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HOUSE HEATING TEST RECORD <br />ADDRESS�� �- X �1�� _-.AM APT. ----.--FLOOR -_CITY SUBURB <br />OCCUPANT A J--- W -�---_/atr <br />NEAT LOSS DATE HTG. INST. <br />SOLD BY �J'� - �iL - --___INSTALLED BY 1- _ <br />Eloctrical Work By-_-- ___-- -- ----__Gas Lina B <br />r <br />TYPE OF HEAT GA ____ FA HW _ STEAM _ ____ SPACE HTR. .- -IINIT HTR. ___OTHER <br />GAS DESIGN <br />MAKE - <br />Model _- f a <br />Seri 1 .jg- af J' S 0" <br />MAKE OF BURNER <br />Model _---- <br />CONVERSION <br />e-�� ;------_-.--_ __. Max. BTU Rating <br />/ Q 0- e 4 s�hiZ�_ -- <br />INPUT MAKE OF FURNACE _ r. <br />CONTROLS <br />THERMOSTAT Heat Plug <br />Volvo - <br />Limit C�-A/ti sr T <br />Limit Setting Add <br />Fen Setting rl A% FX11/ Rl Q _` 04!! - <br />Pilot Type-_9F�t3_-- <br />Pilot Make /Q 04,00n 1__ S <br />Pilot Morel -- <br />Pilot Timing Af c rA A-* Z: ___----] <br />L.W. Cut Off <br />Model - -- --- --- -- - -- <br />Vent Size -3-4'-, <br />KIND OF LINER- - SIZE NONE <br />Draft Hood �k Regulator <br />Filters Sl 20 . _. d?,N XA - -Number 1 --- <br />Chimney Location Inside —I-,— Outside <br />Chimney Construction SE G L A 3S Q -� <br />Smoke Bomb --------..------ Wiring <br />Daft -,Test To <br />g -- -- <br />Door Prossure <br />Pressure 3 AMY y Percent CO2 -AJ Date Tested <br />Input CFH _ 1d A G f N Percent 03 e e) a, d _ Company Testing <br />Stock Temp._ Percent CO -- dam__ Name of Tester <br />Fere 235 <br />-- -- - - ---- Lighting Inst. <br />�}- L- / <br />