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HOU-4 ATING TEST RECORD <br />ADDRESS _ ,;.^ ' ----APT. __ FL OAR � <br />OCCUPANT ._.---_ --OWNER <br />---_ SUBURB <br />HEAT LOSS _DATE HTG. INST. <br />3''i l SOY <br />SOLD BY ._ _.� --- _—__.—..__._INSTALLED BY <br />Electrical work By _.. �'.i� ��� —_._.._ Gas Line By !• '� ~ 'e A <br />TYPE OF HEAT GA FA --,kHN _ STEAM —___ SPACE HTR. UNIT HTR. OTHER <br />G S G CONVERSION <br />XAKk d MAKE OF BURNER <br />Mode! - <br />— Model <br />Serial C Max. BTU Rating <br />INPUT % ` 0 _ MAKE OF FURNACE — <br />Model -- - -- --- <br />CONTROLS <br />THERMOSTAT Heat Plug <br />V*Ivv <br />Limit <br />Limit Setting <br />Fan Settlnq — <br />Pilot Type - ?�� <br />Pilot Make �� _ <br />Piles Model _ <br />Pilot Timing <br />Vent SIR*---_-�__ <br />KIND OF LINER _.__.._. . SIZE NONE <br />Draft Heod ___ ____�___ __ _. Regulator <br />Filters Si.-* <br />Chimney Location Inside <br />Chimney Construction _ <br />Smoke Bomb <br />Draft <br />L.N. Cut Off _ + Door Pressure <br />PressurePercent Co '� i Date Tested <br />Input CFH Q Percent OZ Cam"ny Testi <br />Stoc'c Temp. _ Percent CQ0 07 n Name of Tests <br />235 FuR, ` <br />Outside <br />Wiring ___ _ <br />Test Tap _ <br />—Lighting Inst. <br />3r <br />