Laserfiche WebLink
HOUSE HEATING T£ST RECORD <br />ADDRESS. <br />OCCUPANT. <br />HEAT LOSS- <br />SOLD BY__ <br />'+tCsWS^^ <br />.APT____ <br />.OWNER. <br />FLOOR.CITY.SUBURBi^E-^X^iO. <br />INST.. <br />Electrical Work By_ <br />TYPE OF HEAT GA. <br />'ll -TiiC "or <br />FA.X HW.STEAM. <br />.GAS CO. METER <br />.INSTALLED BY__ <br />.Gas Line By____ <br />fm <br />SPACE HTR.. <br />____ (< <br />UNIT HTR._OTHER. <br />MAKE. <br />Model. <br />Serial- <br />INPUT. <br />GAS DESIGN <br />LxHOtjpV.____________ <br />CONVERSION <br />^'b>jCXsc>T C'ii <br />-.MAKE OF BURNER- <br />—Model __ ______ <br />— Mox. BTU Sating _ <br />-MAKE OFtBORNACE <br />Model_____________ <br />THERMOSTAT <br />Valve______- <br />Limit_______C <br />CONTROLS <br />Heat P,liiq y CaMeat Rlua__y.-Vent Size_____ <br />-KIND OF LINER. <br />-Draft Hood. <br />Limit Setting- <br />Fan Setting_ <br />Pilot Type___ <br />Pilot Make__ <br />Pilot Model- <br />Pilot Timing- <br />Cut Off. <br />i?>\a iiEsras ____SIZE- <br />Regulator. <br />. Number. <br />noneX. <br />I <br />___ Outside ___ <br />________________. _ Smoke Bomb. <br />Drnft________ <br />.Door Pressure. <br />-Wiring______ <br />-Test Tag____ <br />-Lighting Inst. <br />ILL <br />Input CFH^_____________ <br />Stack Temp-------P. <br />Percent C02. <br />Percent 02- <br />Percent CO _ <br />.Date Tested_____ <br />-Company Testing. <br />.Name of Tester __rv-Cvyh^