Laserfiche WebLink
�)(4 HOUSE HEATING TEST RECORD <br /> ADDRESS GICQ i.c«z� Ie"' APT. FLOORS / CITY SUBURB a-,Z'U" <br /> OCCUPANT ✓ �e, s c� ��' OWNER <br /> HEAT LOSS DATE HTG. INST. <br /> SOLD BY 1)760 c _ INSTALLED BY L�a <br /> Electrical Work By � Gas Line By <br /> TYPE OF HEAT GA FA 'r HW STEAM SPACE HTR. UNIT HTR. OTHER <br /> �..� GAS DESIGN CONVERSION `r <br /> MAKE !-- s <br /> / 1 MAKE OF BURNER <br /> Model A/C( 6^i/3 S 61112--2— Model <br /> Serial ��� a 7®�-5 Max. BTU Rating WG <br /> INPUT _L�Gy`y MAKE OF FURNACE <br /> Model CITY or- <br /> CONTROLS <br /> FCONTROLS <br /> THERMOSTAT Heat Plug 'S Vent Size <br /> Valve h'' /tip KIND OF LINER SIZE NONE <br /> Limit It- L" Draft Hood Regulator <br /> Limit Setting Joe"" Filters Size _Number <br /> Fan Setting /U��'��J� ` Chimney Location Inside Outside <br /> Pilot Type � � CSG.>!/ Chimney Construction -- <br /> Pilot Make <br /> Pilot Model Smoke Bomb ` Wiring <br /> Pilot Timing Draft Test Tag <br /> L.W. Cut Off Door Pressure —Lighting Inst. <br /> Pressure � 5l Percent CO 2 Date Tested _Q <br /> Input CFH Percent 02 Company Testing -� <br /> Stack Temp. -?aj Percent CO Name of Tester < <>1 <br /> Form 235 <br />