Refrigerant Leak Reporting – NEW

Use this report when a refrigerant leak must be documented for review by Carrier Enterprise Technical Support / Customer Assurance.

Important: Program eligibility and approvals are subject to current Carrier/Bryant policy review. Submitting a form does not guarantee approval. The information provided helps Carrier Enterprise Technical Service & Support route, review, and respond to the request.

When to use this report

• A refrigerant leak has been found and must be documented.
• New equipment leak documentation is required.
• Warranty assistance, labor/refrigerant consideration, or Customer Assurance review is requested.
• Leak evidence needs to be submitted from the field.

Key evidence rule

The leak must be positively identified and documented. Electronic detector-only evidence or oil stain photos are not acceptable as final proof.

Required information

• Region and technician contact information.
• Dealer/company name.
• Job name or job site/customer name.
• Model and serial number.
• Product type.
• Leak location.
• Leak verification method.
• Photos/videos showing bubbles or liquid leak detector at the leak point.
• Technician notes.

Start the submission

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 - Step 1 of 5
Use 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!!!
Please watch each of these videos prior to proceeding.
Did you watch both videos?
Yes
No
Do you understand that you must show bubbles in the pictures and videos and that an electronic leak detector is NOT ACCEPTABLE?   
Yes
No
Information
ELECTRONIC LEAK DETECTOR OR PICTURES OF OIL STAINS IS NOT ACCEPTABLE!!!
Please select your region. *--- Select Choice ---Central Plains (ND, SD, NE, KS, IA, MO)Florida (FL)Mid-Atlantic (MD, VA, WV, Washington D.C.)Northeast (NJ, NY)Southeast (NC, SC, TN, MS)South Central/South Texas (TX, OK, AR, LA)Canada
Are you at the jobsite now? *
Yes
No
NextSave and Resume Later
Dealer Information
ELECTRONIC LEAK DETECTOR OR PICTURES OF OIL STAINS IS NOT ACCEPTABLE!!!
Dealer Name *
Dealer Account Number *
Job Name *
Name *
First
Last
Technician's Phone Number
Email *
Service Manager's Email *
Service Manager's Phone # *
PreviousNextSave and Resume Later
Product Information
Application *
Residential
Light Commercial - Office/Retail
Heavy Commercial - Manufacturing/Warehouse
Industrial - Heavy Manufacturing/Printing/Chemical/Other
Equipment Type *
Split System
RTU / Package unit
WSHP / Geothermal
Ductless
VRF
Is the leak in a coil?
Yes
No
Coil Type *
Evaporator
Condenser
Reheat
Coaxial Heat Exchanger
Coil Design/Material *
RTPF - Copper ..... Copper tube/aluminum fin
FTPF - Aluminum ..... Aluminum tube/aluminum fin
MCHX ..... Micro-channel heat exchanger
Cupro-Nickel coaxial heat exchanger
Copper coaxial heat exchanger
Coil Coating *
No Coating
Factory coating
Third party coating
Location - Any environmental concerns? *
Yes
No
PreviousNextSave and Resume Later
Equipment Information
Model Number *
Serial Number *
Installation / Start-up Date *
Is this a DOA Leak? *
Yes
No
Found less than 30 days from startup?
Is the equipment operational now? *
Yes
No
Equipment information/history
Provide any pertinent history for this unit. Repairs, failures, issues, etc.
Answer each question about this leak
Was a leak test performed? *
Yes
No
Was the leak identified? (Pictures required with bubbles) *
Yes
No
Is the leak repairable? *
Yes
No
Leak Type *
Solder Joint
Puncture
Tube failure/crack
Leak Location
Leak Location *
U-bend
In fin pack
At tube sheet
Distributor / header
Factory piping
Coaxial heat exchanger
Compressor Shell
BPHX (Braze plate heat exchanger)
Leak's possible cause? *
Operating vibration
Operating rub (metal, tubes, wires, etc)
At tube sheet
Manufacturing workmanship
Environmental corrosion
Shipping
Description 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.
PreviousNextSave and Resume Later
VIDEOS & PHOTOS
SUBMITTING VIDEOS/PHOTOS
In 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) *

	

		

		
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					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 leak
Approve a Replacement Unit
Once the CAM Team/Technical Support has had an opportunity to evaluate the supplied information we will reach out to you with next steps.
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