Laserfiche WebLink
t'e�c►�R-r �► �,��I � � $103 <br /> HOUSE HEATING TEST RECORD ��• <br /> ADDRE55 6 u � ��C E�Ua D �tL�,S I�-QpT. FLOOR CITY SUBURB �'�O�O <br /> OCCUPANT � � �� ��S OWNER <br /> HEAT LOSS DATE TG. INST. ,/,� <br /> SOLD BY INSTALLED BY 195.1 "" �'� t�" 'f' ` � <br /> Electrical Work By Gas Line By -��� � <br /> TYPE OF HEAT GA FA �HW STEAM SPACE HTR. UNIT HTR. OTHER <br /> GAS DESIGN CONVERSION <br /> MAKE � ��^ MAKE OF BURNER — <br /> Model '� ' S� �v Model <br /> Serial �—!� �d Max. BTU Rating <br /> INPUT ,���'�- MAKE OF FURNACE <br /> Model <br /> CONTROLS � <br /> THERMOSTAT ` Heat Plug �^ Vsnt Size � <br /> Valve � S� �IOU KIND OF LIN�!R�� SIZE TNO� N�� <br /> Limit �7E'�^^C� Droft Hood L�v�� � � � Regularor , ����L�„�Z� <br /> Limit SeNing <br /> �� U Filters $ize Number <br /> Fan Setting� �- Chimney Location Inside ,� utside <br /> Pilot Type � Chimney Construction � '� ���`iJ <br /> Pilot Make ����2wK` / <br /> Pilot Model $moke Bomb Wiring �— 7 <br /> Pilot Timing Draft L� Test Tay <br /> L.W. Cut Off Door Prossure Lightiny Inst. �/� <br /> �7 _ a _� . <br /> Pressure J�{ Percent COZ � Date Tested <br /> Input CFH �Percent 02 � � Company Testing ' � �L` � <br /> Stack Tsmp. Percent CO ��� �� Name of Tester <br /> Form 235 <br />