3425 Golfview Dr - House Heating Records
HOUSE HEATING TEST RECORD
7(' ?
ADDRESS ljl vv
APT
F OR
C
TS
O t.CUPANT ?.?-?` i. ?L"' i.Y?J' ,? .
OWNER ?
6 I
UBURB
HEAT LOSS DATE HTG. INST.
SOLD BY -61d „''c• INSTALLED BY .. , '...
Electrical Work BY Gas Line By ?- E
-
?
TYPE OF HEAT GA _ FA )(__HW -STEAM SPACE HTR. UNIT HTR. OTHER
? GAS DESIGN CO
1 VERSION
MAKE MAKE OF BURNER /11
Model Madel
J
Serial 10 r
? "z 2-
Max. BTU Rating
INPUT MAKE OF FURNACE
Model
jCO?TROLS
THERMOSTAT 4 T He t Plug
Vent Si:o U/7/:?
wJ!?i I?C/' ?
Valve KIND OF LINE SIZE NOME
Limit Draft Hood ? Ragularor r
Limit Setting Filters Size Number
Fan Setting Chimney Location Inside Outside Gf
-
Pilot Type Chimney Construction'?"i? _
Pilot Moke
Pilot Model Smoke Bomb °?- Wiring L`
Pilot Timing •??^?- Draft T
t T
z?
es
ag
L.W. Cut Off ! Door Pressure Lighting Inst.
Pressure- percent CO
1 Date Tested
2 X
3' ?
Input CFH VG?? Percent 02
'i%
" Company Testing
?..?
M
Stock Temp percent CO Name of Tester
K?
Form 235 r
HOUSE HEATING TEST RECORD
ADDRESS' v
APT.-FLOOR CITYUBURB
OCCUPANT OWNER
HEAT LOSS DATE HTG. INST.
SOLD BY INSTALLED BY 711
Electrical Work By Gas Line By
TYPE OF HEAT GA _ FA HW -STEAM -SPACE HTR. UNIT HTR. L .Z-OTHER
AS DESIGN CONVERSION
MAKE me MAKE OF BURNER
Model Model
Serial -,9 lC) Max. BTU Rating
INPUT 'w qL 0a C1 MAKE OF FURNACE
Model
CO ROLS
THERMOSTAT _ t Plug Vent Size
Valve diez- KIND OF LINER SIZE
NONE
Limit rrm ?
D
ft H
d
R
l
ra
-
oo
egu
aror
Limit Setting Filters Si
"- N
ze
um or
Fan Setting 'k Chimney Location Inside Outside
Pilot Type Chimne
Co
tr
el
ti
t4 e
y
ns
uc
on
i
Pilot Make
Pilot Model Smoke Bomb Wiring
Pilot Timing Draft %
t T
T
ag
es
?-
-
L.W. Cut Off Door Pressure e
Lighting Inst.
Pressure LAY
Percent C0 L??.2/'-'Q?+?
Date Tested
Input CFH 61 2
Percent 02
yL
Company Testing
Stack Temp. _L/?!/ } Percent CO 41tg Name of Tester ???
Form 235
HOUSE HEATING TEST RECORD
ADDRESS-`, Z' r, APT._FL00 ITY? SUBURB
OCCUPANT G? ?Co 4 OWNER 7
HEAT LOSS 13ATE HTG. INST.
SOLD BY 1W -.l5 INSTALLED BY
Electrical Work By Gas Line By
TYPE OF HEAT GA_FA_HW-STEAM -SPACE HTR. UNIT HTR. OTHER
GAS DESIGN
MAKE ?i?G ?E MAKE OF
Model Model -
Serial Max. BTU
INPUT y/?G>> D ? MAKE OF
Model
THERMOSTAT
Valve
Limit
Limit Setting _
Fan Setting
Pilot Type
Pilot Make -
CONVERSION
BURNER
Rating -
FURNACE
LS Plug _ -4 Vent Size
KIND OF LINEg ? SIZE -NONE-'
Draft Hood Regularor rc-DUS
Filters Siz '^ Number
Chimney Location Inside (? Outside
Chimney Construction 6'w4r -, -4:91
Pilot Model Lf
Smoke Bomb Wiring
Pilot Timing 414G Draft Nest Tag G/
L.W. Cut Off ?- Door Pressure _ /? Lighting Inst.
Pressure Jp''J Percent C02 ?J Date Tested
Input CFH Percent 02 Company Testing -_ i .moo
Stack Temp. w Percent CO Name of Tester
Form 235 6A
HOUSE HEATING TEST RECORD
ADDRESS* ??a •? APT. X FOR CITY?UBURB
OCCUPANT d0 OWNER
HEAT LOSS DATE HTG. INST.
SOLD BY INSTALLED BY? m
Electrical Work By Gas Line By
TYPE OF HEAT GA_FA_HW-STEAM -SPACE HTR. UNIT HTR.L/_OTHER
AS DESIGN
MAKE MAKE OF
Model "tic Model -
Serial 4!!j la tt/ Max. BTU
INPUT - f!Za O, O MAKE OF
Model
THERMOSTAT He Plug
Valve (/
Limit
Limit Setting
Fan Setting
Pilot Type
Pilot Make
Pilot Model
Pilot Timing
L.W. Cut Off
Pressure !?t( Percent C02
Input CFH y?lJ Percent 02
Stack Temp. ?'yU Percent CO
Form 235
CONVERSION
BURNER
Rating -
FURNACE
Vent Size %D //
KIND OF LINER SIZE NONE
Draft Hood Regulator
Filters Size Numbs
Chimney Location Inside y Outside
Chimney Construction 1?7
Smoke Bomb Wiring L/
Draft Test Tog
Door Pressure •? -` Lighting Inst. y
Date Tested
Company Testing
Name of 'Tester
HOUSE HEATING TEST RECORD
ADDRESS' APT. -OOCIT °^^'SUBURB
OCCUPANT g OWNER.
HEAT LOSSDATE HTG. INST.
SOLD BY A_ 7Y7 INSTALLED BY
Electrical Work By Gas Line By?
TYPE OF HEAT GA _ FA _HW-STEAM SPACE HTR. UNIT HTR. -OTHER
ei,r G D_E SIGN CONVERSION
MAKE /?°/®}- - MAKE OF BURNER
Model A'K3 Model
Serial ZA /-,/ Max. BTU Rating
INPUT 'yQD BD D MAKE OF FURNACE
Model
/v`(/ ?S TROLS
THERMOSTAT; r eat Plug
Valve
Limit
Limit Setting
Fan Setting _
Pilot Type -
Pilot Make -
/&
Vent Size
KIND LINE * SIZE--??NONE
Draft Hood , Regularor ?r-+1 (?? •??
Filters Siz Number's
Chimney Location Inside L_? Outside
Chimney Construction A e /13
Pilot Model Smoke Bo
b Wi
i
m r
ng
Pilot Timing y?• Draft d ?/'ew9 T
t Ta
_ es
g
L.W. Cut Off Door Pressure Lighting Inst.
Pressure Percent CO 7'a
2
Date Tested
Input CFH ?Zlg o Percent 02 Company Testing
•
Stock Temp. I Percent CO 0?t !? r .
Name of Tester rswlr..c
Farm 235
HOUSE HEATING TEST RECORD
ADDRESS
OCCUPANT J.? APT.FLO R?J?CIT''e' +ti SUBURB
y OWNER A !'??-c. O
HEAT LOSS DATE HTG. INST. -
SOLD BY ?-7?7-•?. INSTALLED BY
Electrical Work By Gas Line By
TYPE OF HEAT GA_FA,HW_$TEAM SPACE HTR.-UNIT HTR. G.GOTHER
G S DESIGN
MAKE
"
-
a
MAKE
OF BURNER
.fKD D
0? Model
Serial O-,d l/t'riex ,,14/ Max. BTU Rating
INPUT ?XOO dL7 p MAKE OF FURNACE
Model
THERMOSTAT
Valve
Limit
Limit Setting
Fan Setting GL
Pilot Type
Pilot Make
Pilot Model
Pilot Timing 1J o `?t'-°
L.W. Cut Off
Pressure Percent COZ
Vent Size
KIND OF LINE",R_.?.?,' SIZE NONE
Draft Hood Regularor a O .r
Filters Size v -' Numbe
Chimney Location Inside //1-/ Outside
Chimney Construction /_?
Smoke Bomb Wiring
Draft ?s+?'Lr Test Tag
Door Pressure Lighting Inst.
Date Tested Vim^o2??f Z"
Input CFH Percent C) Company Testing -/ '
Stack Temp. Percent CO Name of Tester
Farm 235
HOUSE HEATING TEST RECORD
e
ADDRESS ?_-AP T. 00 CIT SUBURB '
OCCUPANT °I OWNER
HEAT LOSS _DA HTG. IN
SOLD BY INSTALLED BY
Electrical Work By _ Gas Line By I / ! I
TYPE OF HEAT GA _ FA _HW -STEAM SPACE HTR. UNIT HTR, OTHER
GAS DESIGN CONVERSION
MAKES MAKE OF BURNER
Model S/d O 14/R' Model
Serial fG //O
Y14 Max. BTU Raring
INPUT lid- 20 MAKE OF FURNACE
Model
0 CONTROLS
THERMOSTAT Yyry
ea Plu
l,.eJ.rr?
Valve
Limit Limit Setting ?l
Fan Setting etof
Pilot Type
Pilot Make
Vent Size ?d -
KIND OF LINER SIZE- NOI E
Draft Hood -? ?- Regulator A 420
Filters Size
Chimney Location Inside !/ Outside
Chimney Construction e_45/ted .Q
Pilot Model Smoke Bomb Wiring
Pilot Timing y7 Draft 466111100P +wr.? Test Tag f/
L.W. Cut Off - Door Pressure Lighting InsL C-'
Pressure 04 Percent CO 7.V Date Tested
Input CFH ?BPD 2
A Percent 02 jor.-T Company Test'ag
Stack Temp. lPyd Percent CO Name of Tester
Form 235