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KL.EINFEL L7ER <br /> e.rynw�„rxqn,sn•:.•,i. <br /> ABOVEGROUND STORAGE TANK ANNUAL INSPECTION FORM <br /> INTERSTATE TRUCKING INC_, STOCKTON,SAN JOAQUIN <br /> Inspector: signature: Date Completed: 2 <br /> Category: Tank Containment Tank Foundation and Supports Cathodic <br /> Inspection Rens: Containment Drainage Evidence of Cracking or spalfing of Tank supports in Water able to drain Grounding CP system <br /> structure in pipeslvalves fit tank settlement concrete pad or ring satisfactory condition? away from tarn? strap functional? <br /> t�U f <br /> satisactory for continued or foundation wall? <br /> #� secured and <br /> condition? service? washout? In good <br /> condition? <br /> Of Storage or Usage Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No <br /> Location <br /> 71r:1••.`zr ' <br /> Comments: <br /> Note: Enter NA for questions that are not applicable for the specific tank. <br /> 20162686.00iA15AC16R33380 Page 1 of 4 February 19, 2016 <br /> 0 2016 Kleinfeider <br />