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HOUSE HEATING TEST <br />RECORD <br />ADDRESS 101 i fu" -5 ^f <br />APT. <br />FLOOR --CITY <br />� l SUBURB 0'j <br />OCCUPANT <br />OWNER <br />HEAT LOST DATE HTM INST. <br />uLO BY lT-- INSTALLED <br />Eleawiaal Wert« by Goa Line By <br />BYE <br />TYPE OF HEAT GA � FA 1,G..HW _STEAM ._SPACE HTR. UNIT HTR. OTHER <br />G DESIGN CONVERSION <br />MAKE rr MAKE OF BURNER <br />M1e"I ' Medal <br />Sariel Mau. BTU Rating <br />INPUT % O'y MAKE OF FURNACE <br />CONTROLS <br />THERMOSTAT NMI Plug <br />vellpe <br />Limit . .r ire Tsi 1 - <br />Limit Settiwg <br />Fan Se" wg <br />Pilet Type F <br />Vent Size <br />KIND OF LINER � SIZE6=_NONE <br />Draft Heed Ragrlstw <br />Filters Size lu—mber <br />Chimeey Lesolien Inside Outside <br />chimney Csns"wetien �.....� <br />Pilot Menus <br />Piles Msdsl SBomb Wiring L_ / <br />P IIN Timing b a s��_ Dreft 1 ti'-b L t:' Teel Tag _:.Z.._._ <br />L.W. CA* OH Dear Pressure Lighting Inst. - <br />Pressum ff . Pareeo co � v Dees Tossed - -2 <br />Imwt CPH JAI Peraowt 0= -7 i- Company Testing - <br />So" Temp.. /U f Pereswt cm �' Names of Tester <br />