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Run: EPA 608 Technician Certification Roster

Track each refrigerant technician’s EPA 608 certification details, proof-of-certification file location, and roster attestation in one place for easier AIM A...

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Technician Identification

Technician full name (required)

Employee ID

Optional if your company uses an internal employee identifier for roster matching.

Primary work location

Optional location or site assignment for internal roster management.

EPA 608 Certification Details

Certification type (required)

Certifying organization (required)

Name of the certifying organization or approved certifier shown on the credential.

Certification ID number (required)

Enter the credential or certificate number exactly as shown on the certification record.

Certification issue date

Optional if your organization tracks issue dates for internal compliance review.

Certification expiration date

Use only if the certifying organization issues an expiration date or your internal policy requires it.

Proof of Certification and Recordkeeping

Proof-of-certification location (required)

Enter the file path, document management link, or physical record location where proof is stored.

Upload proof of certification

Optional upload of the certification card, certificate, or other proof-of-certification document.

Roster notes

Use for internal compliance notes, such as restricted work scope, renewal reminders, or audit follow-up.

Attestation and Consent

I confirm the information provided is accurate to the best of my knowledge. (required)

Yes No N/A

I consent to my certification information being stored and used for compliance recordkeeping, internal audits, and regulatory verification. (required)

This form collects limited PII for compliance purposes only and should be retained according to company policy and applicable law.

Yes No N/A

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Email (required)

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