4250 Lexington Ave - Heating TestHOUSE HEATING TEST RECORD
ADDRESS Ap T.-FLOOR CIT SUBURB
OCCUPANT -? OWNER
HEAT LOSS ? DATE HTG. iNS
SOLD BY rte' V? ??C? INSTALLED BY -/?>*?
Electrical Work By Gas Line By ` C
TYPE OF HEAT GA _FA _HW STEAM -SPACE HTR. -UNIT HTR. OTHER
GAS DESIGN CONVERSION
MAKE J?.ff'YY? MAKE OF BURNER
Model Model
Serial Max. BTU Rating
INPUT A-40 mw MAKE OF FURNACE
C ROILS
THERMOSTAT Heat P ?
Valve 4,44 4rE/
Limit
Limit Setting
Model
Vent Size
KIND OF LINER_
Draft Hood
Filters Size
Fan Setting _ Chimney Location Ins
Pilot Type Chimney Construction
Pilot Make 4::;Iw
Pilot Model Smoke Bomb
Pilot Timing Draft
L.W. Cut Off Door Pressure
SIZE NONE
or rss- 3
Outside
Wiring X
.Test Tag
Lighting Inst
Pressure 41 Percent CO2 Date Tested `3d P7
Input CFH- 9.,9 Percent 02 Company Testing
Stack Temp. Percent CO Name of Tester 17
Form 235 -
,may / HOUSE HEATING TEST RECORD
ADDRESS ?s+ L Lt/ 6-0 APT.-
OCCUPANT _A-L A.IA4 OWNER
FLOOR
CITY 4URB
HEAT LOSS DATE, ?HTG,.?} NST.
SOLD BY ?C INSTALLED BY
Electrical Work By Gas Line By
TYPE OF HEAT GA FA _HW STEAM -SPACE HTR. -UNIT HTR. -OTHER
AS DESIGN CONVERSION
MAKE S-0 I A lGS MAKE OF BURNER
Model Model
Serial - Max. BTU Rating Z?z
INPUT MAKE OF FURNACE
Model
CO LS
THERMOSTA eat Plug,
Valve Z??i0s/1' L:O c?I'
Limit
Limit Setting
Vent Size
KIND OF LINER SIZE NONE
Draft Hood Regulator 3
Filters Size '? Number
Fan Setting I Chimney Location Inside Outsid
Pilot Type L Chimney Construction -?
Pilot Make A Z'
Pilot Model lS _I evh Smoke Bomb' Wiring
Pilot Timing All / Draft ' Test Tag
L.W. Cut Off Door Pressure Lighting Inst
f d
Pressure Percent CO2 Date Tested L '
Input CFH Percent 02?rt Company Testing
Stack Temp. Percent CO /e Name of Tester
Form 235
HOUSE HEATING TEST RECORD
ADDRESS J't J o ?C?i'f?y(sI?Cr-J /4?E APT.-FLOOR
OCCUPANT OWNER
HEAT LOSS DATE HTG. INST.
SOLD BY INSTALLED BY
Electrical Work By Gas Line By
TYPE OF HEAT -GA _FA_HW -STEAM -SPACE HTR.
- HTR. -OTHER
UNIT
?J
5 GAS DESIGN CONVERSION
7,1A-&
MAKE • -/G r MAKE OF BURNER
Model /0r y X6 QN Model
Serial Max. BTU Rating
INPUT (f MAKE OF FURNACE
Model
CO ROLS .i
?•
THERMOSTAT Vent Size ?
f ? ? ? -
Valve ?/ KIND OF LINER ' SIZE NONE-
Limit Draft Hood '?- Regularor
Limit Setting Tr. Filters Size N
umber
Fan Setting .ter Chimney Location ?
+
Inside ,be Outside
Pilot Type Chimney-Construction ??-r
Pilot Make -----
Pilot Model A ?/? ???^ < < ?
Smoke B Wiring
Pilot Timing ??"???? - Draft ?= Test Tag
L.W. Cut Off Door Pr ssuf;? Lighting Inst.
r-
Pressure
?O? Percent C02 Date Tested
input CFH Percent 02 Company Testing
Stack 'Temp. Percent CO Name of Testet---
_Foim 235 -
CITY -"?SUBURB
?
C2 P" ?
c L
?/
EC01
HEATING TEST
h
.
• ?
D
/
-/ ?
ADDRESS L :nA APT.-FLO OR CITY SUBURB
OCCUPANT OWNER 1
HEAT LOSS DATE HTG. INST.
SOLD BY INSTALLED BY a
Electrical Work By G
45-Pr" G" G Gas Line By pac ec
TYPE OF HEAT GA V F HW STEAM-SPACE HTR. - UNIT HTR. -OTHER
GAS DESIGN NVERSION
MAKE MAKE OF BURNER
Model tIA& 6 Model
S
i
l A
'?;W(
A 6E BTU Ratin
7yh W2 Mo
er
a !L g
z.
INPUT ry '
f,"7e7d MAKE OF FURNACE
1 i
Model
CONTROLS
7r''
THERMOSTAT Heat Plug Vent Size
Valve .> a KIND OF LINER NONE
SIZE
Limit - ??..?? //
Draft Hood f .!A/4Z 5 `
R a I *or
Limit Setting Filters Size 25)(2 / Number.
Fan Setting ` OXV 447? 6f42Chimney Location Inside Outside
Pilot Type f Chimney Construction
Pilot Make C/
Pilot Model Smoke Bomb r Wiring n?
Pilot Timing 72 SAC Draft Test Tag V
L.W. Cut Off •? ` Door Pressure Lighting I t
Pressure -s SPercent C02 -u-'T- Date Tested ?/7/ -?-7
Input CFH? Percent O ° Company Testing -Rouse Mechanical, Inc.
Stock Temp Percent COY 11348 K-Tel Dr.
Minnetonnka,a, MN 55343
Name of Tester z y t