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HOUSE HEATING TEST RECORD <br /> ADDRESS ��l ///:e��L�J �r0 APT. FLOOR CITY U'��-��SUBURB <br /> OCCUPANT /7�C.�%l79' iE;�3SG,l�c� OWNER Sqi�1c <br /> HE/1T LOSS DATE HTG. INST. <br /> SOLD BY INSTALLED BY <br /> El�ctrical Work By Gas Lin• By <br /> TYPE OF HEAT GA FA HW STEAM SPACE HTR. --UNIT HTR.�_OTHER <br /> �/� GAS DESIGN CONVERSION <br /> MAKE �(��'Z.[�'�'�IZ MAKE OF BURNER <br /> Mod�l �T- �7 Modsl <br /> $�ria l �X L 7�7 y��5 7��% 7� Max. BTU Ratiny <br /> INPUT 75 G�l_'�!". MAKE OF FURNACE <br /> Model <br /> CONTROLS <br /> THERMOSTAT ?� � <br /> Heat Pluy V�nt $ize y� <br /> Valvs���r�'�����-' ��P../h/-��%J 7'?.22� KIND QF LINER SIZE^� NONE X <br /> Limit Sx�P �5c� Draft Hood Rsyularor /'//4;Kif",E�C3� ��CS- <�L <br /> Limit S�ttiny ���1���' Filters $izs � Number <br /> Fan Settiny �% � � ���r-ZZ S7 Chimn�y Location Insids Outsids � <br /> Pilot Type SP1f.E'L� Chimnsy Construction ���1� �SS �� <br /> Pilot Make <br /> Pilot Model Smoks Bomb �---�' Wiring ' <br /> Pilot Timiny Draft Test Tap <br /> L.W. Cut Off Doo� Prossurs Liyhtinp Inst. _ <br /> �� <br /> Pressura 7��V �3_:'nc�f p�rc�nt CO�� Dote T�st�d � - ' � <br /> Input CFH 7S �LZ�-P�rc�nt OZ 7 � Company Testing � <br /> Stack T�mp. �P�rc�nt CO Q Name oF Test�r ^/ <br /> Form 235 <br /> L�/�'` � � C7 <br />