Refrigerant Section 609 Certification Verification Log

Counter log for retail refrigerant sales to verify and record purchaser EPA Section 609 certification status before dispensing small cans of refrigerant (≤2 lbs) containing ozone-depleting or substitute substances, per 40 CFR Part 82 Subpart F.

Transaction Details

• Date of Sale
  Date the refrigerant was sold or dispensed at the counter.
• Time of Sale
  Approximate time of the counter transaction.
• Store / Location Name
  Retail location where the sale occurred.
• Transaction / Receipt Number
  Optional POS receipt or invoice number for cross-reference.

Purchaser Information

• Purchaser Full Name
  Name as it appears on the certification card or government-issued ID.
• Business / Employer Name
  Name of the shop or employer the purchaser represents, if applicable.
• Purchaser Phone Number
  Optional contact number for follow-up if a discrepancy is identified.
• Government-Issued ID Type Presented
  Type of photo ID used to confirm purchaser identity.
• Last 4 Characters of ID Number
  Record only the last 4 characters of the ID number — do not record the full ID number.

EPA Section 609 Certification Verification

• Was a valid EPA Section 609 certification card presented?
• Certifying Organization Name
  Name of the EPA-approved organization that issued the Section 609 certification.
• Certification Card Number
  Record the certification number exactly as printed on the card.
• Certification Expiration Date (if shown)
  Note: EPA Section 609 certifications do not expire, but some organizations issue cards with dates. Record if present.
• Certification Type / Scope
  Select all certification categories listed on the card, if specified.
• Reason Sale Was Refused
  Required if certification was not verified. Document the reason for refusal for your records.
• Exemption Basis
  Describe the specific regulatory basis for the exemption under 40 CFR Part 82 Subpart F.

Refrigerant Product Details

• Refrigerant Type / Designation
  Select the ASHRAE refrigerant designation of the product sold.
• Product Brand / Trade Name
  Commercial brand name as labeled on the container.
• Container Size (oz)
  Net weight of refrigerant per container in ounces. Containers ≤2 lbs (32 oz) trigger Section 609 verification requirements.
• Number of Containers Sold
  Total number of containers sold in this transaction.
• UPC / SKU
  Product UPC or internal SKU for inventory cross-reference.

Staff Attestation

• Staff Member Name
  Name of the employee who conducted the verification and completed this log.
• Employee ID / Badge Number
  Optional employee identifier for internal audit trail.
• Staff Attestation
  Check to confirm your attestation before submitting.
• Additional Notes
  Use this field to document unusual circumstances, unreadable cards, verbal certifications pending written proof, or any other relevant detail.