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Site ID Site Name Survey Engineer Survey Engineer Person No. Survey Sub-Con Candidate Survey Date
Name
Signature
Approval Date
Land Available Area(Flat m X m): Site Owner Contact Person Contact Address Owner informatio Has the Owner or Responsible Person agreed n in principle to negotiate proposed site? Special Requests or Conditions 24 Hour Site Access Road Available access informatio Access Road Condition n Geograph y Type Flat Lake Other Yes No
Notice Required: Distance from access road: Dry weather road Hills Other Worst Building new road Hurst m
Mountain swamp
BS8800(Indoor)
BS8900A(Outdoor)
Other:
1.3 Power Supply Power Type 1 Phase 3 Phase Not Available Description of Source: Trenched Overhead
1.4 Transmission Information Tx Type 1.5 Tower Height Tower Soil Condition 1.6 Antenna Antenna Frequency Band New RF antenna(s) GSM900 DCS1800 UMTS New Ant. Cell1/C2/C3 Cell1/C2/C3 Cell1/C2/C3 Ant. Model Ant. Height Azimuth Tilt() Rocky Clayey Sandy m MW Satelites Other:
Date
Obstacles Information
Notice:Number all the obstacles clockwise starting from north. Specify buildings, towers, chimneys, airports, natural obstacles, and existing equipment such as microwave/radio antennas. Specify an estimated height of the obstacle in-line or above the height of proposed antenna sector and distance from site.
NOR
15 30 45 60
75
20m
40m 60m 80m
WE
255
EAS
105
240
120
135
SOU
NO. 1 2 3
Obstacles Height Distance Azimuth Location(La. Lo.) Type: (m) (m) (Degree) Clutter/Buildings Vegetation Water Body (Tank/Pond/St ream)
Remark:
Engineer Photo
GPS Photo
Access Road
45
90
135
180
225
270
315
3.Survey Memorandum
Candidate:
Site ID:
Note: This survey report provides the basic data for equipment commissioning, and shall not be modified once confirmed by both parties. If the user needs to modify the data due to special reasons, contact the local office of ZTE in time. ZTE shall not be responsible for the delay in project implementation due to the modification of the survey results required by the user.
MTNs Comments
MTN's Representative
Name
Signature
Date
ZTEs comments
Customer's Representative
Name
Signature
Date