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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:
1
2
Days
To be filled by participants
Name of the participant
Age (years)
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
Years
Overall Experience in RAC
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
Years
Year when your enterprise started
Type of RSE
Proprietary
Partnership
Pvt. Ltd.
Designation
Proprietor
Technician
Supervisor
Qualification
Engineering graduate & above
Diploma in Engineering
ITI Pass-out
Pvt. Training Institute Course
Trained on the Job
Name of enterprise
Contacts
(Address of your
service enterprise)
Contacts Address
State
Andaman and Nicobar Islands
Andhra Pradesh
Arunachal Pradesh
Assam
Bihar
Chandigarh
Chattisgarh
Dadra and Nagar Haveli
Daman and Diu
Delhi
Goa
Gujarat
Haryana
Himachal Pradesh
Jammu and Kashmir
Jharkhand
Karnataka
Kerala
Lakshadweep
Madhya Pradesh
Maharashtra
Manipur
Meghalaya
Mizoram
Nagaland
Orissa
Pondicherry
Punjab
Rajasthan
Sikkim
Tamil Nadu
Tripura
Uttarakhand
Uttaranchal
Uttar Pradesh
West Bengal
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?
NO
Yes
If yes: R12, kg/ year
R22, kg/ year
R134a; kg/ year
Equipment you use for service and specify
Single Stage Vacuum pump On Workshop
Single Stage Vacuum pump On Site
Single Stage Vacuum pump On Workshop & On Site
Double Stage Vacuum Pump Workshop
Double Stage Vacuum Pump On Site
Double Stage Vacuum Pump On Workshop & On Site
Is your enterprise member of RAC association?
Yes
No
If yes, specify name of association:
If No would you like to be member of an association?
Yes
No
Are you a Franchisee of any of these manufacturers?
Blue Star
Carrier
Daikin
Godrej
Hitachi
LG
Mitsubishi
Samsung
Voltas
Whirlpool
Any Other (Specify)
Any Other (Specify)
How did you learn about HPMP?
First Information
Dealer
Colleague
Employer
Flier
Other……
Any Other (Specify)
In what language would you like to receive the Newsletter?
English
Hindi
Any Other
Any Other (Specify)