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Home My WebLink AboutBoilers and Water Heater Jttl.14.2e0S 1:04PM. t-0.715 P. be 6 DEPARTMENT OF FIRE AND SAFETY SERVlCES 1\ . FIRE PREVENTION DIVISION ..{X Y 100 EAST 111h STR!ET, SAINT PAUL, MN 66101 EXISTING FUEL BURNING eQUIPMENT SAFETY TEST REPORT (Use separdte fonn for each appliance) Address: /..ftW'Ta..U .'>T'.s-~ " " Dateif~~ Owner: -r-~ r,Q.Op~-:r~n I ~'f1 ~ A~~I ~ P. L-- M TYPEOFHEAT:~SLL.27r ~~lo? SSl~ Gravity Air_ Forced Air_ Gravity Hot Wster~ Forced Hot Water.,k Steam _ Unit Heater_ Space Heater Other TYPE OF FUEl: Gas ~ Oil Other GAS DESIGN CONVERSION Make of Burner Ct~rtLlJ^,t\ Make , Model (?C;-"p': ~ Model _~_/ Serial - S~g'f Of 0 Max. BTU ting Input 37 ~ 000 MalaHrl ee - Equipment venting type: Atmospheric-X- Induced Fan_ Other Total BTU input of aO.vented gas appliances per chimney: Type of Chin:me.y: Masonry_Class B~ Other Type pf Ul1er: None _ Metal X Clay Tile_ Combustible Air Supply Required?: Yes~ No_ JnstaJled?~ Yes-X. No_ SafetY. & Ooerating Control jests; Xti N2 Pilot/Flame Safeguard Operating Properly ~ Limit(s) Operating Properly . .-t. Operator(s) Operating Properly ~ Low Water Cut..()ff Operating Properly L All Controls Operating Properly ~ Initial Final Stack Tempera~re 1 FIN'7 ~" FINer Oxygen %, % Carbon Dioxide %' ~ % Carbon Monoxide %/ppm ~ %/ppm Carbon Monoxide Detector ltulfe type} Positive Look At Total Heating System'"'8efo~ You Leave: Does system operate safely and properly? COMMENTS: Fuel AnalvsisJRue Gas AnaIvsis: Yes No Vents Properly Wrthout Spillage .J!... Flame Stays' Inside/Doesn't Roll Out.Li. Burner Ughts Smoothly ~ VISUal Insoection Fuel Piping System-Okay Vent Systems-Drafthood. Connector, Vent Chimney-Qkay .x... Heating Unit-Okay .x Neptive X Yes ~ ~ Yes.)L No Phone # 'S"J-7' ~-/~ Driate Fuel: N 'JPOS~ Certificate of Competency Number From City of Saint Paul for Ap RH1 fRIO'll JUN.14.20BS i:94fIt:1 H:I.715 P .b.6 DEPARTMENT OF FIRE AND SAFETY SERVICES FIRE PREVENTION DMS10N 100 EAS1111h STrca:{, SAINT PAUL, UN 66101 xx- ~ . EXISTING FUEL BURNING EQUIPMENT SAFETY TEST REPORT . (Use separate fann far each appIMce) . Address: i-f~oo1Owe.c S~ Sf. _ Date: :3 -7--0 Z p-- Owner: TYPE OF HEAT: Gravity Air_ Forced Air_ Steam Unit Heater_ TYPE OF FUa: Gas X. Oil GAS DESIGN Make of Burner CA.f(,I....V"'-Y"'I Model GG-37S:-E /" . Serial - ~f.S03' Input .. 7 s-: 000 Equipment venting type: AtmoSJ)heriC-x'- Induced Fan Total BTU input of altvented gas appIance& per .....aey: Type of Chimney.: Masonry_Class a~ Other Type pf Litle.-: None _ Metal A Clay TIle_ Combustible Air SuPPJY Required?: YesJs. No_ Instaled?: Yes.JL No _ Safety &. ODel81ing Control Tests: ~ No Pilot/Flame Safeguard Operating Properly 'x Limit(s} Operating Properly . If Qperator(s} Operating Properiy X Low Water CUt-otf Operating Properiy X All Controls Operating Properiy K Initial fiD.I! Stack Temperature F/Net 'i1s:.. FINer Oxygen %:~ :ilL % Carbon Dioxide %~' H." carbon Monoxide %/Pt:*n 1L- %/ppm .. Carbon M~oxide (tulle ~) Positive Look At Total Heating S)..hr.al'8eroril You Leave: Does system operate safely and ~P8riV? YesX= COMMENTS: ForGed Hot Waterl( Other Gravily Hot Wster_ Space Heater _ Other CONVERSION Mate Model Max. BTU Mak&-ef B Other ~ AIwI..:J:JRue Gas ~ Ves No Vents Properly Without Spillage lL Aame Stays InsideJDoesn't Rolf o~X Burner Lights Smoothly T Y:1SUal1nsDecIion fuel Piping System-0Icay Vent Svstems-Draftbo~ Connector. Vent Chimney-()kay L I:feating Unit-oltay X ~-k.. Yes No X No Name of Licensed Contractor: 5 Address: 31./8' . o!b" -A\I~c- .""",",. Person Doing Test:bint) ~"c..r,., .. Phone #(,Sj-7t.~-J~ ~q) Certificate of Competency Number From C'"1ty of Saint Paul fur A Driate Fuel; N 'JDOS~ RH1 rRm-:ll ~3 JUI.14.2085 1:04PM 1'10.715 P.b"e. DEPA.Rll\IIENT OF FIRE AND SAFETY SERVICES FIRE PREVENTION DIVISION 100 EAST 111h Sl1o:id, SAFf PAUL, MN 66101 EXlsnNG FUEL BURNING EQUIPMENT SAFETY TEST REPORT . (Use sepnte farm far -=h appIatlce) Address: 4 h8 D 10 we{' Sf .r f. Owner: TYPE OF HEAT: Gravity Air_ Forced Air_ Steam Unit Heater_ TYPE Of FUa; Gas ~ Oil GAS DESIGN Make of Burner Cn..r/ldJ I!\.Y'\ Mate Model ac 376- e Model Serial - ~ SLf '1 b Max. gru Input 175" ow Make-ef u Equipment venting type: At.mospheric~ I~ Fan_ Total BTU input of aIrvented gas appliances per pt-1eJ: Type of ChJmAey.: Masonry_Class ~.x Other Type ~f Liner: None _ Metall.2S.. Clay Tile_ Combustible Air SupplY Required?: Yes.2S No+ Instated?: Yes X No_ Date: ]-7-07 GravilY Hot WateJ_ Space iHeater _ Other CONVERSION Forced Hot Water.x Other SafetY &. Quemtina CoMmI Tests: X& NQ Pilot/Flame Safeguard Operating Properly X Limit(s} operating Properly' 2L Operator(5) Operating Properly )c Low Water CUt..otf Operating Properly 1- All Controls Operating Properly L lnitial.B.l:ud VasuallnsDection Stack Temperature I FJNet '130 FINet Fuel Piping System-Okay Oxygen %:" la' % ! Vent Systems-Oraftbo,. Carbon Dioxide 9b ,,' t,H~ % I ConnectOr, Vent Chimney-Qkay L Carbon Monoxide %/p.,m 2- %/ppm ,. ijeating Unit-Qlcay 1:.. Carbon M~xfde Detector (1uJfe typ-e) Positive _ N...._ti~-.2s.. Look At Total Heating Sr.b:rt.tBef~ You 1.e8ve~ Does system operate safely and properly? Yes:~ I ?: COMMEHTS: Fuel Anal.sisIfIue Gas ADalvsis: Ves N! Vents Properly Without Spillage ..A. Rame Stays InsideJDoesn"t RollOut k Burner lights Smoothly Z Yes No A.. No Name of ucensed Contractor: S Address: 31./ O~:~-=- . .,."..,..... ~1""c.r", . ) CertifICate of Competency Number From C-rty of Saint P$uI for , I I I Phone # {,SJ-7'-~- J~ Fuel; N;M:JOS~ RH1 JRffll JUN.14.2e8S 1:04PM DEPARTMENT OF FIRE AND SAFETY SERVICES HO.715 P.b,"6 FIRE PREVENTION DMS10N 100 EAS1111h STlr:t:r, PAUL. MN 66101 EXlsnNG FUEL BURNING EQUI SAFETY TEST REPORT u... SI8f'J8l3te farm each appliance) .r Date: 3-7-07. _--- Address: Owner: TYPE OF HEAT: Gravity Air_ Forced Air_ . HotWateJ_ Steam Unit Heater_ Spiace Heater - TYPE OF FUa: Gas ~ Oil Other GAS DESIGN CONVERSION Make of Burner Co.-rt"-I.IM Mate Model t C:J - 3 7~ E Model Serial - ~ Max. BTU Input :J7~rx:>O Make-ef B Equipment venting type: AtmoSpheric~ I Fan_ Total BTU input of aU-vented gas appliances per · Type of Chimney: Masonry_Class US Other Type pi' Liner: None _ Metal.A. Clay Tile_ Combustible Air SuppJy Required?: Yes X NO+ Instalfed?: Yes~ No Safety &. ODel8tina Control jests: ~ P!Q Fuel AIW..-1c:lRllIt Gas Analvsis: Pilot/Flame Safeguard Operating Properly X Limit{s) Operating Properly . X Operator(s} Operating Properly L Low Water Cut-Off Operating Properly L All Controls Operating Properly L Jniti!l J:irIIl Stack Temperature f FlNet '-135" F/Net. - Oxygen % :'"' 9.~M! % Carbon Dioxide %~' Q % Carbon Monoxide _%/p!3fn 12..-%/ppm_. Carbon M_oxfde Detector (mJre type) Positive look At Total Heating Sro~_ You leave: - ~ Does system operate safely and properly? Yes :X ,- COMMENTS: ~i ForGed Hot Water2r Other Ve;s No vents Property Wrtbout Spillage .JS... Rame Stays' InsideJDoesn't RollOut )( Burner Lights Smoothly 1L iVisualInsDecdon iFuel Piping System-Okay Vent S\IStems-Orafth~ Con~. Vent Chimney-Qkay L IHeating Unit-okay L ~~IiI1e~ Yes No L No_ Name of licensed Contractor: 5 Address; 3L/ . . ~-A~-=" . .-".... s.'t"c.rn Phone #lSJ-7'#f- J~ ~,reJ Certificate of Competency Number From (:Ity of Saint Paul fur A RH11Rm-:t1 Fuel: N;JDOS~ ~~, Jltl.14.2:0B5 1:04PM DEPARTMENT OF FIRE AND SAFETY SERVICES 1'1:1.715 P.b'E. FIRE PREVENTION DIVISION 100 EAS1111h S1Tekr, SAINT PAUL, MN 66101 EXISTING FUEL BURNING EQUI~ SAFETY TEST REPORT (Use ~ fann tat eBCh appIance) 3 . l.J h'gO W\,Jfr .\--(.j'( Date: -7- oZ ~._- Address: Owner: TYPE OF HEAT: Gravity Air_Forced Air_ Steam Unit Heater_ TYPE Of FUEl: Gas .A. Oil GAS DESIGN Make of Burner Wg...JJj... n Model Q,Q. -]75"- E: . Serial -lAy. H:).c. tv fW.). Input .175000 Equipment venting type: Atmospheric~ I~ Fan_ Total BTU input of altvented gas appIance& per~ Type of Chimney: Masonry_Class ..2 Other Type pf Liner: None _ Metal l&.. Clay TIIe_ Combustible Air SuppJv Required?: Yes ^ No_ Jnstaled?: Yes~ No _ GravitY Hot WsteJ_ Space ~eater _ Other CONVERSION =: :::~ Other Forced Hot WaterK Other Safety 8r. Ooemtina ContmI jests: ~!!Q Pilot/Flame Safeguard Operating Properly ~ limit's} Operating Properiy . )<. Operator(s) Operating PropeTly T Low Water Cut..()ff Operating Property r All Controls Operating Property L . lnitial.fim!l MsualInsDection Stack Temperature $. F/Net ifLDF/Net Fuel Piping System-Okay Oxygen % :..' :1JL ". Vent Svstems-Orattho.. Carbon Dioxide " :' 't~ " Connector, Vent Chimney-okay 2- carbon Monoxide _ %/ppm .0... %/ppm .. ~eating Unit-okay -L Carbon M~xide Detector (tulle type) Positive N~liveX Look At Total Heating S\t~lwt'!13ef~ You Leave: <. Does system operate safely and properly? Yes*-__ No_ COMMENTS: - . i'" AaW.....;.JFIue Gas ~ Yes N2 iVents Property Wrtbout Spillage .,A- iRame Stays InsideJDoesn't Rolf Out ~ iBurner Lights Smoothly ^ Yes No .x. AddresS: 3'1 - - Phone # lsSJ-7'~- J~ ,,-ftI Certificate of Competency Number From C"rty of Saint Paul fur A RH1 JRm-:l1 ~L .1UI'I.14.20B'S i:04PM DEPARTMENT Of FIRE AND SAFETY SERVICES 1'1:1.715 P.b-E. FIRE PREVENTION DIVISION 100 EAst 111h S~', SA.,r PAUL, MN 66101 EXlsnNG FUEL BURNING EQUI~ SAFETY TEST REPORT (Use separ.ate fann taf each appIMce) . 7 . 10 W<r ~-r 5 b- Date: . r - 7 --() ~. -.-- - Address:3 fag 0 Owner: TYPE OF HEAT: Gravity Air_ Forced Air_ Steam Unit Heater_ TYPE OF FUa; Gas ~ Oil GAS DESIGN Make of Bumer~ ~ UlV\ Model fG -J7.s-t Serial - J 5'0 3) Input 375 . Equipment venting type: AtmoSpheric...)L Induced Fan Total BTU input of altvented gas appliances per~ Type of Chimney.: Masonry_Class ~.-k Other Type F Liller: None _ Metal L Clay TIle_ Combustible Air SuppW Required?: VasA No_ Instated?: YesL No ~HotWateJ_ Space "'eater _ Other CO Forced Hot Water.x Other SafetY at OaeRJtina Control Tests: ~ l!Q Pilot/Flame Safeguard Operating Properly A Limit{s) Operating Properiy . X- Operator(s} Operating Property II Low Water CUt..Qff Operating Properly L All Controls Operating Properly ..L .!OO!!!.I:iDII VisualInsDection Stack Temperature t F/Net '-jLjO FINer Fuel Piping System-Okay Oxygen %:~ 0 rJ at. . .IL4-- N Vent Svstems-Orattho.. Carbon Dioxide <J6,"'. L( % Con~, Vent Chirnney-Qkay )( Carbon Monoxide _ %/ppfn R %/ppm ., lieating Unit-okay T Carbon M~oxfde Detector (tu,fJe typB) Positive N~-X- look At Total Heating Sy.t.hrtiflW~ You Leave: <. Does.sysr8R1 operate safely and properly? YesL' COMMENTS: iFuel AaW.4l1tIRIIA Gas ~ Yes N!! Vents Properly Without Spillage k' Rame Stays InsideJDoesn't Rolf Out X Burner Lfghts Smoothly ..K Yes No X No_ Phone # "J-7'-'f-J~ Person Doing Test:(print) ~.-eI Certificate of Competency Number From C"rty of Saint Paul for A Fuel; N 'J.DOS~ RH1.Rnr:ll JUI'I.14.2085 i:04PM 1'<<:1.715 P.b.'& DEPARTMENT OF FIRE AND SAFETY SERVICES FIRE PREVENTION DMS10N 100 EAS1111h STl\I:f., s..-r PAUL, UN 66101 EXISnNG FUEL BURNING EQUI~ SAFETY TEST REPORT (Use sepRte farm fat tlIEICb appIatacel J \' -r- s~f- _ Date: -7-Vl Add~: 4t/&O 1;t.J~ Owner: TYPE OF HEAT: Gravity Air_ Forced Air_ Steam Unit Heater_ TYPE OF FUEl: Gas .L Oil GAS DESIGN ~ Make of Burner W"-v Y"-f1rF - Model 6'7- Serial - ~').SL/'N Input 37:). a5V , Equipment venting type: Atmospheric~ Induced Fan_ Total BTU input of altvented gas appliances per"wimney: Type of ChimRey: Masonry_Class....?i Other Type F Liller: None _ Metal ,A.. Clay Tile_ Combustible Air SuPPW Required?: Yes)L No_ Inst8led?: Yes...2L No 1<1 . SafetY &. Quendina Control iests: ~ 1!Q Pilot/Flame Safeguard Operating Properly X Limit{s) Operating Properiy . X Operator(s} Operating Properly l Low Water CUt-Dff Operating Properly l All Controls Operating Properly L . Initial finII Stack Temperature iF~ I.JJs' FINe! Oxygen %: :1.1 % Carbon Dioxide "l' M" carbon Monoxide _%/ppfn 2- %/ppm '. Carbon M~xfde Detector Im.fe type) Positive Look At Total &..litQ S).owifbeJ'_ You leave: . - Does system operate safely and properly? YesX. COMMENTS: Forced Hot W~ Other ee- Fuel Ancd...4.dRIIA Gas AnaIvs:&: Yes No Vents Properly Without Spillage X Flame Stays' InsideJDoesn"t Roll Out .K Burner IJghts 5rn00th1y L VisualInsDection fuel Piping System-Okay Vent Svstems-Oraftho~ ConneeD', Vent ChImney-okay ..K.. lieating Unit-OI~ay )( N~lille 4 Yes No 1. No_ Phone # {,SJ-7''t-J~ Person Doing Test:fIrinU .....FeJ Certificate of Competency Number From C""rty of Saint Paul fur A Fuel: N ',)tJOS~ RH1'Rnnl