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MOUSE MATING TEST RECORD <br />ADDRESS__ APT �— CITY OCCUPANT_ DOM OWNER— SUBURB_" Orono <br />HEAT LOSS _ DATE HTG. INST. GAS CO. METER BADGE # SOLD BY_ INSTALLED BYSam*Electrical Work By t Gas line By <br />TYPE OF MEAT GA- FAQ HW - STEAM__ SPACE HTR. UNIT HTR.---r— OTHER_ <br />GAS DESI 'GN CONVERSION <br />MAKE <br />Model_ GS E- _ -- - - <br />Serial__ - <br />INPUT__ __ <br />CONTROLS <br />THERMOS AT T — Heat <br />Valve D i <br />L i m i t----LIL W <br />Limit SettiV- <br />g <br />Fan SettinPilot Type <br />Pilot MakPilot Mode <br />Pilot Timing <br />1. W. Cut Off_ <br />Pressure_-- <br />input CFH <br />Stack Temp. <br />�G <br />MAKE OF BURNER__ - <br />Model <br />Max. BTU Rating _ <br />MAKE OF FURNACEModel- <br />--Vent Size <br />__KIND OF LIN <br />Draft Hood-1 <br />n <br />_-_Filters Size <br />location I <br />Chimney Construction_ <br />SIZE NORM,-`-✓ <br />Regulator <br />. Number, <br />--_ Outside <br />--Smoke Bomb Wiring_AInst. <br />_ <br />_- __-Draft Test Tag <br />_Door Pressure — lighting <br />Percent CO2 ���/d Date Tested <br />Percent 02_ Company Testing <br />Percent CO -_Name of Tester- <br />