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. ~~"~r ,. ^. MARION COUNTY REFRIGERANT HANDLING ~~ ~ FACILITIES MANAGEMENT REPORT ' WORK ORDER #: ~ ` SERVICE ENGINEER: ~L ~~/ ~ ~ JOB: .~~~ ~DGl~ _ ,~t°~I19~ ~ 1 ~! D ~ LOCATION: J~1tY' n 9~ ~ ~ ~ _ -~. MODEL #: ~ Q ~ p ~{ ~' ~ (~ ~ EQUIPMENT ID #• ~ e jyc~, ~t7 E(feo +~ SERIAL #: 9c~jp 1 SG Yq fi' LEAK IDENTIFICATION/REPAIR REPORT LEAK LOCATION: FACTORY REFRIGERANT CHARGE: REFRIGERANTS TYPE: ESTIMATED ANNUAL LEAK RATE: ` ~ REPAIRED: ~~ ~ :;, ~ :- ,~~~ ,~ ~ ~~ ~~~• REFRIGERANT USE REPORT REFRIGERANT TYPE: ~~ SOURCE: '~~ AMOU(1tT USED/DELIVERED: ~,: GOMMENTS: - , .st ~. ,:; U141NTENTIONAL VENTING REPORT , ~~ ~ :r~ ~~REFRIGERANT TYPE: ~.~'~'~" t SITUATION (SEE WORK ORDER)• ~:' SUPERVISOR NOTIFIED: ~~. ~ _ , _ _ _ _ _ _ . _ _ ~ >; ~ Y~._. . _ , ° "=~.PERSONS IN AREA DURING INCIDENT: - APPROX. AMOUNT VENTED: Y_ . ~ _ :~ - . ~ . ' ~ 1 `j a ,... . . WORK COMPLETED: . . . ' _ . . ~.~ .~.: . . + Y r^ . ~ _ SERVICE ENGINEER: . . , ... ~ ~.;.. . SIGNATURE r E, . ~ ~ G ~ ~ ~ ~ ,h~ '~ .~• ,~ ~ ~~ ~ - -~y ~,~~ :, '~ '~ ~ ~~ . ~ Y : ,~Y `.,~ " ~a., . ` t ~~~ ~ ~ik . ~ • . ~ . . . - F~ "~' _ ~1± RY ~ y ~ ~ . ~ ~] . Y ~y~~~j~~ ' ~ ~ . ~ .. -'x ,.~_Ir. . i S . , . " ~~ . .. N.._.. ~ . RECOVERY REPORT _ REFRIGERANT TYPE: f~ ~ ~ ~ ` '`EQUIPMENT USED: AMOUNT RECOVERED: [~ ~ o RE-WSTALLED: -~q.. , " ;; t` COMMENTS:` < .;