Oxygen USP Bulk Liquid

Oxygen USP COA

AIR LIQUIDE  OXYGEN U.S.P.         Form Number: 2A-ALL-QUA-0005-F

                                                            Revision:         0

                                                            Effective Date: 03/29/06

                                                            Page:               1/1

CERTIFICATE OF ANALYSIS

Air Liquide large Industries U.S. L.P. – Houston, TX 77056

PRODUCED BY AIR LIQUEFACTION

1.Location       Street Address1                                  2. Carrier ________________

Street Address 2

City, State Zip

3. Lot Number ______________________                4. Trailer No _____________

PRE-FILL REPORT                                                   FILL REPORT

5.Residual Assay        6. Odor                                    7. Trailer loaded with appropriate product per appropriate

   (>99.5% O2)                  Detected                                 loading procedure by:

   _______ %                  Yes    No                              Signature _________________________

   ________                    ________                             Date _____________________________

    Initial                            Initial

ANALYSIS REPORT

Test required             Method of Analysis                           Specifications                       Results

OXYGEN ASSAY       PARAMAGNETIC       ___                  99.5% O2 Minimum                9. ____%

                                    8.Analyzer Tag Number        

ODOR                         Organoleptic (Nasal)                           None                                       10. ______

USP applies only when used in a medical application or by medical customers properly registered with the FDA. Note: Oxygen that is produced by the air liquefaction process is exempt from the requirement of the impurity test for Carbon Dioxide and Carbon Monoxide.

11. Analyzed By         ________________________            Date ____________

12. Witnessed By       ________________________            Date ____________

     (only required for HRC customers)

13. Does this lot require additional testing?  ___ NO            ___ YES – attach page 2

14. SQCU Review/Release _______________________     Date ____________

MANDATORY FORM

User must assure that this revision of the form is current prior to use. Completed forms become permanent records subject to the record retention policy.