Attachment___7.pdf

Broadcasting Board of Governors

BBG TVRO Site Survey Report

BBG Contract Number:___________________

Number of Pages 10 (including cover sheet)

[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 Survey Report Revision 2

BBG TVRO Site Survey 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:

Survey

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°

Transponder:

Beam:

Polarization: -Select- -Select-

Band: -Select- -Select-

Does the proposed site provide an unobstructed view to target satellites? -Select-

Antenna

Measured area allocated for antenna installation: 0 -Select- Estimated Antenna Height: 0 -Select-

Antenna Location: -Select- Antenna Base: -Select- Antenna Mount: -Select-

Antenna Type: -Select- Antenna Size: -Select- Antenna Axis: -Select-

Concrete Pad Dims (W x L x H): -Select-

Concrete Pillar Dims (W x L x H): -Select-

I Beam Support Dims (W x L x H): -Select-

Wall Bracket Dims (W x L x H): -Select- Model Number:

NPRM Dims (W x L x H): -Select- Model Number:

PRM (W x L x H): -Select- Model Number:

Ridge/Peak Mount Dims (W x L x H): -Select- Model Number:

I Beam Mount: Model Number:

Ballast required for NPRM lbs./Blocks: -Select-

Inter-facility Link (IFL)

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

Access into building for IFL run: -Select-

Power Data

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

Back Up Power: -Select- Power available at antenna construction Site: -Select-

Weather Conditions

Climate Zone (Köppen Climate Classification): -Select-

Annual rain fall at site (inches or centimeters): 0.00 -Select-

Annual snow fall at site (inches or centimeters): 0.00 -Select-

Maximum Temperatures at site (°F or °C): 0.00 -Select-

Minimum Temperatures at site (°F or °C): 0.00 -Select-

Maximum wind speed at site (MPH or KPH): 0.00 -Select-

Icing Conditions (severe, moderate, light, none): -Select-

Humidity (severe, moderate, light, none): -Select-

Sand Storms (severe, moderate, light, none): -Select-

Hurricane Zone: -Select-

Typhoon Zone: -Select-

Possible Interference Sources

Use additional pages if required:

1. List direction/approximate distances of all possible high power RF interference sources (AM, FM, TV, Microwave, UHF, Power lines etc.)

2. List all known microwave/radar sources of interference, including operating frequencies, type of antenna, azimuth of RF microwave paths, transmit power/ownership/user if obtainable. Perform frequency spectrum survey if required.

3. List aircraft traffic within close proximity of look angle?

4. Are there receiving stations within close proximity of the look angles?

5. Are there any antennas in close proximity, which may cause RF interference?

6. Are there any antennas in close proximity, which may experience RF interference from the satellite antenna?

7. Is it anticipated that the system would be relocated in the future?

General Information

Construction: Estimated Cost:

Local Civil Engineer Available: -Select- US$0.00 -Select-

Local General Contractor Available: -Select- US$0.00 -Select-

Local Antenna Installer Available: -Select- US$0.00 -Select-

Local Electrician Available: -Select- US$0.00 -Select-

Local Welder Available: -Select- US$0.00 -Select-

Local labor Available: -Select- US$0.00 -Select-

Ready Mix Concrete Available: -Select- US$0.00 -Select-

Bagged Concrete available: -Select- US$0.00 -Select-

Heavy Equipment Available (e.g. crane, forklift, man lift excavator etc.) -Select- US$0.00 -Select-

Light Equipment Available (e.g. scaffold, ladders etc.) -Select- US$0.00 -Select-

Construction Supplies Available (e.g. concrete forms, ply wood, lumber, PVC conduit, etc.) -Select- US$0.00

Hardware Supplies Available (e.g. screws, nails, bolt, nuts, washers, electrical cable, glue, lubricants, etc.) -Select- US$0.00

Transport and Accommodation (list name, address and contact information for at least three vehicle rental companies and three Hotels and current rates)

Name: Rate Per Day US$: $

Address 1: Rate Per Week US$: $

Address 2: Email Address: lower case

City/Town: Web Address: lower case

Address 2: Email Address: lower case

City/Town: Web Address: lower case

Address 2: Email Address: lower case

City/Town: Web Address: lower case

General Information continued

Transport and Accommodation (list name, address and contact information for at least three vehicle rental companies and three Hotels and current rates)

Address 2: Email Address: lower case

City/Town: Web Address: lower case

Address 2: Email Address: lower case

City/Town: Web Address: lower case

Address 2: Email Address: lower case

City/Town: Web Address: lower case

General Information continued

List any other information of interest pertinent to this Site Survey.

Type in Comments

Supporting Documentation

Photographs of antenna location Bill of Materials - construction

Photographs of target satellite look angles Indoor RF equipment list

Photographs of building Indoor Audio & video equipment list

Photographs of IFL building access Link analysis (budget) calculations

Photographs of indoor equipment room

Drawing of antenna concrete pad/pillar foundation

Drawing of antenna location in relation to it’s surrounding area

Drawing of proposed site configuration

Logistics and Shipping

Shipping Address:

Site Name:

Site Address 1:

Site Address 2:

City/Town:

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

Insert Name Here

Surveyor: Signature: Date:

Insert Name Here

P.A.S Representative: Signature: Date: