OXYGEN

Oxygen COA Certificate of Analysis Shipped From: Ashtabula Oxygen 2501 Middle Rd. Ashtabula, Ohio Phone: (440) 994-1994 Company Name: TEST Product: Oxygen Load No: 6 Trailer No: 0000 Time In: 16:56:01 Time Out: 16:56:38 Load Date: 12/26/2017 Tare Weight: 0 Gross Weight: 0 lbs Net Weight: 0 lbs Lot Number: 4004O17360060000 Produced by: Air Liquefaction Ashtabula Oxygen Results Units Specifications Purity Pre-Fill: PASS Pass* Purity Post-Fill: 99.99 % >=99.6% Assay, Tested By: Teledyne 3010MA Paramagnetic 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. 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: TF-0001-O Rev.1 Oxygen COA

• Oxygen COA Certificate of Analysis Shipped From: Ashtabula Oxygen 2501 Middle Rd. Ashtabula, Ohio Phone: (440) 994-1994 Company Name: TEST Product: Oxygen Load No: 6 Trailer No: 0000 Time In: 16:56:01 Time Out: 16:56:38 Load Date: 12/26/2017 Tare Weight: 0 Gross Weight: 0 lbs Net Weight: 0 lbs Lot Number: 4004O17360060000 Produced by: Air Liquefaction Ashtabula Oxygen Results Units Specifications Purity Pre-Fill: PASS Pass* Purity Post-Fill: 99.99 % >=99.6% Assay, Tested By: Teledyne 3010MA Paramagnetic 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. 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: TF-0001-O Rev.1 Oxygen COA