HomeMy WebLinkAbout09-17-1981 House HeatingTest RecordADDRESS
OCCUPANT.
/.oBS'
HOUSE HEATING TEST RECORD
0/h/L B /U-
-APT...FLOOR CITY .SUBURB.
HEAT LOSS_____________DATE HTG. \US7. 1__________
SOLD BY ^tUJ •////g» iMi^TAi I pn bY rt-*/ «S*
___________________Gas Lino By _____________________________________________
OWNER C?- >ltf, ^Jt? c, \
Eloctricai Work By ____
TYPE OF HEAT GA FA ^JL,HW STEAM .SPACE HTR..UNIT HTR..OTHER
GAS DESIGN
MAKE _ _ _ _ _ _
Modol ^ O S //C -d
Serial 9 Ci :T J^'^9 ^
— (c^
INPUT____/^1..
CONTROLS
THERMOSTAT T?.k.^------ Hoot Plug
Valve ''lT'io/i A/ S ___________
Limit . ^
Limit Setting
Fan Setting _
Pilot Type __
Pilot Make __
Pilot Model ...
Pilot Timing.
L.W. Cut Off
Q
•i-tA/(E.L-^
// o ^ Q
ps: Jiz
/ ^ S A-/A
Pressure.3,^
Input CFH II ^ ^
Stock Temp.
Form 235
4*0 o
-Percent CO^
. Percent 0^
.Percent CO
CONVERSION
MAKE OF BURNER
Model
Max. BTU Rating
MAKE OF FURNACE
Model _______________
Vent Size______:
KIND OF LINER
Draft Hood------------------
Filters Size
Chimney Location
Chimney Construction
SIZE.6 NONE.
. ReguloTor
___Number.
Inside.. Outside
Smoke Bomb
Droft — __
Door Pressure.
Dote Tested_
.Wiring-------------
^Test Tag--------
. Lighting Inst.
Company Testing
Nome of Tester _