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FORM VC <br />585 Emci y street <br />CeaRestoration, Inc. <br />Sar-Jose ' '' -1g CHAIN <br />OF CUSTODY FORM <br />Main Line i40-8) � -84 <br />Facsimile €408)29"451 <br />Turnarounc# <br />,Today <br />3day _Same day <br />Protect Name: <br />1._ <br />Time: <br />7 day ottaer <br />Project'Number <br />G <br />(working days} <br />_ <br />5'day _ 1 day {' <br />Global i D <br />P,Qjee Aadires& <br />c Zvi <br />S <br />Lab5rata>{y <br />Mt,-Campbeil Ana y'Vca€ <br />Contact. Rosa <br />Anah <br />sea Reqqnested <br />Lab Address/Phone. <br />ProjectManager <br />1535 Willow Pass Road Pftbur : CA 87'# 252-9262 <br />PILI Phone Number <br />A-JQ-S _ ���� - c �_y�, <br />Finallmarnggeore-storation coo <br />� <br />Sampler: <br />I <br />Phone, (408,1292-845.0 <br />2 j <br />r� <br />Sampte <br />Information <br />Container Information <br />Comments <br />t <br />2� <br />ix}iatFi7l <br />FitHd Rrrerar (Name ir <br />M. Type <br />Presevvatrve <br />Samea3 tiR} Sadnp}e <br />Sample tp <br />Date Time <br />Oowaq var <br />eg ,�242,1 <br />1 N% <br />"tifi't <br />cv <br />r 1'rt A "t <br />x 12 7 JL,cj tl'`AO -<1 <br />L$ y 4 Al <br />z a�Ai� 12:04 < <br />i <br />Additional Continents <br />ln-vMce to GeoRestoration Inc ard senb report to main@g-eearestoraton.com <br />Geotracker EDF <br />Relinquished By <br />Recewed B <br />Relinqu}shed By <br />. <br />Datef"irne. - <br />j �% <br />Received By. <br />DatetTtrrae <br />Relinquished 8y <br />Latef ime'- <br />Received By <br />DaterTirne <br />Sarwle �.'ondt bon GooO <br />_ <br />Ye:s ./'No— Reklgarase 1 Ycrc No �,_... <br />Coe4w Ttmp <br />...M Xra�n.,p�rrla l- M"#— <br />gage �._ of <br />Container Type: Y 9£ rt i vaok, t = a d tse and rs at#s, i sr ! _ A ;a kted t2aA . T = tk ,e : <br />tx its; > as+ s.r <br />S6 , P .. pEa,trz 4ftA r" `}° .. <br />ArestrvaGve: ti L }Y�'o�1 a Y, N = NEtrac acrd, G 4z r <br />FORM VC <br />