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eal•wrr 41‘" . <br /> HOUSE HEATING' TEST RECORD L" ' J ) / " 4 5-7? <br /> 7 <br /> ADDRESS C' -1(-5 (:-.);44,), U-ij ` fi t-\ APT. FLOOR CITY SUBURB <br /> OCCUPANT 01'-- �� f <br /> OWNER <br /> HEAT LOSS DA E 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. X OTHER <br /> GAS DESIGN CONVERSION <br /> MAKE � - MAKE OF BURNER <br /> Model to '_Ii X- Model <br /> Serial Max. BTU Rating <br /> INPUT MAKE OF FURNACE <br /> Model <br /> CONTROLS <br /> THERMOSTAT 1.6'."2--"N`1:': <br /> `Heat Plug Vent Si:• <br /> Valve (, -', -:`="'-LL KIND OF LINER SIZE NONE <br /> Limit V. l.-t\ +`‘...‘_ Draft Hood Regulator <br /> Limit Setting I `jt( 1 Filters Sire_ Number <br /> Fan Setting 1•`�"Q1: Chimney Location Inside Outside <br /> Pilot Type Chimney Construction <br /> Pilot Make l� X16,/,k. <br /> Pilot Model �� ' Smoke Bomb Wiring <br /> Pilot Timing Draft Test Tog <br /> L.W. Cut Off Door Pressure Lighting Inst. <br /> 3,It <br /> Pressure Percent CO2 �i Z Dote Tested +C 1.i 1' Y� <br /> Input CFH Percent 02 --y <br /> Company Testing �.` '' Alt- <br /> -Stock Temp. 35-do Percent CO (31434741 Name of Tester 1ohN 1Z l.,''-‘1. A <br />