included in this standard,follow the manufacturer recommended inspection/testing schedules and procedures. The periodic AST Inspection is intended for monitoring the external AST condition and its containment structure.This visual inspection does not require a Certified Inspector. It shall be performed by an owner's inspectorwho is familiarwith the site and can identify changes and developing problems. Remove promptly upon discovery standing water or liquid in the primary tank, secondary containment area, interstice, or spill container. Before discharge to the environment, inspect the liquid for regulated products or other contaminants and disposed of it properly. In order to comply with EPA SPCC(Spill Prevention, Control and Countermeasure)rules, a facility must regularly test liquid level sensing devices to ensure proper operation(40 CFR 112.8(c)(8)(v)). Non-conforming items important to tank or containment intearity require evaluation by an engineer experienced in AST design, a Certified Inspector, or a tank manufacturerwho will determine the corrective action. Note the non-conformance and corresponding corrective action in the comment section. Retain the completed checklists for 36 months. Complete this checklist on an annual basis supplemental to the owner monthly-performed inspection checklists. Note: If a change has occurred to the tank system or containment that may affect the SPCC plan, the condition should be evaluated against the current plan requirement by a Professional Engineer knowledgeable in SPCC development and implementation. Item Task Status 1.0 Tank Containment 1.1 Containment structure Is structure free of: rYes rNo rN/A • Holes or cracks in containment wall or floor r—Yes r—No rN/A • Washout r—Yes r—No PN/A • Liner degradation rYes rNo rN/A • Corrosion • Leakage r—Yes r—No rN/A • Paint failure r—Yes r—No PN/A • Tank settling FYes rNo 17N/A Comments: Double Wall Tank does not require Secondary containment. 2.0 Tank Foundation and Supports 2.1 Foundation Noobserved settlement or foundation washout? rYes r-No 2.2 Concrete pad or ring wall No visible cracking or spelling? r-Yes rNo rN/A 2.3 Supports No visible corrosion, paint failure, etc.? r-Yes rNo r-N/A 2.4 Water drainage Water drainage away from tank7 rYes r No r N/A 2.5 Tank grounding Strap secured and in good condition? r-Yes r-No rN/A If intrinsically ground, please note in comments. Comments: Supports have paint failure, Recommend cleaning and painting. Tank located indoors. WO 6703819 SEPTEMBER 2016