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HOUSE HEATING TEST RECORD <br />i <br />O,eo,vo <br />ADDRESS 45-6 0 <br />-_APT. FLOOR_— CITY SUBURB_'C, <br />OCCUPANT 1860 Pax <br />St. LI -Id tl tx ConstOWNER <br />HEAT LOSS <br />k TG. CO. METER BADGE # _— <br />SOLD BY hU' J1 <br />�.� INSTALLED BY ddkdA.�kGJC1l%� <br />Electrical Work By <br />SNYllIri ^LECT Gas line By_ <br />TYPE OF HEAT GA_ FA <br />HW STEAM_- SPACE HTR._ UNIT HTR.-- OTHER — <br />GAS DESIGN CONVERSION <br />MAKE G /:L -0 .2 L's <br />`�$ MAKE OF BURNER <br />Model <br />_--Model <br />Serial .' ,,72- <br />/ o _-__._________Max. BTU Rating_ -- <br />INPUT ` 1d /`1 <br />_ MAKE OF FURNACE ---- <br />Model - - <br />CONTROLS <br />THERMOST T rC-76_ <br />Heat Plug C —Vent Size - <br />Valve <br />-__KIND OF LINER SIZE NON <br />Limit <br />Draft Hood Regulator <br />Limit Setting Z C <br />Filters ize Number_ <br />Fan Setting / <br />Chimney Location insiclq Outside 11;X1 <br />Pilot Type <br />Chimney Construction <br />Pilot Make.Make <br />Pilot Model <br />Borrl_� <br />Smok�Tj� <br />Pilot Timing <br />U G <br />D afte Test Tag_ <br />L.W. Cut Off <br />r <br />Door Pressure —_Lighting Inst. <br />Pressure '� ! <br />Percent CO2 Date Tested T - L _ <br />Input CFH — <br />Percent 02 -Company Testing <br />Stack Temp. �Z�� <br />Percent CO —�_ Name of Tester <br />r.,e......�._•� -- ;��iu---'_4.°.°-�...-�'.tn,.a:Yw:;�a.. <br />.....,....� ......:,.4r,,.�aa�,o,....•. �-sa4..,., ., - ...- ' <br />HOUSE HEATING TEST RECORD O�O/YO <br />ADDRESS- ��� <br />—APT._. _FLOOR_._ CITY SUBURB_ = <br />OCCUPANT_ McIdu1 ty Con�-,t ------OWNER--- <br />� . <br />HEAT LOSS DATE HTG. INST. Q //,2 / 2 ---GAS CO. METER BADGE # <br />SOLD BY_ CHUNT;-iUr"6 � <br />Electrical Work By--_i YDL,n --INSTALLED L BY- - --- S <br />TYPE OF HEAT GA_ FA�� HW__, STEAM—__ SPACE HTR._ --y.. UNIT HTR._ OTHER_ <br />GAS DESIGN CONVERSi ON <br />MAKE <br />h ___.- _MAKE OF BURNER_ <br />- <br />-- <br />Model_ !� <br />�d _.Model— <br />---------.Model-- <br />-__- <br />Serial <br />_- _ <br />--__Max. BTU Rating <br />INPUT <br />-- _ _ _ _-MAKE OF FURNACE <br />------- <br />Model <br />---- - -- <br />CONTROLS <br />THERMOST T He Plug 3 r -� Vent Size_ <br />Valve - r <br />- - KIND OF LINE <br />L---_-_ <br />NONE - <br />Limit_ L� <br />Draft Hood <br />v <br />Regulator <br />Limit Setting- <br />_ Filters ize <br />_ Number-_ <br />Fan Setting._._. <br />Chimney location <br />Pilot Type_ <br />_ Chimney Construction_ <br />'c,-A., <br />Pilot Make <br />Pilot Model <br />Smoke Bomb <br />Wiring V At <br />Pilot Timing-_ <br />Draft (� - <br />Test Tag <br />Of <br />L.W. Cut f_ <br />_ Door Pressure <br />_ <br />Lighting Inst 0 -- <br />Pressure_.__ ' Percent CO2 ate Tested l - Z <br />_ <br />Input CFH-- b <br />T_. Percent 02 --- Company Testing <br />Stack Temp. <br />Percent CO ('---Name of Tester <br />