Refrigerant Leak Reporting – Form Please enable JavaScript in your browser to complete this form. – Step 1 of 5Use this form to report a refrigerant leak. This is mandatory for new equipment or for labor and/or material concession requests. A minimum of 1 video and 1 photo is required and MUST SHOW BUBBLES.ELECTRONIC LEAK DETECTOR OR PICTURES OF OIL STAINS IS NOT ACCEPTABLE!!! ELECTRONIC LEAK DETECTOR OR PICTURES OF OIL STAINS IS NOT ACCEPTABLE!!!Please watch each of these videos prior to proceeding.Did you watch both videos?YesNoDo you understand that you must show bubbles in the pictures and videos and that an electronic leak detector is NOT ACCEPTABLE? YesNoInformationELECTRONIC LEAK DETECTOR OR PICTURES OF OIL STAINS IS NOT ACCEPTABLE!!!If working with a Technical Support Representative please select below. If not select none.NONETechnical SupportCraig DutyRobert RocheCarey GoetzFrank SposetoAre you at the jobsite now? *YesNoNextDealer InformationELECTRONIC LEAK DETECTOR OR PICTURES OF OIL STAINS IS NOT ACCEPTABLE!!!Dealer Name *Dealer Account Number *Name *FirstLastTechnician's Phone NumberEmail *Service Manager's Email *Service Manager's Phone # *PreviousNextProduct InformationApplication *ResidentialLight Commercial – Office/RetailHeavy Commercial – Manufacturing/WarehouseIndustrial – Heavy Manufacturing/Printing/Chemical/OtherEquipment Type *Split SystemRTU / Package unitWSHP / GeothermalDuctlessVRFCoil Type *EvaporatorCondenserReheatCoaxial Heat ExchangerCoil Design/Material *RTPF – Copper ….. Copper tube/aluminum finFTPF – Aluminum ….. Aluminum tube/aluminum finMCHX ….. Micro-channel heat exchangerCupro-Nickel coaxial heat exchangerCopper coaxial heat exchangerCoil Coating *No CoatingFactory coatingThird party coatingLocation – Any environmental concerns? *YesNoPreviousNextEquipment InformationModel Number *Serial Number *Installation / Start-up Date *Is this a DOA Leak? *YesNoFound less than 30 days from startup?Is the equipment operational now? *YesNoEquipment information/historyProvide any pertinent history for this unit. Repairs, failures, issues, etc.Answer each question about this leakWas a leak test performed? *YesNoWas the leak identified? (video required with bubbles) *YesNoIs the leak repairable? *YesNoLeak Type *Solder JointPunctureTube failure/crackLeak LocationLeak Location *U-bendIn fin packAt tube sheetDistributor / headerFactory pipingCoaxial heat exchangerCompressor ShellBPHX (Braze plate heat exchanger)Leak's possible cause? *Operating vibrationOperating rub (metal, tubes, wires, etc)At tube sheetManufacturing workmanshipEnvironmental corrosionShippingDescription of the leak and its location. *Description should be a compliment to videos and/or photos required to be submitted to TS following this form.PreviousNextVIDEOS & PHOTOSSUBMITTING VIDEOS/PHOTOSIn one or more videos, you should first show the general location of the leak within the unit, followed by a closer look at the leak using liquid leak detector or soap bubbles. The videos can be made with your mobile device’s camera or uploaded from its memory.Leak Videos/pictures (add up to 4 files) * Drag & Drop Files, Choose Files to Upload You can upload up to 4 files. Thank you for your assistance reporting the refrigerant leak!!!What is being requested? Labor/material assistance for repairing a repairable leakApprove a Replacement UnitOnce the CAM Team/Technical Support has had an opportunity to evaluate the supplied information we will reach out to you with next steps.Submit