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gent By: DELLAVALLE LAB. ; 559 2332236; May-14.07 :04PM; Page 3/4 <br /> &L ORATORY, INC. <br /> DELLAVALLE Lt- i <br /> 10)W.McKinloy Avenue,Suitc 110 is Frosyw,CA 43729 <br /> -020 5s9233-61290 900 228-99964-Fiix.59268,8174 <br /> 5-2iddds�'2 No.o0ulliplel I Na of Bottics <br /> T)rinkiiif Wincl Wastewater <br /> Ag Wilor Ornundwollar mlimitming Wet! <br /> Rtslittg Nccded By <br /> Othcr: ';Mb Well <br /> BILL TO 151901. 01 Analysis and 101tiCs ReQUIE& <br /> Purchase Ordcr Nv. X _± ' 03) <br /> TA 104(1)13CII&EDD)(I �'c!L of 3 V OA%v/No2,Q <br /> 6j)=aflo()live R.-aich JX] NO3 (250 ml Wmfiu-ull1)l'c5crvcd) <br /> Name <br /> PO Box 5229 <br /> Address <br /> Wcktoy),CA 95205 <br /> cily,SOeV,Zip <br /> 269 44.1;2848 20 4674362 <br /> TelDphom Fox <br /> Stteet 2ddF0ljj:.'.j.jj'j;Ar-AIS M_WcW)w(,'ull Jack at 209 483-1111 it you <br /> need mm-instructions. MOP IN dtlacl`14 <br /> wArnall COPIES TO: <br /> REQtms'Mi)DY Jou lltwzano <br /> 1,ROJF.CT <br /> Co. I-Tealtb Dept <br /> CROP INTENDED I.KWQCB Copy of chuing <br /> SAMPLEr Y State Forins I I QA/Q'c Document <br /> ion of Swnplc I)atc/Timr r(ec'd <br /> Dliwriptioh V. e Dkiterrime Recd Qeyt <br /> liain 1 0 Temp'C' StAinpled <br /> I. Well 7P 0 6. <br /> 2. 7. <br /> 4. <br /> 5. 10. <br /> CHAIN Of CUSTODY <br /> Signature Company Received(Date)Time) Relinquished(.Datr/Timi) <br /> A - <br /> Second <br /> 41 <br /> W W 1)6­mdl�o liable f., sfid.Wihere shrW4 <br /> lNd thi-&tig.or Ad tituairarciieu Monod,i III—111V-01MAY to cownrul lk wvim;. 4­A­fllorilv.1 emae <br /> Risk";r*uW that idlrmmii ij expected to by C601 with Ism pin unlet tinio imve been pfevirlWY mory"qW. :i.pms rlm nn JO dwi)%�uw,d,-r Pccmlwt-will be&14;W 0 6006 <br /> damase Ear d;.I.i.mm.comerallawl;te is he prk,,I.W1 I ices OrDfllo.il Ifle,4 Q1 b,V,lbdlijlo4 in ldojiwi�under the Ruics Ill$i,mcefhijes of CcrofiK All tlw%*jjV9 LA LittgMiUll,11M. <br /> (.=Wilil l"'Ise.1!6A,dUe&INd I 149;t;M- 'ra4ellUtbS.The PIlkR"I 4A"'Y hear she­31.Ur <br /> puts is nal j(w�jvml in omdirdom lh*n As dillwAlrl`will 1)4:PlibroMild to blildirl;tibil,-11--1 I h�o Calf vnilrr ks Fk,lk�­i l <br /> dwAtto thn ric,14,61tunul aillyuif climb.(h"lipMe,will W"y cmi.Adj ill["t rArR DfUtAdIUMA.mld.WAlf.ARAMM'fees VfVW#'Ml"1 <br /> il F I Vmd' I fir Iffem <br /> t Jn <br /> U <br />