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ADDRESS__ <br />OCCUPANT _______ <br />HEAT LOSS ----------------.- DATE HTG. INST. <br />HOUSE HEATING TEST RECORD <br />APT---------FLOOR <br />OWNER __________ <br />CITY^^7 Ojoe-^o <br />SOLO BY U^ST <br />EUcIrIcal Work By_____ <br />TYPE OF HEAT GA <br />MAKE <br />Sorioi <br />-... FA t^HW <br />. y y GAS DESIGN <br />M/ffL <br />INSTALLED BY <br />Got tin* By « # <br />STEAM _ . SPACE HTR. ___UNITHTR.OTHER <br />INPUT <br />MAKE OF BURNER <br />Modol ____ <br />CONVERSION <br />Mo*. BTU Rofing <br />Volvo <br />CONTROLS <br />---- H«ot Pli#9 <br />MAKE OF FURNACE <br />Mod«l <br />A <br />Limit <br />Limit Setting _ / 7^__________ <br />Fon S«Hing ____________ <br />Pilot Typo C__________ <br />Pilot Molco JIHL_______ _______ <br />Pilot Timing ^ <br />L.W. Cot OH_______________ <br />Vonf Sifo ^ <br />KIND OF LINER _ <br />Droft Hood _____ <br />Filfort Siio <br />SIZE <br />Chimnoy Locotion <br />Chimnoy Construction <br />Rogulovor <br />. ^.Numbop <br />NONE. <br />Intido___Outtido <br />Smoko Bomb ____ <br />Droft <br />Protturo__ <br />V <br />Input CFH^^ <br />Stock <br />Form 235 <br /><Ut Tjrw- <br />Porcont COj <br />Porcont 0.0-"’5?" O <br />Porcont CO ^ <br />Door Prossufo <br />Doto Tostod ^ w <br />Compony Tosting <br />Nomo of Tostor <br />Wiring <br />.Toot Tog <br />Lighting Inst. <br />k.