Attachment_0017_--_Tech_Exhibit_1.5_--_Refrigeration_Removal_Certifications.pdf

Technical Exhibit, TE 2.4

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.