7/21/2019 Lista Uklanjanja Uzoraka

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HT 900000018   IR 10,000 G0 do +4°C   IR

The study for this sample has not been completed______________________________________________________________________

HT1 900000019   IR 10,000 G+5°C do +10°C   IR

The study for this sample has not been completed______________________________________________________________________

ST 900000020   IR 5,000 G+21°C   IR

The study for this sample has not been completed______________________________________________________________________

ST1 900000021   OK 5,000 G+21°C do +25°C   OK

The study for this sample has not been completed______________________________________________________________________

Date Signature

____________________ ______________________________

Sample removal list

General dataNumber of study    S10011999-Z3Material   10011999 50 % Platinum Cookies & Cream, 50g,ITPlant   MP01 ATLANTIC MULTIPOWER D.O.O.Batch   0000000008

Data related to initial sampleSample number    900000017Sample status   OTPSample quantity    30,000 GPrimary packaging   FOLIJA01 Folija-prozirna

______________________________________________________________________StorageCond.SampleNumber StorageLocation Quantity ME______________________________________________________________________

15.12.2014 Sample Removal List ZLALOVIC Original Page 1/ 1