OXYGEN

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 image label

• 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 image label