Site Survey Form Generic Format - Coastal Environmental Systems

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SITE SURVEY REPORT – location nameInsert Discontinuity Site Plan here, the following VISIO drawing is anexample. Add – Delete Site Plans as required.Critical Measurements:DISCONTINUITYSITE PLAN09 ApproachDistance from runway centerline to 3m tower pin: 500 ftDistance from threshold to 3m tower pin: 900 ftNo ScaleMegger Reading: 1.88 OhmsElevation at 3m tower pin: Not RequiredPower and Comm Trenching: Approximately 403 fttrenching distance from staked FMQ-19 location to powerand comm. located within Bak-12 Bldg 2018.. No knownobstacles.09500 ftBak-12Bldg 2018CPCTrenching PathCommunications DemarcTaxiway AlphaWind SockFMQ-133m Tower PinPPower Demarc900 ftGlideslope AntennaTipping DirectionNon Standard conditions:This field group contains winds only. No Ceilometer foundationrequired. Increased foundation depths are required. Seesection 12, item 1 of this report for details.Misc. Info:403 ft to Bak-12 Bldg 2018.405 ft to FMQ-13.337 ft to Wind Sock831 ft West to Taxiway Alpha250 ft South to Taxiway AlphaGPS Coordinates:N 43 56.16W 90 16.00Taxiway AlphaSite Survey Form Generic Format 6-25-13.docPage 7© 2013 Coastal Environmental Systems, Inc.
SITE SURVEY REPORT – location name6. DPU (SERVER) REQUIREMENTSSee DPU Layout, following, for siting of DPU, printer, and required power andcomm connections.Power – DPUPower – PrinterPrinterLocationComm punchdownInterfacepunch-downDial-in VoiceCircuitGroundDPU ClearanceMaint. TerminalNTFS LocationLAN LocationRequirement Existing Action BySiteDedicated 120 VAC 20 Amp duplexoutlet with ground within 6 ft of DPUlocationDedicated 120 VAC 20 Amp duplexoutlet with ground within 6 ft ofPrinter locationWithin 6 ft cable run of DPUWithin 6 ft of DPUSpace for 4” x 12” Coastal-providedinterface punch-down. Location tobe within 6 ft of comm punch-down1 unconditioned 24 AWG or largertwisted copper pair per dedicatedtelephone number from DCO tocomm punch-downCentral facility termination pointwithin 6 ft of DPU36-inch clearance of front, rear, andat least one side for 22”x38”x48”high DPU. Allow for door swing of22”Within 6 ft cable run of DPUWithin 45 ft cable run of DPUWithin 20 ft cable run of DPUAction ByCoastalEnd-to-end End-to-end testing of alltestingcommunication lines.Note incomplete items in Section 12, Outstanding ItemsSite Survey Form Generic Format 6-25-13.docPage 8© 2013 Coastal Environmental Systems, Inc.
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Site Survey Form Generic Format - Coastal Environmental Systems

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