1285 Corporate Center Dr - Heating Test RecordsI ?J
ADDRESS v ?4
_OCQUPANT -??
HEAT.LOSS
SOLD BY ?
Elechical Work By
TYPE OF HEAT
N
MAKE.
Mod•I _
Serial _
INPUT
/
Limit ?
Limit Sotting
Fan Setting -
Pilot Type _
Pilot Make _
Pilot Model .,
Pilot Timing
L.W. Cut Off
Input CFH _
Stack Temp.
Fwm 235
HOUSE HEATING TEST RECORD
APT.CI??SUBURB
_,. _?:;,OWNER
IhSTALLED BY
'T Gas Line By .?
STEAM SPACE HTR.
Vsnt S;ze X
KIND OF LINEql2?-
Drak Hood _LY?
Filte.s sizel
Chimney Loeation
Chimney Construction
Smoke Bomb
DraFt ?
Door Pressure -
Date Testsd _
Company Testing
Name of Tester _
!? ? l
a?DDRE55 ?
OCCUPANT ?
HEAT LOSS `
SOLD BY
Elechical VYork By
TYPE OF HEAT
MAKE.
Mode I
5sria l _
?NPUT
HOUSE NEATING TEST RECORD i
rC,&'2 AL - APT. F 0 R CITY ? B
OWNER ??
HTG.
GA FA __?c
GAS DESIGN
?? • r INSTALLED BY Z2a dy4r1l
Gas Line By /
W STEAM SPACE HTR. UNIT HTR. OTHER -
CONVERSION
Model
Max. BTU Ratiny
MAKE OF FURNi
CONT OLS ?
THERMOST
f eof Pluy Yent Sixs
Valve? KIND OF LINERSIZE -- NONE
Limit Draft Hood
?;?` Reyulator
Limit Settiny ,
? Fi Itors SizsL Number ?
Fan Setting ? Chimnsy Location Insids Outsida
Pilot Typs " [??LZ?LlL11L(? Chfmney Construetion
Pilot Make
Pilot Model Smoke Bomb Wiring
Pilot TiminS DraFt ?7q,/?JzC??Ts.t Tag
L.W. Cut Off Door Pressure Liqhting Inst.
Prossure Percent C0
Dote Testsd
Input CFH 2
Peresnt 0 2 Company Testing /7'
$toek Temp. ? Percent CO Name of Tester
Fwm 235
OCCUPANT
HEAT LO55
SOLD BY '12///Z" ?
Elsctrieal Work By `"
TYPE OF HEAT GA
MAKE.
Model
Serial _
INPUT
HOUSE FiEATING TEST RECORD
4? e?? `? ??"?? D? • APT. F R?-- CITY f>?
7 OWNER ??? ?
E HTG. IN3.T. r?
? INSTALLED BY ?D49,411Q7"/C !? r
C,?7-5- Gas Lins By
FA HW STEAM SPACE HTR. UNIT HTR. OTHER7a/CE l Td? ,
GAS DESIGN
CONVERSION
p N 1 KULJ , -
THERM $TA . h/? Heat Plug Vent Size X3 ;
Valve L KIND OF LIN/ER SIcE NONE
Limit ? Draft Hood Regularor
Limit Settin9 Filters SizeJ&x??K7? Mum6er
Fan Setting Chimney Location ?Insida Outside
Pilot Type ?G?G? raQNlL- Chimney Construction
Pilot Make P
?---
Pilot Model Smoks Bomb n Wiring
Pilof Timing `-? Draft Test Tag
L.W. Cut Off ? Door Pressure Lighting Inst.
Prossure Percent CO2 - ? d Date Testsd Input CFH Percent OZ ?O' 0 p??D Company TesTing ? Js C
Stoek Temp. ? -Percent CO (?Lr D/o Name of Tester
Form 235
,1 _.
??,?.
ADDRESS _
OCCUPANT
HOUSE HEATING TEST RECORD
wrj?;y , APT. FLOOR CITY SUBURB ?
OWNER C2,7-S,
HEAT LOSS '-'- DOE HTG. INS. ?'"- ?
SOLD BY C INSTALLED BY
Electrieal Work By 2?5_ S Gas Line By
TYPE QF HEAT GA FA HW STEAM SPACE HTR. UNIT HTR. OTHER ~
GAS DESIGN CONVER510N
MAKE E OF 6URNER - :
Modsf Model
Sarial ?r p /7// Max. BTU Rating
INPUT ? 3Z9 8'n MAKE OF ACE
O TROLS
THER J? eat Plug ?- Vent Size
Valr? KIND OF LINER SIZE ? NONE ?--
Limif Y ? Draft Hood ?Re`gularor
Limit Seriing.??,??? Filters Size?,Q*?ZD ? ?IVumber.
Fan Setting Chimney Location side Oufaide
Pilot Type 7WO1
?/ 1 A 7 Chimney Construction -5 / ?97?L
Pilot Make - VA?z
Pilot Model / Smoke Bomb Wiring
Pilat Timing Drcft -?Gr_,eo Tese Tag
L.W. Cut Off ??- Door Pressure Lighting Inat.
Prossure.?• -5Percant CO2 •? Date Tested
Inpuf CFH Pereent 02 1/1, 5-1316 Company Testing 5
Stack Temp. ? Pertent CO ?•Q 0 Name af Tester
Form 235
AdDRESS ?
OCCUPANT'
HEAT LDSS
SOCD BY ? -
Eleetrieal Work By
TYPE OF HEAT GA
MAKE.
Model _
Ssria l _
INPUT
Valve ?
Limit -?
Limit Sstting
Fon Setting _
Pilot Type -
Pilot Make _
Pilot Model _
Pilot Timing
L.W. Cut Off
Input CFH_
Stack Temp.
Form 235
HOUSE HEATING TEST RECORD
APT. L R CITY ` SUBURB
OWNER ? S
^ INSTALLEd 6Y
???C " • Gas Line By - s ?
STEAM SPACE HTR. UNIT HTR. OTHER
CONVERSIqN ,:. .
l?rvr nc oo??o f-a
Vent Size ?
KIND OF LINEjtT
Droh Hood
Filters Sixe ?
Chimney l.oeation
Chimney Construction
Draft " L-?/l`
Door Presaure_
Qate Tested __?
Company Testing
Name of 7estsr _
ADDRESS
OCCUPANT SP?R
HEAT LOSS
SOk..D BY
Electrical Work By '
TYPE OF HEAT GA
MAKE.
Model
Serial _
INPUT
HOUSE HEATING TEST RECORD - !
APT. FLOOR CITY ?/?SUBURB
? OWNER 'E HTG. INST. ?
? INSTALLED BY
? Gas Line By II
FA HW STEAM SPACE HTR. UNIT HTR. OTHER
?jl?/?
?ROLS X?
T6
THERMOST ???f at Plug Vent.Size
Valvs KIND OF LINER SIZE NONE - ?
?
Limit ? Droh Hood N-1 RsyulaTOr ? Z
Limit 5etfing Filters SizeIlb k'Z,,,-'9y7- Number
Fan Setting ? - ? Chimnsy Location I de Outside
Pilot Type Chimney Construction
Pilot Make 7'
PilotModel Smoks Bom n Wiring
Pilot Timiny )0%47-0 lz_? ?-•? Droft ?, ?,LGI?G Test Tay
.r---??
L.W. Cut Off Door Pressure Lightiny !ns*-
/' ?
Pressure Percent C02 ? Dafe Teated
Inpuf CFH ?g???p Peresnt OZ to -s?a Company Testin
Stack Temp. ??z.? Percent CO 4?2' ?2d Name of Tester
Form 235
r
? -""a` .
ADDRESS / ':?- O
OCCUPANT -=:J5
HEAT LOSS
SaLD BY -??
Elsctrical Work By
TYPE OF HEAT
HOUSE HEATING TEST RECORD ?
APT. FLOOR CITY?A?SUBURB
OWNER DZOu S
"G . INSTALLED BY .,DBJlI?G ?r'
'rT Gas Line By
STEAM SPACE HTR. UNIT HTR. OTHE -
G 5 DESIGN CONVERSION
MAKE
- M BURNER ? --°
Model 5 47 Model '
5erial d Max. BTU Rafiny
INPUT a 0-3 ?a MAKE OF FU
CQNTROLS >
• i
THERM /???
//I-Fieat Plug ?
Vanf Sise G
Valve , K I N D OF LINER 4E SIZE ?TIONE
Limit ? - ??7 Draft Hood ?NF Rsgularor ?
Limits+*ing /7 'o Filters Size7-Dff ZSXZ Number.
Fan Setting ? Chimney Location Insid
-Outside
Pilot Type ?
Chimnsy Construdion ?T?!?"? L'
Pilot Make
Pilot Model Wiring
Smoke B
om
b
?
-
,/
6:
QNL
Pilot Timing Druft r.lc,dL
Test Tag
4
L.W. Cut Off
C /
Door Pressurs Liyhtiny Inst. Y
"
Pressura Psreent CO Date Tested
Input CFH Z
Peresnt 0 2 • ? D Company Testing ST G
Stoek Temp. ? Pereent CO ' a Name of Tester
Form 235 t
?
HOUSE HEATING TEST RECORD
ADDRESS Z e, APT. FLOOR CITSUBURB '
OCCUPANT
OWNER
HEAT L0S5 DATE HTG INST. ,
SOLD BY INSTALLED B ?/?
Eleetrieal Work By Gas Lins By "--//
TYPE OF HEAT GA FA,,'<-HW ' STEAM SPACE HTR. UNIT HTR. OTHER -
-r , GAS DESIGN CONVERSION
MAKE.
Model
Serial _
INPUT
CONTROLS ` `f
THERMOSTA??/? Heat Plug Vent Si:e ?
ry
Valve KIND OF LINERA/ S1ZE -? NONE
Limit Droft Hood ,l?,.I ,A? Rsgularor, , / /
Limit Settiny ? Fi Iters Size ?„ ? ?, zNumber y
Fan Setting Chimnay Location Inside Outside ?
Pilot 7ype Chimney Construction
Pilot Make
'
",
/
?
Pilot Model Smoke Bomb Wiring
Pilot Timin G??? /? cU ? Cf Draft =/7 TesT Tay
L.W. Cut Off Door Pressure Liyhtiny Inst. ?
i
Prossure ?- S?'
Percent CO 7,9 ?0 Date Tssted
-
Input CFH '? 0D Percent pZ ?. 9_ Company Testing
Staek Temp. 3 70 ? Pereent CO Name of Tester
Fwm 235
HOUSE HEATING TEST RECORD
1 ? S B
ADDRESS APT. FL00 CITY
URB
OCCUPANT OWNER ? ys,
HEAT L055 ATE HTG
NS
T
`
?
,
/
DO
P
SOLD BY INSTALLED BY owfST/C
Elaet?ical Work By ? -o r• Gas Line By
TYPE OF HEAT GA FA HW STEAM SPACE HTR. UNIT HTR. DTHER ??ajrOP
? GAS DESIGN CONVERSION
MAKE E OF BURNER
Model Modsl
Serial 8TU Ratiny
Max
.
INPUT MAKE OF FU
T
E Qp NTROLS - -
?• ?? • /'X?
V
S
?
H Heat Plug ent
ize
Valv l' KIND OF LINER SIZ ` NONE
Limit ?? T?? Draft Hood eN? Reyularor X17r,",,e) - "
Limif SeMiny
Filters Sizs. 41
? Number -
Fon Settinq Chimney Location I side Outside
Pilot Typs LE Chimnsy Construetion
Pilot Maks ? ? V,4^11rJ
Pilot Modsl Smoks Bomb Wiring
Pilot Timing Draft ? ?G
LI-I
Test Tog
Cut Off
L.W.
Door Pressurs
Lighting Inst.
D
Pressure Percent CO2 ,Date Tested
Input CFH Psrcent 0 any Testing
? 15?7 ? Com
2 p
Staek Temp - - Percent C0 Name of Testsr '
Form 235
ADDRESS
OCCUPANT ?d
HEAT LO55 '
SpLD BY
Elsetrical Work By
? TYPE OF HEAT
DESIGN
HOUSE HEATING TEST RECORD
APT. FL OR CITY B
OWNER ??ys
INSTALLED BY
STEAM SPACE
MAK E MA!
Model Model
Serial &I e!:?7 r-5' C Q L Max. BTU Ratiny
INPUT l49Z';'? MAKE OF FURN.
CONVERSION
oLs
T s / ,r
THERMOSTAT ?
?E
eat Plug Vsnt Size ?
?-
Valve KIND OF LINE
SIZE f NONE
Limit Droh Hood Regularor AX?r?L ?
Limit SeMing p
? Filters Sizs???x? TJumber
Fan Setting pwE Q Chimney Location Insi 0utside
Pilot Type ? C_
Chimney Construetion
Pilot Make d _... /
Pilot Mode) U ?
Smoks 8
b Wiring
om l? l
?
?
Pilot Timing lT "" ? y Draft Uv?? Test Tay ?
L.W. Cut Off Door Pressure Lightiny Inst.
Pressure Percent CO Date Tested
Input CFH 2
Percent 0
'd 4 Campany Testin C ` I
0
Stack Temp. 2
Pereent CO (V' O a .
Name oi Tesfer i
Lins By
HTR. U N I T HTR. OTHER -
Form 235
ADDR ESS /v u ?
OCCUPANT --iC
HEAT LOSS -
SOLD BY nYG
Eleetrical Work By
TYPE OF HEAT
HOUSE HEATING TEST RECORD
APT. FL OR CITY'??URB
OWNER D?k Q
INSTALLED BY
%ES li?C Gas Line By -??????"?/C
FA HW STEAM SPACE HTR. UNIT HTR. OTHER ?"5VF "-' TOP
GAS DESIGN
MAKE YevAl"(17- IOM OF BURNI
Model _ Mode
Sxial ?9-5-6- y& Max. BTU Rating
INPUT MAKE OF FURP1l
Limit t:5.
Limit Sefting
Fan Setting _
Pilot Type _
Pilot Make _
CONVERSION
VTROLS = s-? ••x
Heat Plug Vent Size ?"'?
KIND OF LINER SIZE NONE
Draft Hood AIZ&?C Regularor _/Z4//?apL .?ZS` 3
,}? ? .,
Filters Sizef???XZ Number /
LAff Chimney Location In de Outside ?
( Chimney Construetion ?'f`1?L
?
Pilot Model L,!
Pilot Timing
L.W. Cut Off
Prossure 3• Percent CO O ?O
2
(nput CFH --Z4570 PercenT OZ ' 0
Stack Temp. 41E Percent CO ,
Form 235
$moke Bomb Wiring
Draft ?L??XCE Test Tag ?
Door Pressure Lighting Inat. ?
Date Tested
Company Testing
Name of Tester
[ X? ?? . r
AQDR ESS ,1 li A/ G,rinJVJ
OCCUPANT s R
HEAT LOSS ATE I
50LD BY - ?G ?ST G
Elechieal Work By
TYPE OF HEAT GA FA
?
HOUSE HEATING TEST RECORD
Dt, APT. FL? ft CITY ?1?7t75UBURB
OWNER ??
4ST. - -
'G - INSTALLED BY ?249'W"57/? N1'G
Gaa Line By
HW STEAM SPACE HTR. UNIT HTR. OTHER -
GAS DESIGN
MAKE MAK URNER
Model Model
Serial AAax. BTU Rating?
INPUT ?z MAKE OF FURNAC
COIVYERSfON
CON.?T-ROL 5
THERMOSTAT N????Wect Plug ?-
Vent'Size ?
Valve ?-0,4WS0 N KIND OF LINE
R `- SIZE NONE
Limit /
Draft Hood Rsgulator 3?, r` 3?
Limit Sstting ?7 's Filters SizsZOYZSX ? .hlumber
Fan 5etting el? ? Chimney Loeation Inside Outside 91
Pitot Type ?e l 1 LT•CO/1/lG- Chimney Construdion
4N
Pilot Make ?0 /
? ? ?
o ---
l?
Pilot Model - Smoke Bomb Wiring
?j
,?.?,
P ilot Timing ? ? ?/ Draft Test Tay ?
L.W. Cut Off Door Pressurs "'- Lighting Inst.
Pressvre Percent COZ
r pote Tested ?
/
Input CFH Peresnt O Company Testing'
Staek Temp. 3,??! Psrcent C0z "!2^ 49?? Name of Tester
Fwm 235 ? ?
HOUSE HEATING TEST
ADDR E55
OCCUPANT
HEAT LOSS
SOLD BY -
Electrical Work By
TYPE OF HEAT
MAKE
Model.
Ssria l _
INPUT
GA FA
STEAM
R
' CiTY --/ ? SUB B
-INSTALLED BY D/J??1ES?C /?EG
_Gas Lins By
SPACE HTR. UNiT HTR. OTHER ?e
CONTROLS •: =
THERMOSTAT plug ------- VsM Size
Valvs ?4/? KIND OF LINE - SIZE ``-NONE ?- I
Limit Drak Hood /? egulamr ?AXZ ? ? 32
? - ? I
LimitSettiny Filters Sizs Number
Fan Setting ..? Chimney Location Inside ? Ovtsids ?
Pilot Type :r ???_t??.l0 L/ ? Chimney Construetion G??S S
Pilot Make ?
?--
Pilot Model Smoke Bom?b Pilot Timing Draff -1L1
L.W. Cut Off Door Pressure
Date Tested e
Company 7esting
Name of Tester -
Wiring V
.Test Taq I
Lighting Insf. I
«'- • '
ADDRE55 v`
OCCUPANT
HEAT LO55
SOLD BY ?' IG
EJectrieal Work By
TYPE OF HEAT
MAKE_
Modsl _
Seriol _
1NP1ST
GA FA P--
GAS DESIGN
THERMOSTAT ?1e
Yalve E ('/!// T/f..d
Limit 122.7 AgA Z
Limit Sstting
Fan Setting
Pilot Type f:2::& 1!?-
Pilot Make
Pilot Model -?-
Pilot Timing
L.W. Cut Off
. ? ??• .
Input CFH_
5tack Temp.
Forno 235 '
HOUSE HEATING TEST
OWNER
,??"Z?v
CITY SUBURB
- IN57ALLED BY
• G ??'?_ Gas Line By
STEAM SPACE HTR. UNIT HTR. OTHER
{ CONVERSION
VsM Size
KIND OF LINE /- SIZE NONE
Dra4e 4iood , ?-ftagulcyor???n7.&- ?-z 5- - 3!
Filters Size-r - um
Chimney Location Inside Outside
Chimney Construction S
Smoke Bb Wiring Y
Draft Test Tay-,?
Door Pressure Lighting Inst.
.0 ". , ?
ADDRESS /G 2!
OCCUPANT A
HEAT L055
SOLD BY
?
Elsctrieal Work By
TYPE OF HEAT
HOUSE HEATING
TEST RECORD
APT. FLO R CiTY ??B
Q WN E R [2?
ATE HTG. INST.
??ST/G 1fyJ INSTALLED BY Z>D+aI/J F_S`rIC liLI?G ?
Gas Line By 61
GA FA _HW STEAM SPACE HTR. UN1T HTR. ?OTHER ?
AS-DESIGN CONVERSION ?
MAKE OF BURN--
Modal Model
5erial ? s f? ? µox. BTU Rating
INPUT MAKE OF FURN,
CONTROLS - - ? ?? --
THERMOSTAT ?4Tr?r Plug ?- Vsnt Size
Valvs ?
u / ?Q [- KINQ OF LIN • SIZE
Limit Draft Hood ? egulator ?
Limit Setting Filters Sixe ` ?Nu?m,b.r
Fan Setting ?? Chimney Location Inside Y u
Piloi Type Chimney Construction ?ill S
Pilot Make
Pi{ot Model ` Smoke Bomb '?- Wiring ?
Pibt Timing s?C • Draft A14r_ Test Tog ?
L.W. Cut Off Door Pressure ` Lighfing Insf.
Pressure Pereent C42 Date Tested
Input CFH? Percent 02 Company Testing
Stack Temp. Peroent CO Z9' C) 2d Name of Tester
ForrS 235 ?
?
-- __ •'