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Sr. No.

CGI(In following Name of order) the BTS MCC-MNC- Site LAC-CI

BTS Site ID*

BTS Configura tion

District (Full name)#

Complete Latitude TOWN / address of (In VILLAGE the BTS Degrees site only)

Note:
* BTS Site ID Should be the one captured in the CDRs #Full name Without spaces in Capitals

No.of Date of Name of Longitude sharing Name of First TSP's with (In operators Infrastruc radiation whom Degrees (Including ture of the BTS BTS site is only) own Provider (DDshared operator) MMM-YY)

Date of Self certificati on of the BTS (DDMMM-YY)

Date of Submissio n of self certificati on to TERM Cell (DDMMM-YY)

Date of Commerci Date of al Applying radiation For SACFA of the BTS (DD(DDMMM-YY) MMM-YY)

10

11

12

13

14

15

16

17

18

Available Theoretic Date of Tower Antenna Building Type of downlink al SACFA Height Height height BTS site BCCH's in calculated SACFA ID clearance From AGL from AGL from AGL (GBT/RTT the site value of (DD(in (in (in /RTP) (BCCH Maximum MMM-YY) meters) meters) meters) 1,2,3,4) EIRP Ratio

Compliant (YES/NO)

19

20

21

22

23

24

25

26

EMR CALC BASED 27

Compliant (YES/NO)

Self Certificate Reference TERM no. Cell,Vijaya (TSP/EMR wada /TERM/M Testing onth date (DDYear/File MMM-YY) no./ page number

SIGNAGE BASED 28

29

30

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