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�� � r,, j <br /> HOUSE HEATING TEST RECORD <br /> ADDRESS � -- r �' � � � <br /> OCCUPANT � I�"1 : �PT. FLOOR CITY SUBURB <br /> .r-, .�� <br /> OWNER <br /> HEAT LOSS DATE H7G. INSl:' <br /> SOLD BY INSTALLED BY <br /> El�chical Work By Gas Lin• By <br /> TYPE OF HEAT GA FA �_HW STEAM SPACE HTR. UNIT HTR. OTHER <br /> GAS DESIGN CONVERSION <br /> MAKE ` � ! <br /> MAKE OF BURNER <br /> Mod�l "� . , ; : <br /> ' Mod•I <br /> S«ial % t � A4ax. BTU Ratinp <br /> INPUT MAKE OF FURNACE <br /> Mod•I <br /> CONTROLS � <br /> THERMOSTAT ��� H�ar Pluy - ` 1} V•nt 5;:• <br /> Valw _ ' KIND OF LINER_ �� � SIZE r � NONE <br /> Limit '-�- � �` �' • i Droft Hood <br /> �� Rpulawr <br /> Limit S�ttiny -_ � � �.� Filt�rs Si:• r�a' uumb�t <br /> Fan Settiny .r" <br /> Chimn�y Locafion Insid� Ovf�id• <br /> Pilot Typ� �k t } j'"_ � C�imn�y Construction � . � 4 j`�. <br /> Pilot A4aks <br /> Pilot Modsl Smok• Bomb �y����9 ../ <br /> Pilot Timing Draft T�st Top ` "'`r�� <br /> L.W. Cut Off Door Pres:urs Liyhfiny Inat. <br /> Prossure " P�rc�nt C0� ' ^ Dats Tsst�d � <br /> Input CFH 7/ P�rc�nt 0� Company T�sting �- / <br /> ... � ! _ <br /> Stack T�mp. P�rc�nt CO Name oi T�st�r � � ' '" <br /> Fo:m 235 �(���'Y• ✓ �V <br />