Attachment 0016 TE 1.10-01 -- Refrigeration Removal Certifications.pdf
PDF 262 KB Posted
- Attached to
- RIA HVAC Services
- Solicitation number
- W519TC-24-R-2015
About this file
This document is a Technical Exhibit, TE 1.10-01, which provides a Refrigerant Removal Certification in compliance with the Clean Air Act Amendments of 1990, Section 608. The certification is required to be filled out by a certified technician when removing refrigerant from an item, and must include the technician's name, the service organization/company, address, date of removal, and a description of the item from which the refrigerant was removed. The certification must be retained with the turn-in document (DTID) for 3 years.
The related federal contract opportunity is Solicitation Number W519TC-24-R-2015 for RIA HVAC Services, issued by the Department of the Army Materiel Command Contracting Command Rock Island Arsenal. The solicitation requests proposals for HVAC&R systems maintenance and repair services on the Rock Island Arsenal in Rock Island, IL.
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Text version
Technical Exhibit, TE 1.10-01
REFRIGERANT REMOVAL CERTIFICATION
IN COMPLIANCE WITH THE REQUIREMENTS OF THE CLEAN AIR ACT
AMMENDMENTS OF 1990, SECTION 608, I CERTIFY THAT THE
REFRIGERANT HAS BEEN RECOVERED FROM THIS ITEM IN
ACCORDANCE WITH USEPA REGULATIONS AT 40 FR 82.156 (f), (g), and (h)
NAME: ____________________________________________________
(Required by regulation)(Certified Technician recovering refrigerant)
NAME: ____________________________________________________
(Required by regulation)(Service Organization or Company)
ADDRESS: _________________________________________________
(Required by regulation)(Company)
CITY: ___________________________ STATE: _____ ZIP: ________
(Required by regulation)
DATE REFRIGERANT REMOVED: ______________________________
(Required by regulation)
SIGNATURE OF TECHNICIAN: _________________________________
(Required by regulation)
ITEM DESCRIPTION (name, model no, serial no, RIA no, bar code, etc, so that certificate can be matched to the equipment: ___________________
TURN-IN DOCUMENT NO (DTID): ______________________________
NOTE: Retain copy of certificate with the DTID for 3 years.
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