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FCLEINFEL DER <br /> �8•yM1Peyn Rfghf SautMn <br /> ABOVEGROUND STORAGE TANK ANNUAL INSPECTION <br /> FORM INTERSTATE TRUCK CENTER., STOCKTON, SAN <br /> JOAQUIN <br /> Inspector: ..;:,: i. signature: i r3;. Date Completed: Gr -7 <br /> Category: Protection Tank External Tank ShelI/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 shelt(head Flanged connection bofts Standing water on Evidence fo Holes in roof? <br /> failure? shell/head oorrosion or cracking? tight and fully engaged roof? coating <br /> distortions, with no sign or wear or cracking, <br /> buckling, corrosion? crazing, <br /> �'ii•1/ <br /> denting or peeling or <br /> bulging? blistering? <br /> Oil Storage or usage Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No <br /> Location <br /> Comments: <br /> Note: Enter NA for quest+ons that are not applicable forthe specific tank. <br /> 20162686.001 AISAC16R33380 Page 2 of 4 February 19, 2416 <br /> 02016 Kleinfelder <br />