SAQMMA15R0112_SECTION_J _ATTACHMENT_G.docx
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- Operation and Maintenance Support Services at Department of State, New Hampshire facilities
- Solicitation number
- SAQMMA15R0112
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Section J Attachment G Individual Equipment Log for Refrigerant Recovery
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RFP No. SAQMMA15R0112 FACILITY OPERATION AND MAINTENANCE SUPPORT
ATTACHMENT G
INDIVIDUAL EQUIPMENT LOG FOR REFRIGERANT ACCOUNTABILITY
BUILDING NAME:________________________________________
BUILDING NUMBER:________________________
EQUIPMENT NUMBER:____________________________________ MAKE:___________________________________
TYPE OF REFRIGERATION EQUIPMENT:_______________________________________________________
MODEL NUMBER:________________________________________
LEAK TEST:
RESULTS: LEAKS OR NO LEAKS
IF LEAKS, HAVE REPAIRS BEEN IMPLEMENTED? YES OR NO
TYPE OF REFRIGERANT: ___________________________________________
NORMAL REFRIGERANT CHARGE AMOUNT: _______________________________
REFRIGERANT ADDED (LBS/OZS): _____________________________________
REFRIGERANT REMOVED (LBS/OZS): ___________________________________
REASON FOR ADDING OF REMOVING REFRIGERANT: ______________________
WORK AUTHORIZATION NUMBER_____________
DATE ____________
MECHANIC SIGNATURE ____________________
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