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KLE11VFE1-DER <br /> Wigh t P—ph•.Riehl Sn7uf%ons. <br /> ABOVEGROUND STORAGE TANK ANNUAL INSPECTION FORM <br /> INTERSTATE TRUCKING INC., STOCKTON, SAN JOAQUIN <br /> Inspector: Signature: Date Completed: <br /> Category: Tank Containment Tank Foundation and Supports Cathodic <br /> Inspection Item: Containment Drainage Evidence of Cracking or spalling of Tank supports in Water able to drain Grounding CP systems <br /> structure in pipes/valves tit tank settlement concrete pad or ring satisfactory condition? away from tank? strap functional? <br /> satisfactory for continued or foundation wall? secured and <br /> condition? service? washout? in good1 condition? <br /> Oil Storage or EJsagey s No Yes No Yes No Yes No Yes No Yes No Yes No Yes No <br /> Location <br /> m� yclVIA <br /> ocwj <br /> Comments: <br /> Note: Enter NA for questions that are not applicable for thie specific tank. <br /> 20162686.001A/SAC16R33380 Page 1 of 4 February 19, 2016 <br /> Q 2016 Kleinfelder <br />