This document references forms for use by Contractors and others performing EPA section 608 related service work at the University of Michigan.
The forms are as follows:
- Change-Add-Delete Form
This form ties the equipment to our FMS (Facilities Management System) asset database. It also connects the unit to our Refrigerant Compliance Database. This form must be filled out:
a. When removing equipment from service
b. When adding new equipment or replacing old equipmentNote: this applies to all equipment, not only Refrigerant containing appliances
- U-M HVAC RCM Contractor Input Form
This form provides information required for our compliance records to validate that technicians performing work on RCA’s (refrigerant containing appliances) are properly certified per EPA section 608 requirements. A photocopy of the technician’s card is requested, at a minimum the information that would appear on the card must be provided, including:
a. Statement that the technician “has been certified as a [Type, i.e., Type I, Type II, Universal, etc] technician as required by 40 CFR Part 82, Subpart F”
b. Date of certification
c. Certification ID#
d. Name of Technician
- U-M HVAC Refrigerant Equipment Input Form
This form provides the RCA information needed for our RCM (Refrigerant Compliance Management) database.
This form should be submitted for demo’ed equipment as well as for new equipment.
- RCMS Service Order Form
This form provides the service activity information needed for our RCM database. The data appearing on the form will depend on the work performed.
- For new equipment, or for equipment being demolished, this form should be accompanied by a Refrigerant Equipment Input Form.
- At a minimum all refrigerant transfers and additions are required.
- Leak checks and followup verifications, if performed, must be documented.
- Contractors will use their own recovery equipment and may use U-M or other recovery cylinders. For non-U-M equipment, record the the identifying numbers and codes used according to the contractor’s internal business and compliance practices.
- Contractors performing work on RCA’s will have forms and documentation of their own for their company’s internal records. Supply copies of such documentation attached to the Service Order Form.
- Refrigerant used by U-M HVAC staff is tagged with identifying numbers by our procurement department. Contractors not using refrigerant procured through this channel must indicate the source of the refrigerant, quantities used, refrigerant type, etc. Contractors may be requested to supply copies of invoices, bills of lading, and/or other documentation to establish a satisfactory chain of custody for U-M compliance records.
- Contractor Refrigerant Acquisition and Disposal Form
Contractors must comply with Section 608 requirements regarding venting and disposal of refrigerant. Contractors may or may not, depending upon project specifications, be required to remove, and arrange for disposal of, refrigerants from RCA’s. This form parallels the Service Order Form to specify the information we need to assure that refrigerant not acquired and disposed of by us is handled correctly.
Completed forms may be submitted:
- To your U-M project manager. Please specify that copies are to be transmitted to:U-M Mechanical Systems Program Manager (Craig Butcher)
Maintenance Auxiliaries and Central Shops
326 E Hoover
Ann Arbor, MI 48109-1002
- Forms may be emailed as scans to:firstname.lastname@example.org
- Forms may be faxed to:734-936-3458
Thank you for your cooperation and assistance.
U-M Mechanical Systems Program Manager