Site Survey Form Generic Format - Coastal Environmental Systems

SITE SURVEY REPORT – location nameInsert Primary Site Plan here, the following VISIO drawing is an example.Critical Measurements:PRIMARY SITEPLAN27 ApproachDistance from runway centerline to 3m tower pin: 500 ftDistance from threshold to 3m tower pin: 1195 ftMegger Reading: 2.19 ohms3M Tower PinTipping DirectionNo ScaleElevation at 3m tower pin: 896.95 ftPower and Comm Trenching: Approximately 200 fttrenching distance from staked FMQ-19 location to powerdisconnect within generator building (bldg 616). Volk Fieldto provide a fiber demarc within generator building. No fiberdemarc available during time of survey. No knownobstacles.CPTrenching PathCommunications DemarcPower DemarcCu Comm. PedestalRW 215Propane TankGeneratorBldg 616Bak-12Bldg 2018C PAccess Road500 ft1195 ft27 Glide SlopeAntenna, Bldg 618Glideslope AntennaNon Standard conditions:27Increased foundation depths are required. See section12, item 1 of this report for details.Misc. Info:116 ft to Glide Slope Antenna200 ft to nearest corner of Generator Bldg 616337 ft to Copper Comm. Pedestal RW 215GPS Coordinates:N 43 56.446W 90 14.424Site Survey Form Generic Format 6-25-13.docPage 6© 2013 Coastal Environmental Systems, Inc.