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} 4 <br /> � Northiand Mechanical Contractors. Inc. �ate Job No. Orsat Test Record <br /> 9001 Science Center Drive �`�-��O� 0�"� 3�� <br /> _ New �iope, iVlf�l 55428 Tester's Na ic�e f�jo�� j� <br /> treet Address Apt. loor ity Zip ode <br /> 3333 S��r , 3 v� o,�'m�r� 5�3 <br /> Occu t Owner Phone <br /> ��S Q, �. � . � ���,� c 9�� � a7 3��3 <br /> Heat Loss Date Htg.Inst. old B Installed Ele ' I ork By <br /> �-�� <br /> � \ <br /> Gas Line By Type of Heat <br /> �` �GA Q FA �HW Q Steam Q Space Heater �'�Jnit Heater �Other <br /> Make ��,, �„�-(��-y��; del erial No. Input <br /> ' `'Y�o���. � =,`4 � 5 -�� 1 �lloll ��3-- 3$( �S ��� <br /> Make of Burner odel Max.BTU Rating Make of Furnace Model <br /> • • �� .�, ,! _ ,—� <br /> Thermos�at Heat Plug Valve Limit �� �p� Limit Setting <br /> ��` �- °���V� — �1J�t'R-Y�"��� �� ��Q°-� <br /> � �� Fan Se ing Pilot Type . Pilo Make Pilot Model Pilot Timing L.W.Cut Off <br /> S�G�.�r`s �i� �JY�yw��) — � —a'> <br /> Vent Size i� Kind o Liner ize Dra Hood Regulator <br /> � None ,�� 3,LS-3 YY`�C.T.�! <br /> Filters Size Number Chimney Location Chimne Construction <br /> � . � Inside Outside �'�� <br /> Smoke Bomb Wiring Draft Test Tag Door Pressure Lighting Inst. <br /> � �� �� � � �� <br /> Pressure ercent nput ercent 2� tack Temp.� Percent <br /> 3 s� �,.� �; `�'� �s; ��� � ���v 3��� -� �i� <br />