ANALYTICAL TEST REPORT

PROJECT NO.: ___
DATE: ___

PROJECT NAME: ___

LOCATION: ___

CUSTOMER’S SPECIFICATION: ___

DESCRIPTION: ___

• HELIUM LEAK CHECK
  RESULT: ___ ATM CC/SEC
  ☐PASSED ☐FAILED ☐N/A

• PARTICLE COUNT
  RESULT: ☐PRINT OUT ATTACHED
  ☐PASSED ☐FAILED ☐N/A

• OXYGEN TEST
  RESULT: __ PPB
  BASELINE: __ PPB
  ☐PASSED ☐FAILED ☐N/A

• MOISTURE TEST
  RESULT: __ PPB
  BASELINE: __ PPB
  ☐PASSED ☐FAILED ☐N/A

• TOTAL HYDROCARBON TEST
  RESULT: __ PPB
  BASELINE: __ PPB
  ☐PASSED ☐FAILED ☐N/A

REMARKS: ___

PERFORMER: ___
WITNESS: ___

SIGNATURE: ___
SIGNATURE: ___