Chiller City Online Refrigerant Purchase Certification

	Chiller City Corporation
	563 West 3rd Ave.
	Mesa, AZ 85210-1246 USA
	Toll-Free: 877-244-5501
	Voice: 480-889-1092
	Fax: 602-532-7545

[ Para Español, Haga Clic Aquí ] Refrigerant Purchase Certification

Certify Eligibility to Purchase Refrigerant:

EPA Section 608 states the following:

Wholesalers that sell refrigerant for resale are legally responsible for ensuring that their customers fit into one of the categories of allowed purchasers under the sales restriction. Although the regulation does not specify precautions that wholesalers must take to verify the intent of individuals purchasing refrigerant, EPA recommends that wholesalers obtain a signed statement from the purchaser indicating that he or she is purchasing the refrigerant only for eventual resale to certified technicians. You can learn more by clicking here.

[ PDF and Web Printable Versions Available Here ]

Certification:

First Name:

Last Name:

Company Name (optional):

Street Address:

City:

State:

Zip:

Ebay Username:

E-Mail Address:

Contact Phone:

Contact Fax (optional):

Additional information

By checking this I certify that all the information above is true to the best of my knowledge.

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