Nitrogen

Certificate of Analysis                    Shipped From:

                                                                                                                Ashtabula Oxygen

                                                                                                                2501 Middle Rd.

                                                                                                                Ashtabula, Ohio                              

                                                                                                                Phone: (440) 994-1994

Company Name: TEST

Product:               Nitrogen

Load No:              5                                                                                              Trailer No:          0000

Time In:               16:44:58               Time Out:            16:46:04               Load Date:          12/26/2017

Tare Weight:     0                              Gross Weight:   0           lbs           Net Weight:       0    lbs

Lot Number:      4004N17360050000                                         Produced by: Air Liquefaction

  Assay per NF requirements is by difference of O2 only

Ashtabula Oxygen

ResultsUnitsSpecifications

Purity Pre-Fill:                  PASS                                                                      Pass*

Purity Post-Fill:                99.99                     %                            >=99.999%

Assay, By Difference)

O2:                                                                         ppm/V                  <=2.0ppm

  O2 Tested By: Teledyne 3000TA-XL Electrochemcial

CO:                                                                         ppm/V                  <=5.0ppm

  CO Tested By: Teledyne GFC-7001T Non-Dispersive Infrared

H2O:                                                                      ppm/V                  <=2.0ppm

  H20 Tested By: Teledyne 8800A Electrochemcial

Odor:                                                                    None                     None

  Odor Tested By: Organoleptic

Ashtabula Oxygen Analyst: I declare that this analysis was completed with all Ashtabula Oxygen policy and procedures and that the product meets all Ashtabula Oxygen and USP/NF specifications.

Signed:         Date/Time:

Product Release Specialist/Release By: I declare that this certification is accurate, complete and compliant with all applicable policies and procedures and that the product meets all Ashtabula Oxygen and USP/NF specifications.

Signed:         Date/Time:

Picked Up By: I declare that I have received the required documentation for shipment of this product and that I have the North American Emergency Response Guide or a MSDS.

Signed:         Date/Time:

• The Pre-Fill is tested against Ashtabula Oxygen and USP/NF specification and a “Pass” indicated that the results met and exceeded the applicable specifications. The results of the Pre-Fill tests are kept on file.