1 (5)

Name
House No
Street
Colony
Area
City
Pincode
Latitude
Length Width Height
1-GSM 2-Mw 1-GSM 1-GSM 1 1 1
E
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Building height ( m )
Inner Dimensions in mm
Type -- Prefab / Civil Room / OutDoor Cage
S
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H
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(
M
)
Pole 6
Longitude
2
Pole 5
H
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(
M
)
H
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(
M
)
H
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(
M
)
SiteSurveyForm
Site Type GBT /RTT /POLE /DELTA
Survey Start Time Survey End Time
Tower/Pole/Delta Ht
Site Owner
Site Address
Site Name
Pole 2-Airtel
2-Mw
H
t
(
M
)
2
Zone
Tower Foundation Height No. of floors
Site ID
Survey Vendor
Survey Date
Site Owner ID
2-Mw
Pole 3-Airtel
Town
Pole 4
H
t
(
M
)
Pole 1- Airtel
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1- Airtel
O
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H
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Ht means Height from
Ground
H
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4 3 2
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(
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Sl No
1
2
3
4
A
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T
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O
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H
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H
t
(
M
)
Remarks ( Which and how many antenna loaded )
MW Antenna. ( 1.8m)
MW Antenna. ( 1.2m)
E
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A
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T
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Height
F
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M
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D
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s
Orientation Type(Dual/Single)
GSM Antenna. Sector 4
(240-360 deg)
O
r
i
e
n
.
H
t
(
M
)
MW Antenna. ( 0.3m)
MW Antenna. ( 0.6m)
GSM Antenna. Sector 2
(120-240 deg)
Ht means Height from
Ground
GSM Antenna. Sector 1
(0-120 deg)
H
t
(
M
)
GSM Antenna. Sector 3
(240-360 deg)
O
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n
.
F
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T
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F
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O
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.
A
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T
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H
t
(
M
)
A
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T
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F
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T
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Sheet: Survey Form
No: F01-EIL/PI-10 Uen Uen
Rev: PA1
2 (5)
Is Free mount/Space available at given proposed RND Ht & orientation for WCDMA antenna at Tower/pole Mount/Space / NA
Yes / No
BATTERY BANK #2
Make L W H Make L W H
Make
Model
Existing Load Measurement( Amps )
Rectifier Rating ( Amps or Watt)
Maximum number of Rectifier holding capacity
No of Rectifier loaded at present
Holes Available In Positive Bus Bar
Spare Battery breaker and its rating
6 Amp 32 Amp 6 Amp 32 Amp
10 Amp 40 Amp 10 Amp 40 Amp
16 Amp 50 Amp 16 Amp 50 Amp
20 Amp 63 Amp 20 Amp 63 Amp
25 Amp Others 25 Amp Others
Sl No
1
2
3
4
2 3 4 5
Operator Name
Make
Model
Dimension ( LxWxH mm)
Is Space available for new Indoor BTS(650x500mm) Yes / No If Yes Space available in ( L x W X H mm) -
Is space available for OutDoor BTS in existing platform(1500x1500mm) Yes / No If Yes Space available in ( L x W mm) -
Is Space available for new Platform(2.0x2.0 mm show in sketch)
Space available in 19" rack for 16 U(712 mm) Yes / No
Position of Free space for proposed BTS in existing 19Rack (Bottom/Middle/Top)
Total space avaialable in 19" rack ( in mm )
Space availability for wall mount BTS ( 70 Kg weight, 488mm height, 350mm depth, 488mm width ) Yes / No
Is Flamingo(RBS 2964) stacked Yes / No
DRU Position in Flamingo(RBS 2964) 1 2 3 4 5 6
Flamingo(RBS 2964) on ground (put cross in the DRU 1-6)
Stacked Flamingo( RBS 2964)(put cross in the DRU 1-6)
Third Flamingo( RBS 2964) if present(put cross in the DRU 1-6)
Configuration of existing GSM
Total No. of existing feeder used separate for 900 and 1800
Length of J umper Required, from proposed Node B to existing feeder in meter.
N
o

o
f

v
a
c
a
n
t

M
C
B
s

Remarks ( If any) Present At Site
Power Plant #1-Airtel
Equipment
Total no of MW Antenna
DG
Capacity (AH)
B
T
S

D
e
t
a
i
l
s
BTS No.
No of Free slot(Means there is space
available for new MCB)
Voltage
Power Plant #2
1800
1800
Other Details
900
Space available for RBS 6601 in BTS 2954 or IP55
Door opening of Existing outdoor BTS(Left to Right or Right to Left), Also Mark in Sketch
900
D
C

P
o
w
e
r

P
l
a
n
t

D
e
t
a
i
l
s
Total no of GSM Antenna
Working status
Electrical
Board Meter
Length of existing jumper used for GSM 1800 in meter.
Total no of
BTS
1-Airtel
Length of existing jumper used for GSM 900 in meter.
Capacity (AH)
Is Tx Rack properly grouted or Not(Yes or No)
Is space available for New mount at Tower/pole
If Yes, Then give Ht. & in which sector it is possible
Total no of
Operators
Earthing
P
o
w
e
r

D
e
t
a
i
l
s
A.C.
D
i
m
e
n
s
i
o
n
B
a
t
t
e
r
y

B
a
n
k

D
e
t
a
i
l
s
Voltage
D
i
m
e
n
s
i
o
n
BATTERY BANK #1- Airtel
Sheet: Survey Form
No: F01-EIL/PI-10 Uen Uen
Rev: PA1
3 (5)
Connector type at feeder end towards GSM BTS for 900
Connector type at feeder end towards GSM BTS for 1800
Connector type at feeder end towards Antenna
Length of Existing Antenna J umper if any
Indoor Cable ladder available over proposed Node B
Number of Free Holes in existing Internal ECB (Earth Collector Bar)
Number of Free Holes in existing external ECB (Earth Collector Bar)
Space available on outdoor ladder for six more feederes(150 mm)
Total Outdoor ladder length between Tower leg & Existing/Proposed Roxtec in meter.
Total Outdoor extra ladder length in meter required wherever it required in case of no space
Is space available for TMA on existing Pole/Delta/Tower(Ht-230mm,width-154mm,Depth-64mm)
Required feeder length from proposed Node-B to proposed Antenna height in meter.
Feeder clamp type 3-way 2-way Tie
Space available in existing roxtec for 6 new feeders(If no please propose new roxtec in layout) Yes / No
1. Complete Tower & Shelter 7. Routing of outdoor horizontal. Ladder(3 photos)
2. Inside Front View of Shelter 8. Free Mounts on Tower(3 Different. views)
3. Left Bay of Shelter 9. Front View of TX Rack
4. Right Bay of Shelter 10. Power Plant in door open condition
5. Proposed BTS Location 11. Complete Tower +Building
6. Existing Roxtec from Outside 12. Routing of Outdoor vertical Ladder
Name of Survey Engineer - Signature of Survey Engineer -
Date
Tower Leg / Tower Top
Yes/No
If No, then length of indoor ladder required.
Cell A
Is External alarm extended to existing 2G BTS(Yes or No)
Position of external alarm box,(in 19" rack/Wall mount/etc.) Mark in Sketch.
Cell C
Cell B
Is Space available for RRH on existing Pole/Delta/Tower(Ht-636mm,width-383mm,Depth-169mm.)
YES/NO

Is cable lead-in(Roxtec) available on same side of Proposed Node B
6-way
Cell D
Free number of Holes available in existing roxtec.
P
h
o
t
o
g
r
a
p
h
s
Sheet: Survey Form
No: F01-EIL/PI-10 Uen Uen
Rev: PA1
4 (5)
Front View of Transmission Rack ROXTEC DIAGRAM SHOW WITH FREE/EXISTING HOLES
SHELTER/EQUIPMENT ROOM LAYOUT
Sheet: Survey Form
No: F01-EIL/PI-10 Uen Uen
Rev: PA1
5 (5)
Existing Antenna
Details
OUTDOOR LAYOUT
Existing MW
Antenna Details NORTH
Sheet: Survey Form
No: F01-EIL/PI-10 Uen Uen
Rev: PA1