HomeMy WebLinkAbout1980-03-21 House Heating Test RecordHOUSE HEATING TEST RECORD W krl2 # /
ADDRESS APT. LOOR ..SUBURB
OCCUPANT OWNER ems— ���.
HEAT LOSS T HTG. INS �t
SOLD BY �, �,L INSTALLED BY _tb((V t1d-
Electrical Work By —Gas Line By-.-I-litilw4
TYPE OF HEAT GA FA HW STEAM SPACE HTR. UNIT HTR. OTHER
GAS DESIGN
CONVERSION
MAKE
_ MAKE OF BURNER
Model
Model
Serial
Max. BTU Rating
INPUT
MAKE OF FURNACE
Model
CONTROLS
THERMOST
Heat Plug Vent Size
Valve
KIND OF LINER-
4SIZE NONE
Limit jr
W_Draft Hood
Regulator
Limit Setting—
Filters Size
ber
Fan Setting
1 Chimney Location Ins*
Outside
Pilot Type
Chimney Construction t,
Pilot Make
Pilot Model Smoke B b _Wiring AJ
Pilot Timing ,Q..Q.(_ Draft � Test Toq
L.W. Cut Off Door Pressure-. Lighting Inst.
4
Pressure_3 T Percent CO2 Date Tested /;Tj Of
Input CFH Percent 02 Company Tasting
Stack Temp. Percent CO Name of Tester
Form 235
HOUSE HEATING TEST RECORD
ADDRESS
y1 J� GOAPT. FLOOR I SUB .
OCCUPANT OWN
E
HEAT LOSS ATE TG.¢T.
SOLD BY (-� INSTALLED BY 4�A1-"
Electrical Work By Gas Line By t 4�
EAT GA FA 1GHW STEAM SPACE HTR. UNIT HTR. —OTHER.-
IT r-r- OF H
GAS DESIGN
MAKE
MAKE OF BURNER
Model
Model
Serial
Max. BTU Rating
INPUTAT
MAKE OF FURNACE —
Model _
CONVERSION
CONTROLS
THERMOS T
Heat Plug
Vent Size (p
-
SIZE NONE
Volvo
KIND OF LINER
Limit
A. --Draft Hood /
Regulator
Limit Setting
C/O
Filters Size_—
Nun "r
Fan Setting
Q
Chimney Location
I idsOutside
ir—
Pilot Type
�iJ
Chimney Construction liz
Pilot Make
Pilot Model
_Smoke Bo b
Wiring
Pilot Timing
`S
Draft —
Test Tog
L.W. Cut Off
-
- Ono► Pressure
—Lighting lnst.�E�
Pressure CO2
--T— Date Tested
CFH
�—Percent
Percent 02
J Company Testing
Input
Stock Tem-
Percent CO
or .
Name of Tester
Form 235
ADDRESS --
OCCUPANT _
HEAT L0
R&
USE HEATING TEST RECORD
APT. FLOOR
OWNER
SOLD BY mac.. Y - INSTALLED BY
Electrical Work By Gas Line By
TYPE OF HEAT GA FA HW STEAM SPACE HTR. UNIT HTR. OTHER
MAKE
Model
Soria
INPU1
THERMOST,�
Valve —�
Limit —�
Limit Setting
Fan Setting _
Pilot Type _
CONTROLS
.4m Heat Plug
MAKE OF BURNER _
Model
Max. BTU Rating —
MAKE OF FURNACE
Model
11
Vent Size __ 9
KIND OF LINER —
Draft
Hood
CONVERSION
Regulator _
SUB
Filters Size NIAMber
Chimney Location Outside
Chimney Construction 1 d
Z&--
Pi lot Make
Pilot Model Smoke Bo b Wiring
Pilot TimDraft Test Tag
L.W. Cut Off Door Pressure Lighting Inst.
Pressure 17 Percent CO Date Tested —
Input CFH Percent 02 Company Testing
Stack Temp. Percent CO Name of Tester
NONE
3
Form 235