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KLEINFELDER <br /> 8nhAnae.�'gA[Sehrlpns <br /> ABOVEGROUND STORAGE TANK ANNUAL.INSPECTION <br /> FORM INTERSTATE TRUCK CENTER.,STOCKTON, SAN <br /> JOAQUIN <br /> Inspector: Signature: il,,c Rate Completed: GI,7- 5 I <br /> Category: Protection Tank External Tank ShelVHeads Tank Manways,Piping Tank Roof <br /> Coating and Equipment within <br /> Secondary Containment <br /> Inspection Item: Rectifier reading Evidence of paint Noticeable Evidence of shelVhead Flanged connection bolts Standing water on Evidence to Holes in roof? <br /> failure? shelllhead corrasion or cracking? tight and fully engaged roof? coating <br /> distortions, with no sign or wear or cracking, <br /> buckling, corrosion? crazing, <br /> v denting or peeling or <br /> bulging? blistering? <br /> Cil Storage or Usage Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No <br /> Location <br /> .e;t <br /> Comments: <br /> Note: Enter NA for questions that are not applicable for the specific tank. <br /> 20162686.001AISAC161933380 Page 2 of 4 February 19, 2016 <br /> 02016 Klelnfelder <br />