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Possible Defective Material
Company Name
(Required)
Email
(Required)
Phone
(Required)
Pickup Address
(Required)
Street Address (Required)
Address Line 2
City (Required)
State / Province / Region (Required)
ZIP / Postal Code (Required)
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
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Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
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El Salvador
Equatorial Guinea
Eritrea
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Eswatini
Ethiopia
Falkland Islands
Faroe Islands
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Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
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Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
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Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
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Jordan
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Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
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Lao People's Democratic Republic
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Liberia
Libya
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Lithuania
Luxembourg
Macao
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Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
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Niger
Nigeria
Niue
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North Macedonia
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Palestine, State of
Panama
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Paraguay
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Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
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Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
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United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Pickup Hours (Open-Close)
(Required)
Please list the hours of operation for your warehouse
Name
(Required)
First Name (Required)
Last Name (Required)
Title
(Required)
Refrigerant
(Required)
R11
R12
R13
R13B1
R14
R22
R23
R113
R114
R116
R123
R124
R125
R134a
R236fa
R245fa
R401A
R401B
R402A
R402B
R404A
R407A
R407C
R407F
R408A
R409A
R410A
R416A
R417A
R421A
R422A
R422B
R422D
R427A
R438A
R448A
R449A
R450A
R452A
R500
R502
R503
R507
R508B
R513A
R514A
R515B
R1233zd
R1234yf
R1234ze
SF6
Other
To select multiple, hold down CTRL
Cylinder Size R-11
100
200
1000
Cylinder Size R-12
30
50
145
1000
Cylinder Size R-13
9
20
23
Cylinder Size R-13B1
10
80
150
1000
Cylinder Size R-14
5
10
24
70
Cylinder Size R-22
10
15
30
50
125
1000
1750
Cylinder Size R-23
5
9
20
70
Cylinder Size R-113
100
200
Cylinder Size R-114
30
150
1000
Cylinder Size R-116
95
Cylinder Size R-123
100
200
1000
Cylinder Size R-124
30
145
Cylinder Size R-125
100
790
Cylinder Size R-134a
30
125
1000
1750
Cylinder Size R-236fa
145
150
1000
Cylinder Size R-245fa
30
100
1000
Cylinder Size R-401A
30
125
Cylinder Size R-401B
30
125
1700
Cylinder Size R-402A
110
Cylinder Size R-402B
13
Cylinder Size R-404A
24
100
800
1300
Cylinder Size R-407A
25#
115#
Cylinder Size R-407C
25
29
115
950
1550
Cylinder Size R-407F
25
115
Cylinder Size R-408A
24
100
Cylinder Size R-409A
30
125
Cylinder Size R-410A
25
100
850
1350
Cylinder Size R-416A
25
125
Cylinder Size R-417A
25
110
Cylinder Size R-421A
25
110
Cylinder Size R-422A
24
Cylinder Size R-422B
25
Cylinder Size R-422D
25
110
Cylinder Size R-427A
25
110
Cylinder Size R-438A
25
110
1550
Cylinder Size R-448A
25
100
850
Cylinder Size R-449A
25
100
110
900
1450
Cylinder Size R-450A
25
110
Cylinder Size R-452A
25
110
Cylinder Size R-500
30
50
125
1000
1400
1750
Cylinder Size R-502
30
50
125
Cylinder Size R-503
9
20
70
Cylinder Size R-507
25
100
800
Cylinder Size R-508B
10
20
70
Cylinder Size R-513A
25
110
125
850
1450
Cylinder Size R-514A
100
200
Cylinder Size R-515B
100
Cylinder Size R-1233zd
10
100
Cylinder Size R-1234yf
10
25
100
Cylinder Size R-1234ze
10
20
110
Cylinder Size SF6
38
110
115
Other: Refrigerant Type
Other: Cylinder Size
Quantity of Defective Cylinders
(Required)
Please list breakdown by refrigerant ex. 2 (R-410A), 3 (R-22), etc.
Brand Name
(Required)
If multiple, please specify. If unknown, list N/A
Cylinder Batch # (if multiple, please specify)
(Required)
Batch Number located on the top of the box
Date Product Received
(Required)
MM slash DD slash YYYY
USA Refrigerants Invoice Number
(Required)
Customer Purchase Order
(Required)
Type of Defect
(Required)
Empty (please submit photo of the cylinder on a scale)
Partial
Defective System
Defective Valve/Handle
Out of Spec (must supply lab report)
Leaking
Other
To select multiple, hold down CTRL
Other Defect
Is Valve/Drum Sealed?
(Required)
Yes
No
Please submit a photo of the cylinder on a scale, showing that the seal is still intact
File Upload
Accepted file types: jpg, gif, png, pdf, Max. file size: 300 MB.
Empty Cylinder File Upload
Accepted file types: jpg, gif, png, pdf, Max. file size: 300 MB.
Comments
Warranty: All products, other items of sale, cylinders and other containers furnished by USA Refrigerants are warranted for one (1) year from the date of sale to conform to the description thereof published by the manufacturer at the time of sale, and all gas products will meet Seller’s purity specifications.
SELLER SPECIFICALLY DISCLAIMS ANY OTHER EXPRESS OR IMPLIED STANDARDS, GUARANTEES, OR WARRANTIES, INCLUDING ANY WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE OR NON-INFRINGEMENT AND ANY WARRANTIES THAT MAY BE ALLEGED TO ARISE AS A RESULT OF CUSTOM OR USAGE.
Warranty Policy
By checking this box, you confirm that you have read and agreed to our warranty policy