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��l�a�� ���� � <br /> . HOUSE HEATING TEST RECORD <br /> ./, �;_' <br /> ADDRESS (� �f ��✓� r���r� �'4� APT. FLOOR CITY�y}��%-� SUBURB <br /> OCCUPANT �t''F`�t��-�-'�'- OWNER <br /> HEAT LOSS DATE HTG. INST. <br /> SOLD BY INSTALLED BY <br /> El�ctricol Work By Gas Lin• Br <br /> TYPE OF HEAT GA FA HW STEAM SPACE HTR. UNIT HTR. OTHER <br /> GAS DESIGN CONVERSION <br /> MAKE � �`�N� � MAKE OF BURNER <br /> Mod•I ,��I � <%r�� Mod�l <br /> SKiul �Lt v�� (,�/���� Mo:. BTU Ratiny <br /> INPUT �`� a����� MAKE OF FURNAGE <br /> Med�l _ <br /> CONTROLS ( <br /> THERMO TAT ' ' Hwt Pluq V��t Siz�_y �/ �1�� t'�`��`�� <br /> Valv aJ3�L�T°'t�r KIND OF LINER SIZE NONF <br /> Limit Droh Hood Rpulowr <br /> -,' L• <br /> Limit S�Hiny Filt�►s Si:• ►rumb�r <br /> Fen S�ttinq � 'y"�� Cl�imm�r Location lesid� Oufsid� <br /> Pilot Typ� "3�, Qimn�y Constrvetio� <br /> Pilot Mok• <br /> Pilor Mod.l Smok. Bomb Wirinp <br /> Pilor Timiny D�aft T•st Taq <br /> L.W. Cut Off Dow Pr�ssw� Li9htinq Inst. <br /> � � <br /> Pr�saw� ?: � P�rc�ntCO2 �' Dot� T�st�d ����-r`'�,U � <br /> Inpur CFH PKe��t �Z � Co�ponr T.s�+ny ��r <br /> Statk T�mp. ' r P�re�nt CO �' Nanw of T�sNr �!� ''�= , 1�i,"� / '.�'�. <br />