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0 9 xr HOUSE HEATING TEST RECORD <br />ADDRESS `3 5� "AIQ SZ i F, Li LA APT. FLOOR <br />OCCUPANT OWNER <br />HEAT LOSS DATE HTG. INST. <br />SOLD BY <br />Electrical Work By <br />TYPE OF HEAT <br />PeozwT tici5r <br />TY SUBURB MNO <br />INSTALLED BY <br />Gas Line By <br />GA FA HW STEAM SPACE HTR. _ <br />GAS DESIGN <br />MAKE ti � r, _ MAKE OF <br />Model Model — <br />Sariel S�� L--c i 3 C.) Mon. BTU <br />INPUT •`.:n , G c 7 MAKE OF <br />CONTROLS <br />THERMOSTA F Heat Plus <br />Valve i l c. —d O Lie - <br />Limit �4zti <br />Limit Setting �G <br />Fen Setting <br />Pilet Type <br />Pilot Make — <br />Pilot Model . <br />Pilot Timing <br />L.W. Cut Off <br />BURNER <br />Rating <br />FURNACE <br />UNIT HTR. OTHER <br />CONVERSION <br />Model <br />Vent Size I, <br />KIND OF LINER SIZ NONE x <br />Draft Haod & , I L� N Rega:eter <br />Filters Size umber <br />Chimney Legation Inside X Outside <br />Chimney Construction 1 f Li4 s C, 45 <br />Smoke Bomb wiring V <br />Draft G << Test Tog <br />Door Pressure <br />90 Pressure Percent CO2 ' Date Tested <br />Input CFH (i Percent 02 Company Tei <br />Ste ck Temp. Percent CO C ' C Name of Test <br />Lighting Inst.""'Y <br />Fps 235 <br />