OXYGEN REFRIGERATED LIQUID, USP-045

PACKAGE LABEL.PRINCIPAL DISPLAY PANEL

ROBERTS OXYGEN ROCKVILLE, MARYLAND 20866 TEL: (301) 948-8100

CERTIFICATE OF ANALYSIS OXYGEN REFRIGERATED LIQUID, USP*

PRODUCED BY AIR-LIQUEFACTION PROCESS

TRAILER#: ______________

DATE:  _________________

LOT#: _________________

*USP applies only when used in a medical application or by medical customers properly registered with the FDA.

Component Test Method Limit Result

Oxygen ______ >99.5% _______

Odor ORGANOLEPTIC N/D ______

________ _________ _________ _________

Product is identified as OXYGEN, USP through process validations, dedicated piping, and product specific connections.

Notes:  _____________________________________

RELEASED BY: ____________________________

SIGNATURE

RELEASED BY: ____________________________

PRINTED NAME

Printed & Published by J.J. KELLER & ASSPCIATES, INC., Neenah, WI * USP

(800) 327-6868 *jjkeller.com * Printer in the Unitied States