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ADDRESS <br />14n J (, <br />USE HEATING TEST RECORD <br />APT. F <br />CITY SUBURB <br /># 707 <br />C,0oKo <br />OCCUPANT — OWNXIk! a <br />HEAT LOSS DATE HTG. INST. i <br />SOLD BY I N S T A L f s�9 t <br />Electrical Work By ___�irf0 By <br />TYPE OF HEAT GA FA HW STEAM -- SPACE! .UNIT HTR. OTHER <br />Y GAS D SIGN �.'t CONVERSION <br />MAKE MAKE OF BURNER <br />Model Model . -- <br />Serial Max. BTU Rating <br />INPUT �/ ► L MAKE OF FURNACE <br />Model _--_-- <br />THERMOSTAT <br />Volvo <br />Limit <br />Limit Setting _ <br />Fan Setting <br />Pilot Type — <br />Pilot Make <br />CONTROLS <br />r' 101 - Heat PLua - <br />Pilot Model <br />Pilot Timing <br />Vent Size __ a <br />KIND OF LINER SIZE wwjj N <br />Draft Hood _ ' , Regularor <br />Filters Size Number <br />Chimney Location Inside x Outside <br />tl <br />Chimney Construction <br />Smoke Bomb — Wiring <br />Draft ____— — Test Tag <br />L.W. Cut Off '— -- Door Pressure --- Lighting Inst. l� <br />Pressure ��--- Percort CO2 / hate Tested <br />Input CFH Percent 02 — — Company Testing <br />Stock Temp. _— -- Percent CO --1 dame of Tester - <br />Form 235 <br />