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fK f C6 --C <br /> ^� (� <br /> HOUSE HEATING TEST RECORD k'5-3 g7 <br /> ADDRESS S r S Oco CJx� t�-aH1? ti APT._FLOOR CITY SUBURB <br /> OCCUPANT �'i OWNER <br /> HEAT LOSS ATE HTG. INST. <br /> SOLD BY INSTALLED BY <br /> Electrical Work By Gas Line By <br /> TYPE OF HEAT GA FA HW STEAM SPACE HTR. UNIT HTR. OTHER <br /> AS DESIGN CONVERSION <br /> MAKE Le/1/01C 1041,5MAKE OF BURNER <br /> Model 6-2' tel 3 -60- Model <br /> S«iel -S ! T i 3475 Max. BTU Rating <br /> INPUT 4-t,ld�'" MAKE OF FURNACE <br /> Model <br /> NTROLS <br /> TNERMOST T Heat Plug Vent Size <br /> Valve Lt-) A KIND OF LINER SIZE NONE <br /> Limit Draft Hood Regulator <br /> Limit Setting 1 1e510a Filters Sire _Number <br /> Fon Setting 1006 <br /> Chimney Location Inside Outside <br /> Pilot Type 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 1• ("V <br /> Percent CO / Wit- <br /> CFH <br /> — Date Tested i is <br /> Input CFH COp Percent OZ Company Testing AU A <br /> Stock Temp. O Percent CO 1 11 Name of Tester A^h K LA 1`301e\ <br />