OXYGEN- oxygen gas 
Air Liquide Large Industries U.S. LP

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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.

Cert of Analysis

OXYGEN 
oxygen gas
Product Information
Product TypeHUMAN PRESCRIPTION DRUGItem Code (Source)NDC:11853-013
Route of AdministrationRESPIRATORY (INHALATION)
Active Ingredient/Active Moiety
Ingredient NameBasis of StrengthStrength
OXYGEN (UNII: S88TT14065) (OXYGEN - UNII:S88TT14065) OXYGEN99 L  in 100 L
Packaging
#Item CodePackage DescriptionMarketing Start DateMarketing End Date
1NDC:11853-013-6025000 L in 1 TANK; Type 0: Not a Combination Product01/01/1960
2NDC:11853-013-6150000 L in 1 TANK; Type 0: Not a Combination Product01/01/1960
Marketing Information
Marketing CategoryApplication Number or Monograph CitationMarketing Start DateMarketing End Date
NDANDA20573701/01/1960
Labeler - Air Liquide Large Industries U.S. LP (180015062)
Registrant - Air Liquide Large Industries U.S. LP (180015062)
Establishment
NameAddressID/FEIBusiness Operations
Air Liquide Large Industries U.S. LP791294122manufacture(11853-013)
Establishment
NameAddressID/FEIBusiness Operations
Air Liquide Large Industries U.S. LP832290014manufacture(11853-013)
Establishment
NameAddressID/FEIBusiness Operations
Air Liquide Large Industries U.S. LP831993303manufacture(11853-013)
Establishment
NameAddressID/FEIBusiness Operations
Air Liquide Large Industries U.S. LP047089305manufacture(11853-013)
Establishment
NameAddressID/FEIBusiness Operations
Air Liquide Large Industries U.S. LP111765132manufacture(11853-013)
Establishment
NameAddressID/FEIBusiness Operations
Air Liquide Large Industries U.S. LP117158467manufacture(11853-013)

Revised: 10/2019
 
Air Liquide Large Industries U.S. LP