SVC Chiller PM Repair Tech Exhibit 2 10062020.pdf

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Preventive Maintenance and Repair Services for Chiller Systems
Solicitation number
W912CN-21-R-0004
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DPW, Environmental Clean Air Program. CAA Section 608: National Recycling and Emission Reduction Act

PREVENTATIVE MAINTENANCE, REPAIRS OF CHILLER, COOLING TOWER, AND HEAT

PUMP SYSTEMS

II. AIR CONDITIONING/REFRIGERATION SERVICE REPORT & LEAK RATE CALCULATION

1. Appliance Type: _ 2. Comfort Cooling System ______ or

3. Building #: _________ Commercial (cold storage) System _____

4. Location of Appliance: _____________________ 5. Installation: ____________________

6. Make: __________________________________ 7. Model: ________________________

8. Serial # _________________________________ 9. Manufacturer: ___________________

10. Refrigerant Type: ________________________ 11. Refrigerant Charge: ____________lbs

Date Name of Technician

Type of Service (maintenance, repair, initial or follow –up verification test, etc.)

Lbs of Refrigerant Added

Calculate Leak Rate for equip containing >50lbs (*use formula below)

Does leak rate trigger a repair (*yes or no)?

*How to Calculate Leak Rate Step 1. Take the sum of the quantity of refrigerant added to the appliance over the previous 365‐day period (or since last repaired if less than one year) Step 2. Divide the result of Step 1 by the quantity of refrigerant the appliance normally contains at full charge Step 3. Multiply the result of Step 2 by 100 to obtain a percentage.

lbs of refrigerant added over 365 days Leak rate = (or since last leaks were repaired) X 100%

(% per year) lbs of refrigerant in full

Maximum Allowable Leak Rates

ODS AC&R System Leak Rate

Commercial 20%

Comfort Cooling 10%

*If leak rate is over allowable rate, please fill out Form III. Regulatory Timeline and Checklist and notify DPW Environmental Clean Air Program @ 808-656-3104 or 808-656-3316 or by email kimberly.c.decaprio.civ@mail.mil or dustin.c.phommanivong.civ@mail.mil

DPW, Environmental Clean Air Program. CAA Section 608: National Recycling and Emission Reduction Act

II. AIR CONDITIONING/REFRIGERATION SERVICE REPORT & LEAK RATE CALCULATION

Date Name of Technician

Type of Service (maintenance, repair, verification test, etc.)

Lbs of Refrigerant Added

Calculate Leak Rate for equip containing >50lbs (*use formula below)

Does leak rate trigger a repair (*yes or no)?

*How to Calculate Leak Rate Step 1. Take the sum of the quantity of refrigerant added to the appliance over the previous 365‐day period (or since last repaired if less than one year) Step 2. Divide the result of Step 1 by the quantity of refrigerant the appliance normally contains at full charge Step 3. Multiply the result of Step 2 by 100 to obtain a percentage.

lbs of refrigerant added over 365 days Leak rate = (or since last leaks were repaired) X 100%

(% per year) lbs of refrigerant in full

Maximum Allowable Leak Rates

ODS AC&R System Leak Rate

Commercial 20%

Comfort Cooling 10%

*If leak rate is over allowable rate, please fill out Form III. Regulatory Timeline and Checklist and notify DPW Environmental Clean Air Program @ 808-656-3104 or 808-656-3316 or by email kimberly.c.decaprio.civ@mail.mil or dustin.c.phommanivong.civ@mail.mil

Make: _____________________ Model: _____________________ Serial: _____________________

1 Appliance Type:
3 Building:
4 Location of Appliance:
5 Installation:
6 Make:
7 Model:
8 Serial:
9 Manufacturer:
10 Refrigerant Type:
11 Refrigerant Charge:
DateRow1:
Name of TechnicianRow1:
Type of Service maintenance repair initial or follow up verification test etcRow1:
Lbs of Refrigerant AddedRow1:
Calculate Leak Rate for equip containing 50lbs use formula belowRow1:
Does leak rate trigger a repair yes or noRow1:
DateRow2:
Name of TechnicianRow2:
Type of Service maintenance repair initial or follow up verification test etcRow2:
Lbs of Refrigerant AddedRow2:
Calculate Leak Rate for equip containing 50lbs use formula belowRow2:
Does leak rate trigger a repair yes or noRow2:
DateRow3:
Name of TechnicianRow3:
Type of Service maintenance repair initial or follow up verification test etcRow3:
Lbs of Refrigerant AddedRow3:
Calculate Leak Rate for equip containing 50lbs use formula belowRow3:
Does leak rate trigger a repair yes or noRow3:
Leak Rate:
Commercial:
20:
Comfort Cooling:
10:
Make:
Model:
Serial:
DateRow1_2:
Name of TechnicianRow1_2:
Type of Service maintenance repair verification test etcRow1:
Lbs of Refrigerant AddedRow1_2:
Calculate Leak Rate for equip containing 50lbs use formula belowRow1_2:
Does leak rate trigger a repair yes or noRow1_2:
DateRow2_2:
Name of TechnicianRow2_2:
Type of Service maintenance repair verification test etcRow2:
Lbs of Refrigerant AddedRow2_2:
Calculate Leak Rate for equip containing 50lbs use formula belowRow2_2:
Does leak rate trigger a repair yes or noRow2_2:
DateRow3_2:
Name of TechnicianRow3_2:
Type of Service maintenance repair verification test etcRow3:
Lbs of Refrigerant AddedRow3_2:
Calculate Leak Rate for equip containing 50lbs use formula belowRow3_2:
Does leak rate trigger a repair yes or noRow3_2:
DateRow4:
Name of TechnicianRow4:
Type of Service maintenance repair verification test etcRow4:
Lbs of Refrigerant AddedRow4:
Calculate Leak Rate for equip containing 50lbs use formula belowRow4:
Does leak rate trigger a repair yes or noRow4:
DateRow5:
Name of TechnicianRow5:
Type of Service maintenance repair verification test etcRow5:
Lbs of Refrigerant AddedRow5:
Calculate Leak Rate for equip containing 50lbs use formula belowRow5:
Does leak rate trigger a repair yes or noRow5:
DateRow6:
Name of TechnicianRow6:
Type of Service maintenance repair verification test etcRow6:
Lbs of Refrigerant AddedRow6:
Calculate Leak Rate for equip containing 50lbs use formula belowRow6:
Does leak rate trigger a repair yes or noRow6:
DateRow7:
Name of TechnicianRow7:
Type of Service maintenance repair verification test etcRow7:
Lbs of Refrigerant AddedRow7:
Calculate Leak Rate for equip containing 50lbs use formula belowRow7:
Does leak rate trigger a repair yes or noRow7:
DateRow8:
Name of TechnicianRow8:
Type of Service maintenance repair verification test etcRow8:
Lbs of Refrigerant AddedRow8:
Calculate Leak Rate for equip containing 50lbs use formula belowRow8:
Does leak rate trigger a repair yes or noRow8:
Leak Rate_2:
Commercial_2:
20_2:
Comfort Cooling_2:
10_2:
Check Box1: Off
Check Box2: Off

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