2975 Lone Oak Dr - Heating Test Record HOUSE HEATING TEST RECORD jo?* 3 S4K
ADDRESS a"17S LO OAV N '
APT.-FLOOR_ CITY
Y?L2-5UBUR6
OCCUPANT t?nL6/.S ' GOeP OWNER
HEAT LOSS DATE HTG. INST.
SOLD 8Y N?ONLC 4 INSTALLED 8Y
Elscfrical Werk 8y Gos Line By
TYPE OF HEAT GA _ FA yK--HW STEAM -SPACE HTR. -UNIT HTR. -OTHER
GAS DESIGN CONVERSION
MAKE N C) MAKE OF BURNER
Model Modsl
Ssrial _ Maz. BTU Rating ? 0
INPUT ? alv MAKE OF FURNACE
Modsl
CONTROLS
THERMO TAT saf Plug Van1 Si:e
G
n
? M
?
Va lva V
-?lL SU N I
iT S3 KIND OF LINER SIZNONE
Q
Limff f?? ek le-L- Dro{}Hood Regulotor ? ?> >
h
Limit SaNing 'Au Filtars Size
Numbar
/t
7
Fan Selting Chimney Lo<ation Inside Outaide
?
-?/
Pilot Typs yrd?f Chimnsy Canstruction
Pilot Maka L//AAId ?
Pilot Modsl Smoke Bomb Wiring ?f
Pilot Timinq ? Dru{t ?.N??'? Test Tag ?Cf
L.W. Cut Of( ' Door Preseure ? lighting Inst.
?t
Pressure A? W?
7#0 h Dofa Tasted ?/2 k[
PeresnlCO
u
Input CFH t ? ?
Percent OZ Company Testing 'V
$rock Temp. nt CO Name oi Testar ?_
F«m 235
HOUSE HEATING TEST RECORD
ADDRESS 2-175 L45rVi-' dUlC Ok APT.-FLOOR
DCCUPANT M44116 coa p OWNER
HEAT LOSS DATE HTG. INST.
SOLD BY 1NPNZlL INSTALLED BY
Electrical Work By Gas Lina 8y
TYPE OF HEAT GA_FA HW -STEAM -SPACE HTR. UNI7HTR. _OTHER
?/ GAS DESIGN CONVERSION
MAKE ????.L? MAKE OF BURNER
Medel Q5??,j? Modsl
S b??D6E l? !f? Max. 8TU Roti?g
INPUT ? U? 437V MAKE OF FURNACE
Medel
CONTROLS
THERMOS AT Heat Plug
Valva V Sra o CoJ, 7?16
Limit t "4e(-
Limit Settiny
Fan Setting
Pilot Type
Pilot Make LeAlNC? ?
Pilot Model io I 7 -6/ o
Pilm Tlming 1?0 57,e(--
L.W. Cut Oif
Vsnf $ixe I/1 ?`Lt I
KIND OF LINER SIZE NONE
Drafl Nood Regulmor 9;tS r
Filfsrs $ize ???au xZ Mumber q
Chimnsy LocaTion Inside Outside
Chimnsy Canatruttien
Smoke Bomb ?r Wiring ?
Draft -EN?t7f'e? Test Tag
Door Pressure?LighTing Inst. ,Z
Dofe Tesfed _
Prossurs Psreenf CO? ??y `? ?
Input CFHPeresnt OZ , 7tOM Cempany Testing
Stack Tamp. L(?7 Pareanf CO Name o( Tester _
,Tob0 3SHv
CITY 1?'kSUBURB
Form 235
HOUSE HEA7ING TEST RECORD ?ry1pr? .??? 35??
AUDRE55 a?15 LCJti2 l/A(L !/f- ppT.-FLOOR_CITYN-1b'°SUBl1R8-
OCCUPANT fi0?? 409P OWNER
HEAT LOSS DATE HTG. INST.
SOLD BY bjy 'vu4 - INSTALLED BY
Eleehical Work By Gos Lins By
TYPEOFHEAT GA-FA._.,&-HW STEAM _SPACEHTR. UNITH7R. OTHER
GAS DESIGN CONYERSION
Y.,
MAKE l?NNU? MAKE OF BURNER
Modsl TG-AQhn dpH j Model
Swial 69O Ma:. BTU Rarinq
INPUT MAKE OP FURNACE
Modal
CONTROLS
THERMOSTAT Heot Plu Vsnt 5izs 0 (/`fL ?
g
Vulva 11 KIND OF LINER SIZE NONE
LimH p1/ ?"t ? Droff Hood Regularor
Limit $eMing 3 ?UUr Filters $ize ??Numbar ?
1
FanSetTing 11 ?"'KC ChimnayLocation Inside Oufsida
Pilet Typa ir1/V"e Conseruetion
Chimna
y
Pilot Make 1-rN"vx
Pilof Mode) $moks Bomb -- Wiringg
?
Pibt Timing Draft _ZVA/ - ?TesT Taq
?'
L.W. Cut Of{ Door Pressure Lighfing Insf. ?
/
13' WC
b n 66 ?
Pressuro
ParcenTCOZ ' Date Tested
Inpvt CFH /90 Parcent OZ ? ?On Company Tesling NzIe-
$tetk Tamp
? F ParcanT CO Name of Tester e?
. _
Form 235
a,ew -KkD9 01g,
HOUSE HEATING TEST RECORD
ADDRESS p?,"/ 75- I 11Aaf dr<?41 119dK- .APT._FLOOR CITY'_SUBURB
OCCUPANT NULn4if!5 c- ore OWNER
HEAT LOSS DATE HTG. INST.
SOLD BY kreA,2-'L f-- INSTALLED 8Y
Eleelrieal Werk By _
TYPE OF HEAT GA
Gas Line By
FA _,4_HW _STEAM SPACE HTR. UNIT NTR. - OTHER
yGAS DESIGN CONVERSION
MAKE &OA /? T MAKE OF BURNER
Model -d U h1 16T Model
Sxial Tb 0 _6_6r06 SS3b Max. BTU Rating
INPUT f?,,WX1 151V MAKE OF FURNACE
Model
THERMOSTA
Va Ive -IC?
L-imil -
Limit Sstfing
Fon Settin9 _
Pilot Type _
Pilof Make _
Pilot Model _
Pilot Timing
L.W. Cut 04S
CONTROLS
Pressure j w Psrcent COZ {? ?h
Input CFH M Pereent OZ 6????
Stack Temp. ? Percenf CO 2
Fwm 235
Venf Size Ai?G ?-
KIND OF LINER SIZE NONE
Draft Hood Ragulaior
Fil}ers $ixe 0- _Num6er
Chimney Locafion Inside Oulside
Chimney Construclion
Smoke Bom6Wiring _ ?
Drah
Door Press.re l Lightin9 lnst. _
Dote Teated ?/2'7/d?+
Compony Teslin g tAevZ"Kc
Name oF TesTer VQ/
-
HOUSE HEATING TEST RECORD
ADDRESS ';?q/J /?? OCAZ n9l APT.-FLOOR
OCCUPANT- kfOLNVs GOV, d OWNER
J-01, 4?" 35-9 ?,
CITY 'MBURB
HEAT LO55 DATE HTG. INST.
SOLD BY "'UZe C INSTALLED BY
Elatfrical Work By -
TYPE OF HEAT GA
Gas Lina By
FA J.A_HW STEAM -SPACE HTR. _UNIT HTR. _OTHER
GAS DESIGN CONVERSION
MAKE ??Ok MAKE OF BURNER
Model 7l'/?Q?? S n7. 45M 1 Model
Saial Max. &TU R ' e `
INPl1T MAKE OF FURNA['E
Modsl
Valvs _v
Limit -$i
Limit $affiny
Fan Setting _
Pilot Type _
Pilof Maka _
CONTROLS
_Fleat Plug
Pilot Model 'v r / - uIv
Pilot Timing 620
L.W. Cut Off ?
11
Prossure &y Parcent CO2
Input CFH Pareanf 02 ,l
$tack Temp. Psresnt CO
Fam 235
Vsnt Size ? 11Te-?
KIND OF LINER SIZE NONE
Droff Hood Regularor 32IS-S a-
Filters Si:e «I'1i+? Numbsr. , ?-1
Chimney Location Insids Oufside
Chimnay Consiruction
Smoke Bomb r Wiring
0.afi '.t?hUf?C Test Tag ??,O/
Dow Prassure Lighting Inst.
Dofe Tesfad
Company Testing
Name of Tester
HOUSE HEATING TEST
ADDRESS A"` _75? ?kIC.APT. _
OCCUPANT ji)WmGS CD12? ? OWNER.
HEAT LO55 DATE HTG. INST.
SOLD BY ?e??'?1- INSTALLED BY
Elecerical Werk By .Gos Line By
TYPE OF HEAT GA _ FA __HW _STEAM SPACE HTR. UNIT HTR. A- OTHER
?Ay ?J GAS DES(GN CDNVERSION
MAKE /-? D / MAKE OF BURNER _
Model S e j7- ?.ef 0 "S Model
Setial 5-60q ??q 417 Mox. BTU Roting
INPUT ,2A-140'00 74/ MAKE OF FURNACE
Medel
CONTROLS
- Heaf Plug
Va I va .=F,?
Limit iQl
Limit SeHing
Fan Setlin9'
Pilot Type -
Pilot Make _
Pilot Model _
Pilot Tlmin9 'IV ?c?..
L.W. Cuf Offy
Pressure 5/ -?'f,W' L? Percent C02 j,q ffA
Input CFH °' 5-7 Pereent OZ 16 Sicck Temp. ?1?VG percent CO 6
RECORD 3 SV
FLOOR _CITY 1r4NSU8UR8
Venf $ixe
1(
KIND OF LINER SIZE NONE
Draf1 Hood _ Repularor 3???
Filrors Size ?- _Nvmber ?
Chimney Location
Chimney Consirutlion
Inside Outaide
Smoke Bomb -? _Wiring
Dra(1 ?? Tesl Tag?
s !?
Door Pressure / Lighfing (naf.
Date Tested % //2 6.1
Company Testing
Nome o{ Teafer
Form 235
HOUSE HEATING TEST RECORD ?-`t?
AUDRESS 2A 75' Lxn? oaqL O .APT._FLOOR CITYJW?/SUBURB
OCCUPANT 5 COrP OWNER
HEAT LO55 DATE HTG. INST.
SOLD BY U,-e- tiZ?" INSTALLED 8Y
Eleetrical Werk By .Cas Line By
TYPE OF HEAT GA _ FA HW _STEAM _SPACE HTR. _UNIT HTR. _OTHER ?
J GAS DESIGN CONVERSION
MAKE ??N,1d1? MAKE OF BURNER.
Model '7G?N-IfSa J>j? ? G- Model
Sarial 96 LLI_?5cle Max. BTU Rating
INPUT MAKE OF FURNACE
Model
THERMOSTAT
CONTROLS
Vent Si:e
Valve 11
Limi1
Limif $siting_
Fan Setein9 -
Pilet TyPe _
Pilot Make -
Pilot Mode1 _
Pilot Timing _
L.W. Cut OFf _
KIND OF LINER SIZE NONE
Droft Hood - Regulo,or ?
Filters Sie ?Z _Numbm )
Chimney Lacation Inside Outside
Chimney Construction
v?
$moke Bom6 -- Wiring _
Drah .'/ut9(/!e Test Tog
Donr Prossore_ Lighting Inst. ? OPA Pressure ?J "w? `, percenf COZ --? Date Teseed ?h•+ o L
Inpu? CFH I?7? Pereenl O2 73 ?Company Testing OleNf.
Sfack 7emp. Percent CO Name af Tester h/p?
Fonm 235