Attachment___6.pdf

Broadcasting Board of Governors

BBG TVRO Site Maintenance Report

BBG Contract Number:_______________________

Number Of Pages 8 (including cover page)

[Pick the date]

Pursuant to the terms of BBG Contract No. ____________________, the Government has unlimited rights in all drawings, designs, specifications, notes, and other works either developed or delivered in the performance of this contract, including, but not limited to, the right to use same on any other Government design or construction without additional compensation to the Contractor. The Contractor hereby grants to the Government a paid-up license throughout the world to all such works to which the Contractor may assert or establish any claim under patent or copyright laws.

File: BBG TVRO Site Maintenance Report Revision 2

BBG TVRO Site Maintenance Report

Contract #: BBG Task Order #: 0 Date: 2013-01-01

Report Type: -Select- Region: -Select- Country:

Contracting Company:

Installer/Technician Name:

Contracting Company Contact 1:

Name: Title/Position:

Telephone #: +0-0-0-0 Extension: Fax #: +0-0-0-0

Mobile/Cell #: +0-0-0-0 Email Address:

Contracting Company Contact 2:

Name: Title/Position:

Telephone #: +0-0-0-0 Extension: Fax #: +0-0-0-0

Mobile/Cell #: +0-0-0-0 Email Address:

Site Information

Site Name: Work Week: Insert Work Week

Site Address 1: Office Hours: Insert Office Hours

Site Address 2:

City/Town:

State/Provence: ZIP/Postal Code: Country:

Telephone #: +0-0-0-0 Fax #: +0-0-0-0 Time Zone:

Site Contact 1:

Site Contact 2:

Site Contact 3:

Antenna

Manufacturer: -Select- Type: -Select- Diameter: -Select-

Reflector: -Select- Serial No: Mount Type: -Select- Snow Shield: -Select-

Motorized: -Select- Limit Switches: -Select- Actuators: -Select- Gear Chain Drive: -Select-

Installation Type: -Select- Roof Height: 0 -Select- Side Wall Height: 0 -Select-

NPRM Dimensions: -Select- Number Of Trays: -Select- Ballast Type: -Select- Grounded: -Select-

Antenna Condition: Comments

Concrete Pad, NPRM, Wall Bracket, I-Beam: -Select- Type in comments

Mast, King Post: -Select- Type in comments

Reflector Rear Support: -Select- Type in comments

Reflector: -Select- Type in comments

Tie Downs: -Select- Type in comments

Azimuth Limit Switch: -Select- Type in comments

Azimuth Motor: -Select- Type in comments

Azimuth Actuator: -Select- Type in comments

Azimuth Actuator Weather Boot: -Select- Type in comments

Azimuth Chain Drive -Select- Type in comments

Elevation Limit Switch: -Select- Type in comments

Elevation Motor: -Select- Type in comments

Elevation Actuator: -Select- Type in comments

Elevation Actuator Weather Boot: -Select- Type in comments

Electrical Connections: -Select- Type in comments

Feed and Low Noise Block Down Converter (LNB)

Feed Manufacturer: Model #: Serial #:

Polarization: -Select- Configuration: -Select-

LNB 1 Manufacturer: Model #: Serial #:

LNB 1 Manufacturer: Model #: Serial #:

Gain Noise L.O.

Frequency

L.O. Frequency Stability

Input Frequency Output Frequency

LNB 1 0 dB 0°K to 0 °K 0 MHz ± 0 KHz Typical 0.00GHz to 0.00GHz 0MHz to 0MHz

LNB 2 0 dB 0°K to 0 °K 0 MHz ± 0 KHz Typical 0.00GHz to 0.00GHz 0MHz to 0MHz

Feed and LNB Condition: Comments

Feed Support Struts: -Select- Type in comments

Feed Body: -Select- Type in comments

Feed Horn Window: -Select- Type in comments

LNB 1 -Select- Type in comments

LNB 2 -Select- Type in comments

RF (F Type) Connectors: -Select- Type in comments

DC Voltage: -Select- Type in comments

LNB 1 Shroud -Select- Type in comments

LNB 1 Shroud -Select- Type in comments

IFL

Manufacturer: Cable Number:

Type: -Select- IFL Cable Condition: -Select- Connectors: -Select-

IFL Run (Antenna to Control Room): 0 -Select- Installation Type: -Select- -Select-

Line Amplifier: -Select- Attenuator: -Select- Hybrids: -Select-

IFL DC Power Supplied By: -Select- Explain Other:

Power Data

Voltage: -Select- Frequency: -Select- Measured AC: 0 V

Back Up Power: -Select- UPS Rating: 0 -Select- Surge Suppressor: -Select-

Equipment. Grounding: -Select-

Satellite

NOTE: Record Latitude and Longitude, Magnetic Variation and Magnetic Declination Data in Decimal Degrees.

Site Latitude: 0.00 ° -Select- Site Longitude: 0.00 ° -Select- Altitude: 0 -Select-

Magnetic Variation: 0.00 ° -Select- Magnetic Declination: 0.00 ° -Select-

Primary Satellite Secondary Satellite

Satellite Name:

Orbital Location: 0.00°-Select- 0.00°-Select-

Elevation Look Angle: 0.00° 0.00°

Azimuth Look Angle (True): 0.00° 0.00°

Azimuth Look Angle (Magnetic): 0.00° 0.00°

Weather Conditions: -Select- Temperature: 0.00 ° -Select-

Downlink

IRD 1 IRD 2

C-Band Down Link Frequency: 0.000000 MHz 0.000000 MHz

L-Band Down Link Frequency: 0.000000 MHz 0.000000 MHz

FEC: -Select- -Select-

Symbol Rate: 0.0000 MSym/s 0.0000 MSym/s

Network I.D.: 000 000

Virtual Channels Received: 000 000

Signal Level: 00 00

Carrier/Noise: 0.00 dB 0.00 dB

UA 00 00

BER: 0.0 E - 0 0.0 E - 0

Margin: 0 0

AFC: 0 0

CEC Count Per Hour: 0 0

Decoder Version: 00 00

Additional Versions: 00 00

Firmware Versions: 00 00

Equipment Check List

Comments

IRD tuned: -Select- Type In Comments

Aux. equipment operating: -Select- Type In Comments

Distribution equipment operating: -Select- Type In Comments

RF connectors check and sealed: -Select- Type In Comments

IFL cable secure: -Select- Type In Comments

All fasteners torqued -Select- Type In Comments

Antenna Az/El adjustment tightened: -Select- Type In Comments

Refuse removed: -Select- Type In Comments

Site clean and tidy -Select- Type In Comments

Site Personnel Briefed: -Select- Type In Comments

Equipment Inventory

Make Model Serial Number Tracking Identification

LNB 1

LNB 2

IRD 1

IRD 2

Feed Horn

Video Monitor

Audio Monitor

Distribution Amp

L Band Line Amp

RF Attenuator

UPS

Surge Suppressor:

Additional Items:

Summary Actions

List any broken or missing parts, panels and any other deficiencies. Each entry should be numbered.

Type in Comments

Logistics and Shipping

Shipping Address:

Site Name:

Site Address 1:

Site Address 2:

City/Town:

State/Provence: ZIP/Postal Code: Country:

Telephone #: +0-0-0-0 Fax #: +0-0-0-0

Site Logistics Contact 1:

Telephone #: Extension: Fax #:

Mobile/Cell #: +0-0-0-0 Email Address: +0-0-0-0

Site Logistics Contact 2:

Telephone #: Extension: Fax #:

Mobile/Cell #: +0-0-0-0 Email Address: +0-0-0-0

Special shipping and handling instructions:

Type in Instructions

Acceptance

Contractor: Signature: Date:

P.A.S Representative: Signature: Date: