New Leak Record
Key:
RequiredMust be completed
OptionalSituational — complete if applicable
Site & Unit Info
RequiredRefrigerant Info
Required
? Refrigerant Recovered and Refrigerant Added are locked to —. Clear the Refrigerant Type selection to unlock.
Special Circumstances
Optional — check all that apply
? The EPA tracks each circuit as a separate appliance. If disposing multiple circuits, check the box above to handle all circuits in one record.
?
Each circuit will be recorded as a separate EPA appliance disposal and archived individually. Recovery data above applies to this circuit. Add refrigerant data for each additional circuit in the replacement section below.
Replacement Unit Info
Circuit Info
?? Each circuit listed will be added to the site equipment list as a separate EPA appliance and the disposed circuits will be archived.
?
Recovery required for unit disposal. EPA Section 608 requires all refrigerant to be recovered before disposing of equipment. Please log recovery above or select a reason if the unit was empty.
? Refrigerant Recovered is locked to the old refrigerant and Refrigerant Added is locked to the new refrigerant.
Refrigerant Recovered?
RequiredLog recovery for each circuit separately — the EPA records each circuit as an individual appliance.
Refrigerant Added?
RequiredCalendar Year Leakage (Jan 1 – Dec 31)
YTD Net Loss
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YTD Rate
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To Chronic Leaker (125%)
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