3962 Denmark Ave - Heating Test RecordSEDGWICK HEATING & AIR CONDITIONING CO.
8910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS, MN N 55420 • (952) 881 -7739
ADDRESS 3919 0� M A X A `0 E CITY
OCCUPANT �` c ,44 OWNER
SOLD BY INSTALLED BY
MAKE MODEL
SERIAL NO.
VALVE
LIMIT
LIMIT SETTING
FAN SETTING
PILOT TYPE
FORM 235 (REV. 6/08)
L n
- c?(( rd (7
THERMOSTAT
460
IGNITION MODEL
PILOT TIMING
PRESSURE
INPUT CFH PERCENT 02
STACK TEMP.
PERCENT CO
PERCENT CO
INPUT
VENT SIZE
TYPE OF LINER
LINER SIZE
FILTERS SIZE
WIRING
TEST TAG
LIGHTING INST.
DATE TESTED
COMPANY TESTING
NAME OF TESTER
HEATING
TEST RECORD
JOB NO
AP? 1
S La --Ou.4 o9A/ 3 L,
� K-2-c - /r1
L //5-7/
NUMBER
FORM DISTRIBUTION: WHITE COPY - JOB FILE YELLOW COPY - CITY