Fillable Form 3: CONSOLIDATED TEST RESULTS SUMMARY

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CONSOLIDATED TEST RESULTS SUMMARY
Please see the following pages for full test results.
BULK SKU BATCH #
PRODUCT NAME SERVING SIZE
LABORATORY
:
COLUMBIA LABORATORIES OREGON ACCREDITATION
:
OR100028
NR
:
Not Reported
NA: Not Available
LOQ: Limit Of Quantitation
LOD: Limit Of Detection
1 g = 10
-
3
kg = 10
3
mg = 10
6
μg
1 mg/kg = 1 ppm = 1000 ppb
POTENCY PER SERVING PER GRAM REGULATORY ACTION LEVEL
Cannabidiol (CBD) mg/serving mg/g N/A
Total THC (d9-THC, d8-THC, THCA) mg/serving mg/g 3 mg/g
Cannabigerol (CBG) mg/serving mg/g N/A
Cannabinol (CBN) mg/serving mg/g N/A
Cannabichromene (CBC) mg/serving mg/g N/A
Tetrahydrocannabinolic Acid (THCA) mg/serving mg/g N/A
Delta-9-THC (d9-THC) mg/serving mg/g N/A
Delta-8-THC (d8-THC) mg/serving mg/g N/A
HEAVY METALS PER SERVING PER GRAM REGULATORY ACTION LEVEL
Arsenic μg/serving μg/g 10 μg/day
[1]
Cadmium μg/serving μg/g 4.1 μg/day
[1]
Lead μg/serving μg/g 3.5 μg/day
[2]
Mercury μg/serving μg/g 2 μg/day
[1]
PESTICIDES REGULATORY ACTION LEVEL
None of the 59 pesticides tested found above limit of detection in the sample. 10 ppb
[1]
RESIDUAL SOLVENTS
None of the 36 residual solvents tested found above limit of quantitation in the sample.
MICROBIAL PASS/FAIL
Yeast & Mold Pass
Coliform Pass
Water Activity Pass
TERPENES % OF SAMPLE
Farnesene %
ß-Caryophyllene %
a-Bisabolol %
TERPENES % OF SAMPLE
Guaiol %
Humulene %
Caryophyllene Oxide %
1. American Herbal Pharmacopoeia. (2014). Cannabis Inflorescence: Standards of Identity, Analysis, and Quality Control. Washington DC: AHP.
2. US Food and Drug Administration. (2019). Lead in Food, Foodwares, and Dietary Supplements. Washington DC: FDA.US Food and Drug Administration. (2019). Lead in Food, Foodwares, and Dietary Supplements. Washington DC: FDA.
202011
DRYCP50
DA10
50 mg Dry Capsules
0.38 g
55.1
145
0.977
2.57
1.34
3.52
<LOQ
<LOQ
1.10
2.90
<LOQ
<LOQ
0.977
2.57
<LOQ
<LOQ
<LOQ
<LOQ
<LOQ
<LOQ
<LOQ
<LOQ
<LOQ
<LOQ
<LOQ
47.45
10.59
2.46
10.10
4.78
12423 NE Whitaker Way
Portland, OR 97230
503-254-1794
01/22/2021
OR100028
12:29
01/11/21
21-000285/D09.R00
Product identity:
FORM-DA10-DRYCP50
Client/Metrc ID:
.
Customer:
01/11/21
11:20
Sample Date:
21-000285-0007
Laboratory ID:
Etz Hayim Holdings
Summary
Residual Solvents:
All analytes passing and less than LOQ.
Pesticides:
All analytes passing and less than LOQ.
Terpenes:
Analyte
Percent
by weight
Percent
of Total
Analyte
Percent
by weight
Percent
of Total
0.484
ß-Caryophyllene
†
47.45%
0.155
(R)-(+)-Limonene
†
15.20%
0.108
a-Bisabolol
†
10.59%
0.103
Humulene
†
10.10%
0.0943
ß-Myrcene
†
9.25%
0.0488
(-)-caryophyllene oxide
†
4.78%
0.0251
(-)-Guaiol
†
2.46%
1.02
Total Terpenes
†
100.00%
Metals:
Less than LOQ for all analytes.
Page 1 of 13
www.columbialaboratories.com
Test results relate only to the parameters tested and to the samples as received by the laboratory. Test results meet all requirements of NELAP and the Columbia Laboratories quality assurance plan
unless otherwise noted. This report shall not be reproduced, except in full, without the written consent of this laboratory. Samples will be retained for a maximum of 30 days from the receipt date unless
prior arrangements have been made.
Testing in accordance with: OAR 333-007-0410
12423 NE Whitaker Way
Portland, OR 97230
503-254-1794
01/22/2021
OR100028
12:29
01/11/21
21-000285/D09.R00
Customer:
Etz Hayim Holdings
16427 NE Airport Way
PORTLAND 97230
United States
Product identity:
FORM-DA10-DRYCP50
01/11/21
11:20
Sample Date:
21-000285-0007
Laboratory ID:
Client/Metrc ID:
.
Client
Relinquished by:
19.3 °C
Temp:
Sample Results
Solvents
Batch 2100541
Method EPA5021A
Units µg/g
Analyze 01/20/21 09:17 AM
LOQ
Analyte
Result
Limits
Status
Notes
LOQ
Analyte
Result
Limits
Status
Notes
< LOQ
380
pass
1,4-Dioxane
100
< LOQ
5000
pass
2-Butanol
200
< LOQ
160
pass
2-Ethoxyethanol
30.0
< LOQ
2-Methylbutane
200
< LOQ
2-Methylpentane
30.0
< LOQ
5000
pass
2-Propanol (IPA)
200
< LOQ
2,2-Dimethylbutane
30.0
< LOQ
2,2-Dimethylpropane
200
< LOQ
2,3-Dimethylbutane
30.0
< LOQ
3-Methylpentane
30.0
< LOQ
5000
pass
Acetone
200
< LOQ
410
pass
Acetonitrile
100
< LOQ
2.00
pass
Benzene
1.00
< LOQ
5000
pass
Butanes (sum)
400
< LOQ
3880
pass
Cyclohexane
200
< LOQ
Ethanol
†
200
< LOQ
5000
pass
Ethyl acetate
200
< LOQ
Ethyl benzene
200
< LOQ
5000
pass
Ethyl ether
200
< LOQ
620
pass
Ethylene glycol
200
< LOQ
50.0
pass
Ethylene oxide
30.0
< LOQ
290
pass
Hexanes (sum)
150
< LOQ
5000
pass
Isopropyl acetate
200
< LOQ
70.0
pass
Isopropylbenzene
30.0
< LOQ
m,p-Xylene
200
< LOQ
3000
pass
Methanol
200
< LOQ
600
pass
Methylene chloride
200
< LOQ
Methylpropane
200
< LOQ
n-Butane
200
< LOQ
5000
pass
n-Heptane
200
< LOQ
n-Hexane
30.0
< LOQ
n-Pentane
200
< LOQ
o-Xylene
200
< LOQ
5000
pass
Pentanes (sum)
600
< LOQ
5000
pass
Propane
200
< LOQ
720
pass
Tetrahydrofuran
100
< LOQ
890
pass
Toluene
100
< LOQ
Total Xylenes
400
< LOQ
2170
pass
Total Xylenes and Ethyl
600
Page 2 of 13
www.columbialaboratories.com
Test results relate only to the parameters tested and to the samples as received by the laboratory. Test results meet all requirements of NELAP and the Columbia Laboratories quality assurance plan
unless otherwise noted. This report shall not be reproduced, except in full, without the written consent of this laboratory. Samples will be retained for a maximum of 30 days from the receipt date unless
prior arrangements have been made.
Testing in accordance with: OAR 333-007-0400 OAR 333-007-0410
12423 NE Whitaker Way
Portland, OR 97230
503-254-1794
01/22/2021
OR100028
12:29
01/11/21
21-000285/D09.R00
Pesticides
Batch 2100643
Method AOAC 2007.01 & EN 15662 (mod)
Units mg/kg
Analyze 01/22/21 11:34 AM
LOQ
Analyte
Result
Limits
Status
Notes
LOQ
Analyte
Result
Limits
Status
Notes
< LOQ
0.50
pass
Abamectin
0.250
< LOQ
0.40
pass
Acephate
0.250
< LOQ
2.0
pass
Acequinocyl
1.00
< LOQ
0.20
pass
Acetamiprid
0.100
< LOQ
0.40
pass
Aldicarb
0.200
< LOQ
0.20
pass
Azoxystrobin
0.100
< LOQ
0.20
pass
Bifenazate
0.100
< LOQ
0.20
pass
Bifenthrin
0.100
< LOQ
0.40
pass
Boscalid
0.200
< LOQ
0.20
pass
Carbaryl
0.100
< LOQ
0.20
pass
Carbofuran
0.100
< LOQ
0.20
pass
Chlorantraniliprole
0.100
< LOQ
1.0
pass
Chlorfenapyr
0.500
< LOQ
0.20
pass
Chlorpyrifos
0.100
< LOQ
0.20
pass
Clofentezine
0.100
< LOQ
1.0
pass
Cyfluthrin
0.500
< LOQ
1.0
pass
Cypermethrin
0.500
< LOQ
1.0
pass
Daminozide
0.500
< LOQ
0.20
pass
Diazinon
0.100
< LOQ
1.0
pass
Dichlorvos
0.500
< LOQ
0.20
pass
Dimethoate
0.100
< LOQ
0.20
pass
Ethoprophos
0.100
< LOQ
0.40
pass
Etofenprox
0.200
< LOQ
0.20
pass
Etoxazole
0.100
< LOQ
0.20
pass
Fenoxycarb
0.100
< LOQ
0.40
pass
Fenpyroximate
0.200
< LOQ
0.40
pass
Fipronil
0.200
< LOQ
1.0
pass
Flonicamid
0.400
< LOQ
0.40
pass
Fludioxonil
0.200
< LOQ
1.0
pass
Hexythiazox
0.400
< LOQ
0.20
pass
Imazalil
0.100
< LOQ
0.40
pass
Imidacloprid
0.200
< LOQ
0.40
pass
Kresoxim-methyl
0.200
< LOQ
0.20
pass
Malathion
0.100
< LOQ
0.20
pass
Metalaxyl
0.100
< LOQ
0.20
pass
Methiocarb
0.100
< LOQ
0.40
pass
Methomyl
0.200
< LOQ
0.20
pass
MGK-264
0.100
< LOQ
0.20
pass
Myclobutanil
0.100
< LOQ
0.50
pass
Naled
0.250
< LOQ
1.0
pass
Oxamyl
0.500
< LOQ
0.40
pass
Paclobutrazole
0.200
< LOQ
0.20
pass
Parathion-Methyl
0.200
< LOQ
0.20
pass
Permethrin
0.100
< LOQ
0.20
pass
Phosmet
0.100
< LOQ
2.0
pass
Piperonyl butoxide
1.00
< LOQ
0.20
pass
Prallethrin
0.200
< LOQ
0.40
pass
Propiconazole
0.200
< LOQ
0.20
pass
Propoxur
0.100
< LOQ
1.0
pass
Pyrethrin I (total)
0.500
< LOQ
0.20
pass
Pyridaben
0.100
< LOQ
0.20
pass
Spinosad
0.100
< LOQ
0.20
pass
Spiromesifen
0.100
< LOQ
0.20
pass
Spirotetramat
0.100
< LOQ
0.40
pass
Spiroxamine
0.200
< LOQ
0.40
pass
Tebuconazole
0.200
< LOQ
0.20
pass
Thiacloprid
0.100
< LOQ
0.20
pass
Thiamethoxam
0.100
< LOQ
0.20
pass
Trifloxystrobin
0.100
Page 3 of 13
www.columbialaboratories.com
Test results relate only to the parameters tested and to the samples as received by the laboratory. Test results meet all requirements of NELAP and the Columbia Laboratories quality assurance plan
unless otherwise noted. This report shall not be reproduced, except in full, without the written consent of this laboratory. Samples will be retained for a maximum of 30 days from the receipt date unless
prior arrangements have been made.
Testing in accordance with: OAR 333-007-0400 OAR 333-007-0410
12423 NE Whitaker Way
Portland, OR 97230
503-254-1794
01/22/2021
OR100028
12:29
01/11/21
21-000285/D09.R00
Terpenes
Batch 2100554
Method J AOAC 2015 V98-6
Units %
Analyze 01/20/21 09:36 AM
LOQ
Analyte
Result
Notes
% of Total
LOQ
Analyte
Result
Notes
% of Total
0.484
ß-Caryophyllene
†
47.45%
0.020
0.155
(R)-(+)-Limonene
†
15.20%
0.020
0.108
a-Bisabolol
†
10.59%
0.020
0.103
Humulene
†
10.10%
0.020
0.0943
ß-Myrcene
†
9.25%
0.020
0.0488
(-)-caryophyllene oxide
†
4.78%
0.020
0.0251
(-)-Guaiol
†
2.46%
0.020
< LOQ
(-)-a-Terpineol
†
0.00%
0.020
< LOQ
(-)-Isopulegol
†
0.00%
0.020
< LOQ
(-)-ß-Pinene
†
0.00%
0.020
< LOQ
(+)-Borneol
†
0.00%
0.020
< LOQ
(+)-Cedrol
†
0.00%
0.020
< LOQ
(+)-fenchol
†
0.00%
0.020
< LOQ
(+)-Pulegone
†
0.00%
0.020
< LOQ
(±)-Camphor
†
0.00%
0.020
< LOQ
(±)-cis-Nerolidol
†
0.00%
0.020
< LOQ
(±)-fenchone
†
0.00%
0.020
< LOQ
(±)-trans-Nerolidol
†
0.00%
0.020
< LOQ
a-cedrene
†
0.00%
0.020
< LOQ
a-phellandrene
†
0.00%
0.020
< LOQ
a-pinene
†
0.00%
0.020
< LOQ
a-Terpinene
†
0.00%
0.020
< LOQ
Camphene
†
0.00%
0.020
< LOQ
cis-ß-Ocimene
†
0.00%
0.006
< LOQ
d-3-Carene
†
0.00%
0.020
< LOQ
Eucalyptol
†
0.00%
0.020
< LOQ
farnesene
†
0.00%
0.020
< LOQ
gamma-Terpinene
†
0.00%
0.020
< LOQ
Geraniol
†
0.00%
0.020
< LOQ
Geranyl acetate
†
0.00%
0.020
< LOQ
Isoborneol
†
0.00%
0.020
< LOQ
Linalool
†
0.00%
0.020
< LOQ
Menthol
†
0.00%
0.020
< LOQ
nerol
†
0.00%
0.020
< LOQ
p-Cymene
†
0.00%
0.020
< LOQ
Sabinene
†
0.00%
0.020
< LOQ
Sabinene hydrate
†
0.00%
0.020
< LOQ
Terpinolene
†
0.00%
0.020
< LOQ
trans-ß-Ocimene
†
0.00%
0.013
< LOQ
valencene
†
0.00%
0.020
Total Terpenes
1.02
ß-Caryophyllene
(R)-(+)-Limonene
a-Bisabolol
Humulene
ß-Myrcene
(-)-caryophyllene
oxide
(-)-Guaiol
%
Metals
Units
LOQ
Analyze
Notes
Method
Analyte
Batch
Result
Limits
AOAC 2013.06 (mod.)
mg/kg
01/18/21
X
2100499
< LOQ
0.0416
Arsenic
AOAC 2013.06 (mod.)
mg/kg
01/18/21
X
2100499
< LOQ
0.0416
Cadmium
AOAC 2013.06 (mod.)
mg/kg
01/18/21
X
2100499
< LOQ
0.0416
Lead
AOAC 2013.06 (mod.)
mg/kg
01/18/21
X
2100499
< LOQ
0.0208
Mercury
Nutrition
Units
LOQ
Analyze
Notes
Method
Analyte
Batch
Result
Limits
AOAC 978.18
Aw
01/20/21
X
2100578
0.328
0.650
0.030
Water Activity
Page 4 of 13
www.columbialaboratories.com
Test results relate only to the parameters tested and to the samples as received by the laboratory. Test results meet all requirements of NELAP and the Columbia Laboratories quality assurance plan
unless otherwise noted. This report shall not be reproduced, except in full, without the written consent of this laboratory. Samples will be retained for a maximum of 30 days from the receipt date unless
prior arrangements have been made.
Testing in accordance with: OAR 333-007-0400 OAR 333-007-0410
12423 NE Whitaker Way
Portland, OR 97230
503-254-1794
01/22/2021
OR100028
12:29
01/11/21
21-000285/D10.R00
Product identity:
FORM-DA10-DRYCP50
Client/Metrc ID:
.
Customer:
01/11/21
11:20
Sample Date:
21-000285-0006
Laboratory ID:
Etz Hayim Holdings
Summary
Microbiology:
Less than LOQ for all analytes.
Page 1 of 5
www.columbialaboratories.com
Test results relate only to the parameters tested and to the samples as received by the laboratory. Test results meet all requirements of NELAP and the Columbia Laboratories quality assurance plan
unless otherwise noted. This report shall not be reproduced, except in full, without the written consent of this laboratory. Samples will be retained for a maximum of 30 days from the receipt date unless
prior arrangements have been made.
Testing in accordance with: OAR 333-007-0390
12423 NE Whitaker Way
Portland, OR 97230
503-254-1794
01/22/2021
OR100028
12:29
01/11/21
21-000285/D10.R00
Customer:
Etz Hayim Holdings
16427 NE Airport Way
PORTLAND 97230
United States
Product identity:
FORM-DA10-DRYCP50
01/11/21
11:20
Sample Date:
21-000285-0006
Laboratory ID:
Client/Metrc ID:
.
Client
Relinquished by:
19.3 °C
Temp:
Sample Results
Microbiology
Units
LOQ
Analyze
Notes
Method
Analyte
Batch
Result
Limits
AOAC 991.14 (Petrifilm)
cfu/g
01/20/21
X
2100470
< LOQ
10
E.coli
AOAC 991.14 (Petrifilm)
cfu/g
01/20/21
X
2100470
< LOQ
10
Total Coliforms
AOAC 2014.05 (RAPID)
cfu/g
01/20/21
X
2100469
< LOQ
10
Mold (RAPID Petrifilm)
AOAC 2014.05 (RAPID)
cfu/g
01/20/21
X
2100469
< LOQ
10
Yeast (RAPID Petrifilm)
Page 2 of 5
www.columbialaboratories.com
Test results relate only to the parameters tested and to the samples as received by the laboratory. Test results meet all requirements of NELAP and the Columbia Laboratories quality assurance plan
unless otherwise noted. This report shall not be reproduced, except in full, without the written consent of this laboratory. Samples will be retained for a maximum of 30 days from the receipt date unless
prior arrangements have been made.
Testing in accordance with: OAR 333-007-0390
12423 NE Whitaker Way
Portland, OR 97230
503-254-1794
01/15/2021
OR100028
12:29
01/11/21
21-000285/D05.R00
Product identity:
FORM-DA10-DRYCP50 bottom
Client/Metrc ID:
.
Customer:
01/11/21
11:20
Sample Date:
21-000285-0005
Laboratory ID:
Etz Hayim Holdings
Summary
Potency:
Units
Status
Result
Limits
Analyte per 1g
2.90
CBC per 1g
†
mg/1g
145
CBD per 1g
mg/1g
0.501
CBDV per 1g
†
mg/1g
3.52
CBG per 1g
†
mg/1g
0.103
CBL per 1g
†
mg/1g
2.57
∆9-THC per 1g
mg/1g
CBD-Total per 1g
145 mg/1g
THC-Total per 1g
2.57 mg/1g
(Reported in milligrams per serving)
Page 1 of 7
www.columbialaboratories.com
Test results relate only to the parameters tested and to the samples as received by the laboratory. Test results meet all requirements of NELAP and the Columbia Laboratories quality assurance plan
unless otherwise noted. This report shall not be reproduced, except in full, without the written consent of this laboratory. Samples will be retained for a maximum of 30 days from the receipt date unless
prior arrangements have been made.
Testing in accordance with: OAR 333-007-0430
12423 NE Whitaker Way
Portland, OR 97230
503-254-1794
01/15/2021
OR100028
12:29
01/11/21
21-000285/D05.R00
Customer:
Etz Hayim Holdings
16427 NE Airport Way
PORTLAND 97230
United States
Product identity:
FORM-DA10-DRYCP50 bottom
01/11/21
11:20
Sample Date:
21-000285-0005
Laboratory ID:
Client/Metrc ID:
.
Client
Relinquished by:
19.3 °C
Temp:
1 g
Serving Size #1:
Sample Results
Batch: 2100339
Potency per 1g
Method J AOAC 2015 V98-6 (mod)
Analyze: 1/12/21 7:52:00 PM
Units
LOQ
Notes
Analyte
Result
Limits
CBC per 1g
†
mg/1g
0.0328
2.90
CBC-A per 1g
†
mg/1g
0.0328
< LOQ
CBC-Total per 1g
†
mg/1g
0.0616
2.90
CBD per 1g
mg/1g
3.28
145
CBD-A per 1g
mg/1g
0.0328
< LOQ
CBD-Total per 1g
mg/1g
3.31
145
CBDV per 1g
†
mg/1g
0.0328
0.501
CBDV-A per 1g
†
mg/1g
0.0328
< LOQ
CBDV-Total per 1g
†
mg/1g
0.0613
0.501
CBG per 1g
†
mg/1g
0.0328
3.52
CBG-A per 1g
†
mg/1g
0.0328
< LOQ
CBG-Total per 1g
†
mg/1g
0.0613
3.52
CBL per 1g
†
mg/1g
0.0328
0.103
CBN per 1g
mg/1g
0.0328
< LOQ
∆8-THC per 1g
†
mg/1g
0.0328
< LOQ
∆9-THC per 1g
mg/1g
0.0328
2.57
THC-A per 1g
mg/1g
0.0328
< LOQ
THC-Total per 1g
mg/1g
0.0616
2.57
THCV per 1g
†
mg/1g
0.0328
< LOQ
THCV-A per 1g
†
mg/1g
0.0328
< LOQ
THCV-Total per 1g
†
mg/1g
0.0616
< LOQ
Total Cannabinoids 1g
†
mg/1g
155
Page 2 of 7
www.columbialaboratories.com
Test results relate only to the parameters tested and to the samples as received by the laboratory. Test results meet all requirements of NELAP and the Columbia Laboratories quality assurance plan
unless otherwise noted. This report shall not be reproduced, except in full, without the written consent of this laboratory. Samples will be retained for a maximum of 30 days from the receipt date unless
prior arrangements have been made.
Testing in accordance with: OAR 333-007-0430
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Form 3: CONSOLIDATED TEST RESULTS SUMMARY

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Completed 18 April 2022

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