EPA Refrigerant Compliance.xlsx

1601 Las Plumas Ave
San Jose, CA 95133-1613
Ph: 408-347-3400
www.therma.com

JOB SITE INFORMATION

JOB NUMBER:
DATE:
JOB SITE NAME:
CONTRACTOR: THERMA LLC
TECHNICIANS NAME:
ADDRESS:

UNIT MAKE/CYL

UNIT MODEL/SIZE
SERIAL
REF WT
TRANSFERRED TO

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I hereby accept performance and charges as being satisfactory and acknowledge that the equipment has been left in good condition. Environmentally harmful refrigerants have been removed in compliance with section 608 of the Clean Air Act. Work has been completed by a Therma LLC location or an independently owned and operated franchise business.
Customer's Signature:
Technician's Signature:
THERMA LLC