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ICLEINFELG�ER <br /> e+;hr ire.Rrgnr son,r,v.rs. <br /> ABOVEGROUND STORAGE TANK ANNUAL INSPECTION <br /> FORM INTERSTATE TRUCK CENTER., STOCKTON, SAN <br /> AQUlN <br /> Inspector: Signature: ,e or <br /> _ Date Completed: a <br /> Category: Protection Tank External Tank Shell/Heads Tank Manways,Piping Tank Roof <br /> Coating and Equipment within <br /> Secondary Containment <br /> inspection Item, Rectifier reading Evidence of paint Noticeable Evidence of shell/head Flanged connection bolts Standing water on Evidence fo Hales in roof? <br /> J failure? shell/head corrosion or cracking? tight and fully engaged roof? coating <br /> distortions, with no sign or wear or cracking, <br /> truckling, corrosion? crazing, <br /> denting or peeling or <br /> bulging? blistering? <br /> Oil Storage or on tio <br /> LocaUsage yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No <br /> JJ yy nn <br /> Comments: <br /> Note: Enter NA far questions that are not applicable for the specific tank. <br /> 20162686.001A1SAC16R33380 Page 2 of 4 February 19, 2016 <br /> ©2016 Kleinfelder <br />