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HCFC PHASE-OUT MANAGEMENT PLAN (HPMP) REFRIGERATION & AIR-CONDITIONING (RAC) SERVICING SECTOR

TRAINEE INFORMATION SHEET (INFORMATION OF TRAINEE AND ENTERPRISE)

ORGANIZER:

Place / Venue of program:

Program dates

Start Date:    

Duration:  Days

To be filled by participants

Name of the participant
Age (years) Years Overall Experience in RAC Years Year when your enterprise started
Type of RSE Designation 

Qualification 

Name of enterprise
Contacts
(Address of your
service enterprise)		 Contacts Address
State
Telephone
Mobile Number
e-mail
Approximate
number of
Equipment
Serviced &
assembled at
your
enterprise
 (Per Year)  		  
Equipment Installed Serviced Assembled
Commercial Appliances
(e.g. Bottle Coolers, Water coolers, Visi coolers etc.)
Air Conditioners (Window)
Air Conditioners (Split)
Equipments using Open Type Compressors
Any other type of equipments (e.g., Chillers) Pl specify
Type of refrigerant used
and quantity per year in
your Enterprise
R22         kg / Year R410A kg / Year
R32         kg / Year R407c kg / Year
HC290   kg /Year R134a kg / Year
Do you recover & recycle (R&R) refrigerants?    If yes: R12, kg/ year   R22, kg/ year R134a; kg/ year
Equipment you use for service and specify
Is your enterprise member of RAC association?      If yes, specify name of association:
If No would you like to be member of an association?     
Are you a Franchisee of any of these manufacturers? Any Other (Specify)
How did you learn about HPMP? Any Other (Specify)
In what language would you like to receive the Newsletter? Any Other (Specify)