HomeMy WebLinkAbout1977-12-28 House Heating Test RecordADDRESS
OCCUPANT
HOUSE, ATING TEST RECORD / ? s-
1. 'so
,-' APT. FLOOR CITY SUBURB
OWNER
HEAT LOSS ,,� - DATE HTG IN,ST
g—
SOLD BY ��L' :L l
Electrical Work By TYPE OF HEAT GA ._ FA 1'" HW STEAM SI
INSTALLED BY M -`1-�`
, Gas Line By a-'�'
ACE HTR. UNIT HTR. OTHER
S DESI CONVERSION
MAKE ''j MAKE OF B','RNER
Model { ! / �; Model
Serial V Max. BTU Rating —
INPUT G MAKE OF FURNACE
Model
l CONTROLS G ,
THERMOSTAT rL7
t Plug _ Vent Size
Valve KIND OF LINER.
SIZE 6 NONE
Limit Draft Hood Regularor _
Limit Setting T— Filters Size .Number
Fort Setting" Chimney Location Insi Outside
Pilot Type Z-'� Chimney Constructions
Pilot Make w
Pilot Model Smoke Bo m Wiring -
Pilot Timing '" ' �'�1' Draft G Test Tog
L.W. Cut Off _ Door Pressure Liohtins Inst.
Pressure 3 r Percent CO2 Date Tested
Input CFN Percent OZ Company Testing
Stock Temp. — 2- _ Percent CO Name of Tester _
Form 235
HOUSE HEATING TEST
ADDRESS _. rJA APT. —
OCCUPANT OWNER.
HEAT LOSS - SOLD BY
Electrical Work By
TYPE OF HEAT
GA FA Y HW STEAM
RECORD 13 S'
_FLOOR CITY SUBURB 10,9
—INSTALLED BY _�'--
r.
—Gas Lino By'-.'1�t-�-�
SPACE HTR. UNIT HTR. OTHER
AS DE GN
MAKE MAKE OF BURNER
Model Model --
Serial Max. BTU Rating
INPUT MAKE OF FURNACE
CONTROLS
THERMOSTAT Hp, g1,
Valve (1(
Limit
Limit
Fan Si
Pilot'
Pilot I
Model
Vent Six*
CONVERSION
KIND OF LINER cQ_— SIZENONE
Draft Hood Regulator
Filters Size dumber
Chimney Location Outside
Chimney Construction 1X. Leleft
i r.
Pilot Model Smoke Bomb Wiring
Pilot Timing Draft L; Test Tag _
L.W. Cut Off Dow Pressure ____L ightino Inst.
i
Pressure q, Percent Co Date Tested
Input CFH q Percent OZ Company To,
Stock Temp. — -Percent CO Name of Test
Form^,3S