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%clr«rt,-41 06-9 <br /> HOUSE HEATING TEST RECORD ,� 572?7 <br /> ADDRESS `". ' . L l.11 37, L -c.-_ l OA APT. FLOOR CITY SUBURB <br /> OCCUPANT . . ' .1-k-- OWNER <br /> HEAT LOSS DATE 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 /> Lefva>0 �GA$�DEESIGN CONVERSION <br /> MAKE / MAKE OF BURNER <br /> 6-2/ �� —/ <br /> ModelQ 3 – 66 Model <br /> Serial c 41YE 36y/ 0 Max. BTU Rating 96 <br /> v <br /> INPUT 9o� 1 MAKE OF FURNACE 'i <br /> Model G\I <br /> CONTROLS <br /> THERMOSTAT '''''''•` ''• Heat Plug Vent Size <br /> Valve "_ KIND OF LINER SIZE NONE <br /> Limit Draft Hood Regulator <br /> Limit Setting Filters Size _Number <br /> Fan Setting Chimney Location Inside Outside <br /> Pilot Type Chimney Construction <br /> Pilot Make ../ <br /> Pilot Model Smoke Bomb Wiring <br /> Pilot Timing '''-''' Draft Test Tog <br /> L.W. Cut Off Door Pressure Lighting Inst. • <br /> Pressure Percent CO2 41:7, Date Tested l�' ` ' <br /> t <br /> Input CFH -7 Percent 02 oCon,pony Testing .� ,t, \ tom' 'r ` \ <br /> Stock Temp. ;2- Percent CO I/ PPfri Name of Tester <br />