Laserfiche WebLink
�E�VK <br /> \�� ���� HOUSE HEATiNG TEST RECORD ����� ✓ <br /> ADDRESS G� `v / C� J" S�/C.2� � APT. FLOOR CITY SUBURB �-J�U �'� <br /> OCCUPANT OWNER <br /> HEAT LOSS DATE HTG. INST. <br /> SOLD BY INSTALLED BY � � � � <br /> � <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 j'�- MAKE OF BURNER <br /> Modsl T � Model <br /> $erial � Max. BTU Rating <br /> INPUT ��`� (,.s_ MAKE OF FURNACE <br /> Model <br /> , CONTROLS (� � <br /> THERMOSTAT e� Plu Vent Size bL <br /> Valvs � KIND OF LINER SIZE ON <br /> Limit Draft Hood � Rsyularor � ` r �'L <br /> Limit S�Hing Filters Size Numbe► <br /> Fan Setting � Chimnsy Location Insids t�— utside <br /> Pilot Type Chimney Construetion � - <br /> Pilot Make / �� <br /> Pilot Model Smoks Bomb Wiring �� <br /> Pilot Timing � Draft Test Tap <br /> L.W. Cut Off Door Pressure Liyhtin Inst. <br /> Prossure � � P�resnt CO2 � Date Tested — � � / <br /> Input CFH � Percent 0 Company Testing � � <br /> 2 <br /> Stack Temp. �(l�Perc�M CO —a�����-- Name of Tsat�r <br /> Form 235 <br /> �����y ��.� <br />