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KLEINFEL DHA? <br /> ertghrProyle.Frghr�h Epps. <br /> ABOVEGROUND STORAGE TANK ANNUAL INSPECTION <br /> FORM INTERSTATE TRUCK_ CENTER., STOCKTON, SAN <br /> UIN <br /> Inspector. Signature: — date Completed: C}' <br /> Category: Protection Tank External Wank ShelVHeads Tank Manways,Piping Tank Roof <br /> Coating and Equipment within <br /> Secondary Containment <br /> Inspection Item: I Rectifier reading Evidence of paint Noticeable Evidence of shelllhead i Flanged connection bolts Standing water on Evidence fo Hales in roof? <br /> failure? shell/head corrosion or cracking? tight and fully engaged roof? coating <br /> �D distortions, with no sign or wear or cracking, <br /> buckling, corrosion? crazing, <br /> ol�. denting or peeling or <br /> bulging? blistering? <br /> Oil Storage or Usage <br /> Location Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No <br /> � y !} <br /> Comments: <br /> Note: Enter NA for questions that are not applicable for the specific tank. <br /> 20162686.001 AISAC 16833380 Page 2 of 4 February 19, 2016 <br /> @2016 Kleinfelder <br />