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A'v <br />FOR [ / /'r 6'r ��2vwv <br />LOCATION <br />F. Q17F /-4O NrE C OM>�oR T rzoV7ER. <br />SOndd�O ,G0 DO �dE . 3 : JOB NO. <br />c '.4 !/•1c.c s ,iY.J 9/G PAGE <br />1A CROSSF. W/FCO/l'S/A' 5460 I <br />DATE 1 -/40 -,&/ <br />HOUSE <br />/ AW / <br />SEE <br />MEN■■�■ <br />■i■ii■�ii■■�■■■■■■ <br />iii■i■ <br />■■■�■iii■ii■■ii■■■ <br />■■ <br />■■■■■i■■■ <br />1i■■i <br />ti■iiiiiii■ <br />. <br />i■ <br />■i■i0■■■i■■■■■1!"■�GRE■ <br />'� <br />®■N■iiii■i■ <br />■■■/■■ir■■■■i®� <br />■i <br />ilii <br />■■■i■ <br />No <br />m <br />HOUSE HEATING TEST RECORD <br />ADDRESS o&O"24o2 ejV Lk"' —_—APT. FLOOR CITY - SUBURB C4N4 <br />OCCUPANT 6!&W& -0G C/1 2AsaT OWNER.—[ Lt� <br />HEAT LOSS —DATE HTG. INST. <br />SOLD BY TeAi�w /v- r- L ____INSTALLED BY JGFSJL.� <br />Electrical Work By Gas Line By -rLv7- %�•. �i��-<�'L- <br />TYPE OF HEAT GA _jZ_ FA _(-/ HW STEAM _—_ SPACE HTR. —_UNIT HTR. _OTHER _ <br />GAS DESIGN <br />MAKE %SNE _MAKE OF BURNER . <br />Model 1( (QE)3 A -es'7A _ Model - <br />Serial ,yam 2T- 6:%:5 'L /1— Myrc. BTU a�tV -- <br />INPUT Cab MArKE OF FURNACE <br />Model <br />CONTROLS <br />THERMOSTAT *Heat Plug <br />Valva <br />Limit <br />Limit Setting —;�!Qo- 04 ---_ <br />Fan Setting 90- /3S' — - <br />P i l of Type I AP I -A a sL �__—_-_-_ _-- <br />Pilot Make A0 -'A >'" C'iOV� <br />Pilot Model &Of�bb <br />Pilot Timing 6'dn -, rAws T _ <br />L. W. Cut off <br />r <br />Vent Size <br />CONVERSION <br />KIND OF LINER_ 6yAI.._T"AS __ SIZENONE <br />Draft Hood Regulator <br />Filters size j2vt J& Number 2 <br />Chimney Location Inside _Outside — <br />Chimney Construction -._- <br />Smoke Bomb LZ Wiring <br />Draft - ----Test Ta <br />Door Pressure <br />Pressure Percent CO2 �— Date Tested <br />Input CFH_ Percent 02�_. Company Tea <br />Stack Temp-.--s__-Percent CO—_ Name of Tesi <br />Form 235 <br />Lighting Inst <br />