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��`f3 `i <br /> ✓� HOUSE HEATING TEST RECORD <br /> � ACIbRESS .� S(>S L�`IIZ �G �I/I�Z APT. FLOOR CIT�R O NO BURB <br /> OCCUF'ANT � U a� L�/VI.� �L/� � OWNER L7N� !�' A`L <br /> ; HEAT LO55 DATE HTG. INST. _ �q <br /> y SOLD BY , /�'L H/i.ti���/G'G INSTALLED BY �',/�I-"L <br /> ,' 1 Electrical Work By Gas Line By ,�,�t'L <br /> TYPE OF HEAT GA FA�HW STEAM--SPACE HTR. —_UNIT HTR. OTHER <br /> � GAS DESIGN� CONVERSION <br /> f MAKE L"��NQ MAKE OF BURNER <br /> , Model �'y�� � .3 �'�C� �� Model <br /> Sericl .5"893 ��t�o �q Max. BTU Rating <br /> INPUT��UU� 13 'TrlJ MAKE OF FURNACE <br /> Model <br /> CONTROLS <br /> � THERMOSTAT T��� Heat Plug Vent Size �� D <br /> Valve .JN/f-1 /T� 1��D�E R5 KIND OF LINER SIZE NONE <br /> � ' Limit fj0/�/F�'�W�LL DraftHood Regulator <br /> Limit Ss»ing ���° Filters $ize l �x r�;� Number , <br /> Fan $etting ��^'�1; STi4/ZT Chimney Location Inside Outside <br /> Pilot Type S ��/�K Chimney Construction �V G p�ld� . <br /> Pilot Moke ri r+��T c�e.��r- <br /> . . Pilot Model Smoke Bomb Wiring <br /> Pilot Timing �'���g�r Draft � Test Tag v <br /> L.W. Cut Off Door Pressure Lighting Inst. `� <br />, Prossure �� ��✓G � Percent CO2 ��G Date Tested � ����� <br /> Input CFH Q Percent O�T_�Q Compony Testing �L � �M� <br /> Stack Temp. ��� Percent CO _� Name of Tester � <br /> Form 235 <br /> , <br /> • _`,- - <br /> , -� <br /> t <br /> . ��,f�a �;�. �.�.�i3 <br /> . <br /> x � <br /> , <br />