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fCL�INFEL�ER <br /> Rynrr���ryason,tmrn <br /> ABOVEGROUND STORAGE TANK ANNUAL INSPECTION FORM <br /> INTERSTATE TRUCKING INC.,STOCKTON, SAN JOAOUIN <br /> Inspector: 90:;4 G e'4d e�- JiSignature: n - a � — bate Completed: _4Z 2': -- <br /> Category: Tank Containment Tank Foundation and Supports Cathodic <br /> Inspection Item; Containment Drainage Evidence of Cracking or spalling of Tank supports in Water aline to drain Grounding CP system <br /> rf structure in pipeslvalvesfit tank settlement concrete pad or ring satisfactory condition? away from tank? strap functional? <br /> 1 Vti i d satisfactory for continued or foundation wall? secured and <br /> t " condition? service? washout? in good <br /> condition? <br /> Oil Storage or Usage Yes No Yes No Yes No Yes No Yes No Yes No Yes Na Yes No <br /> Location <br /> rx tz v V �lF� YVIS <br /> Comments: <br /> Note: Enter NA for questions that are not applicable for the specific tank. <br /> 20162686MMSAG16R33380 Page 1 of 4 February 19, 2016 <br /> Q2016 Kleinfelder <br />