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  • California RMP ARB Leak Check Report Form

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    Ines Hoyos
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    This document is a leak inspection and repair reporting form for companies to record information about leak inspections, detections, and repairs of refrigeration systems. The form includes fields to enter the date of service, type of service performed, whether a leak was detected and by which method, amounts of refrigerant added or removed, and the purpose of any refrigerant changes. If a leak is detected, the form has sections to record the dates of initial verification, follow-up verification, and repair, as well as a description of the leak and repair. The document notes that leak inspections are required at least once every 90 days for systems between 200-2000 pounds of refrigerant and annually for systems between 50-200 pounds, unless using

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    Reporte de filtraciones

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    This document is a leak inspection and repair reporting form for companies to record information about leak inspections, detections, and repairs of refrigeration systems. The form includes fields to enter the date of service, type of service performed, whether a leak was detected and by which method, amounts of refrigerant added or removed, and the purpose of any refrigerant changes. If a leak is detected, the form has sections to record the dates of initial verification, follow-up verification, and repair, as well as a description of the leak and repair. The document notes that leak inspections are required at least once every 90 days for systems between 200-2000 pounds of refrigerant and annually for systems between 50-200 pounds, unless using

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    © All Rights Reserved
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    61 views1 page

    California RMP ARB Leak Check Report Form

    Uploaded by

    Ines Hoyos
    This document is a leak inspection and repair reporting form for companies to record information about leak inspections, detections, and repairs of refrigeration systems. The form includes fields to enter the date of service, type of service performed, whether a leak was detected and by which method, amounts of refrigerant added or removed, and the purpose of any refrigerant changes. If a leak is detected, the form has sections to record the dates of initial verification, follow-up verification, and repair, as well as a description of the leak and repair. The document notes that leak inspections are required at least once every 90 days for systems between 200-2000 pounds of refrigerant and annually for systems between 50-200 pounds, unless using

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    © All Rights Reserved
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    R3 Reporting Aid - Leak Inspection and Repair

    Inputinformationat www.arb.ca.gov/rmpͲr3
    *Thisworksheetisforcompanyuseonly.DONOTRETURNTOARB.*
    CompanyName: TechnicianName:
    FacilityName: TechnicianCertificateType:
    TechnicianCertificateNumber:
    SystemID(asreportedinR3):
    LeakDetection AmountRefrigerant AmountRefrigerant PurposeofAddedor
    DateofService TypeofService LeakDetected
    Method Added(lbs) Removed(lbs) RemovedCharge
    LeakInspection Bubbletest InitialCharge
    LeakRepair Yes Leakdetectiondevice Leakrepair
    RoutineService No Electronic/Ultrasonic ToppingOff
    Other_________________ Other_________________ Other_________________

    Ifaleakwasdetected,fillouttheinformationbelow.

    InitialVerification FollowͲupVerification Causeofleak:


    DateLeakDetected DateLeakRepaired
    TestDate TestDate

    Descriptionofleakrepair:

    Continueonbackifnecessary.

    Leakinspectionsmustbeconductedatleastonceevery90daysperRule95385(b)forany
    refrigerationsystemwithanoperatingchargeof200ormorepoundsbutlessthan2000pounds,and
    atleastannuallyforanysystemwithanoperationchargebetween50and200poundsperRule
    95385(c),unlessthesystemismonitoredbyanAutomaticLeakDetectiondevice(ALD).Additional
    requirementsapplytoallhighͲGWPHVAC/Rsystemsincludingleakrepairwithin14days.Complete
    RMPRuleisavailableathttp://arb.ca.gov/rmp

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