LDAR Repair Report
Report and document repairs completed as part of Leak Detection and Repair (LDAR) activities.
Site/Facility Name
*
Location (Area/Unit)
*
Equipment or Component ID
*
Component Type
*
Please Select
Valve
Pump
Flange
Compressor
Connector
Other
Leak Description
*
Date Leak Detected
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Repair Action Taken
*
Repair Completion Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Was the repair successful?
*
Yes
No, further action needed
Name of Person Completing Repair
*
First Name
Last Name
Additional Comments (optional)
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