NITROGEN- nitrogen gas 
UCG Georgia, LLC

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Nitrogen

UIG Universal Industrial Gases, Inc

Certificate of Analysis

All NF Nitrogen delivered by Universal Industrial Gases, Inc, when used in a medical application or by medical customers properly registered with the FDA, is classified as NF Nitrogen

Shipped From

Taylor Data Systems

181 E. Evans St

Suite A

Florence, SC 29505

843-656-2084

Company: Taylor Data Systems Operator: Admin

Product: Nitrogen Product Code: NI 300

Driver: Test Driver Tractor No: 14 Trailer No: 123

Load No: 92 Certificate No: 214 Tank No: 1100

Time In: 12:29 PM Time Out: 2:48 PM Certification Date: 6/4/2018 2:48 PM

Tare Weight: 10010 lbs Gross Weight: 45000 lbs Net Weight: 34990 lbs

Lot Number: TDS-155-18-N-1100-1 Produced By: TDS

Assay per NF requirements is by difference of O2 only

Results Units USP/NF Specifications TDS Specifications

Purity Pre-fill 99.9985 % >=99.9985 % >=99.9985 %

Purity Post fill 99.9992 % >=99.00 % >=99.999 %

Assay, by Difference

O2 4.00 ppm/V <=1.0 % <=5.00 ppm/V

O2-Nitrogen

CO 4.00 ppm/V <=10.0 % <=10.00 ppm/V

CO-Nitrogen

Odor None None None

Organoleptic

Identity Nitrogen Nitrogen Nitrogen

Dew Point -88.50 deg. F 0.00 deg. F

Moisture 4.00 ppm/V <=5.00 ppm/V

-

Critical Analyzers Yes

*The Pre-Fill is tested against UIGI specifications and a Pass indicates that the results met or exceeded the applicable specifications. The results of the Pre-Fill tests are kept on file.

Quantity delivered to trailer: 34,990.00 Gallons: 2.04 Cubic Feet: 482966.97

UIGI Analyst: I declare that this analysis was completed within all UIGI policy and procedures and that the product meets all UIGI specifications.

Signed: Date: 06/04/2018

Product Release Specialist / Released By: I declare that this certificate is accurate, complete and compliant with all applicable policies and procedures, that all pre-fill inspections including inspection of the loading hose and connections were performed following all applicable procedures, and that the product meets all UIGI specifications.

Signed: Date: 06/04/2018

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 SDS.

Signed: Date: 06/04/2018 nitrogen

NITROGEN 
nitrogen gas
Product Information
Product TypeHUMAN PRESCRIPTION DRUGItem Code (Source)NDC:72457-005
Route of AdministrationRESPIRATORY (INHALATION)
Active Ingredient/Active Moiety
Ingredient NameBasis of StrengthStrength
NITROGEN (UNII: N762921K75) (NITROGEN - UNII:N762921K75) NITROGEN995 mL  in 1 L
Packaging
#Item CodePackage DescriptionMarketing Start DateMarketing End Date
1NDC:72457-005-011.5819 L in 1 TANK; Type 0: Not a Combination Product11/01/2018
Marketing Information
Marketing CategoryApplication Number or Monograph CitationMarketing Start DateMarketing End Date
NDANDA21231511/01/2018
Labeler - UCG Georgia, LLC (107923171)
Establishment
NameAddressID/FEIBusiness Operations
UCG Georgia, LLC107923171manufacture(72457-005)
Establishment
NameAddressID/FEIBusiness Operations
UNIVERSAL INDUSTRIAL GASES, LLC118689412manufacture(72457-005)

Revised: 7/2022
Document Id: e3db1f26-037a-15f9-e053-2a95a90aa2a4
Set id: 7b077025-c8f6-2790-e053-2991aa0aa9c2
Version: 5
Effective Time: 20220715
 
UCG Georgia, LLC