# 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:** ___