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HOUSE HEATING TEST RECOR9L�(0y1U /�i 0� <br /> ADDRESS (1�0 "' "" APT. FLOOR CITY SUBURB <br /> OCCUPANT OWNER <br /> HEAT LOSS DATE HTG. INST. <br /> SOLD BY INSTALLED BY V/0& M <br /> Electrical Work By Gas Lina By Ja LA-,E <br /> TYPE OF HEAT GA FA HW STEAM SPACE HTR. UNIT HTR. OTHER <br /> GAS DESIGN CONVERSION <br /> MAKE MAKE OF BURNER <br /> Model I ' Q Model <br /> Serial f7` I Max. BTU Rating <br /> INPUT leo, UexJ MAKE OF FURNACE <br /> Model <br /> CONTROLS U <br /> THERMOSTATeat Plug Vent Size_ <br /> Valve Z KIND OF LINERSIZE ONE <br /> Limit 'v co Draft Hood f�"`� Rogulepr 1 TE i9ef" <br /> Limit Setting Filters Size Number <br /> Fan Setting 1� Chimney Location Inside X outfid• <br /> Pilot Type Chimney Construction 77 <br /> Pilot Make 'k A <br /> Pilot Model 00 Smoke Bomb Wiring <br /> Pilot Timing Sir C Draft Test Tog <br /> L.W. Cut Off �— Door Pressure �j Lighting Inst. <br /> Pressure 31f- <br /> Percent CO /Z Dote Tested I -o <br /> Input CFH U Percent OZ Company Testing \16&7- <br /> Stock <br /> 1C&7 Stock T, mp. Percent CO 60Nome of Tester JZL4 <br />