Form Validasi CAF (Contoh)

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Survey Summary

Survey Date : 30 September 2012


Surveyor's :

Site Information

Site Name : Ciburuy Address 1 : Jl.Babakan Pasir Angin Rt.01 Rw.1


Site ID TBG : 120199106 Address 2 : Kel.Ciburuy Kec.Padalarang
Site ID Operator : xxxxx City / Residence : Kab.Bandung Barat
Coordinat Survey : 107.47203 (longitude) Jawa Barat
-6.83432 (lattitude) Company : TI

Equipment Already Installed on Tower


Information
Height on
Operator Antenna Type Jumlah
No Leg Panjang Mounting Tower Azimuth ᵒ
(tenant) RF/MW/Other Manufacture Model unit
(m) length(m) (m)

1 AXIS A RF / Sectoral 2.0 3.0 KATHREIN 742213 1 50.6 60


2 AXIS B RF / Sectoral 2.0 3.0 KATHREIN 742213 1 50.6 120
3 AXIS D RF / Sectoral 2.0 3.0 KATHREIN 742213 1 50.6 300
4 AXIS D MW 0.6 0.6 HUAWEI A07S06HAC 1 32.6 330
5 AXIS D MW 0.6 0.9 Xian Putian WTG06-142DAR-ON 1 30.2 330
6 HCPT A RF / Sectoral 1.9 3.0 AGISSON DX-1710-2170-65-19.5i-M 1 46.5 30
7 HCPT B RF / Sectoral 1.9 3.0 AGISSON DX-1710-2170-65-19.5i-M 1 46.5 140
8 HCPT D RF / Sectoral 1.9 3.0 AGISSON DX-1710-2170-65-19.5i-M 1 46.5 300
9 HCPT A MW 1.2 0.9 HUAWEI A07S12HAC 1 34.5 90
10 HCPT C MW 0.3 0.6 HUAWEI A23S03HAC 1 34 150
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Survey Antenna Form
Survey Date 1-Mar-12
Surveyor's Much Kusaini Phone 8E+09
Agus Subiantoro Phone 8E+10

Site Data

Site Name WIDODAREN Address : Ds.Ngasinan Karanganyar


Site ID TBG TBGO3_EJ135 Ngawi
Site ID Operator
Coordinat No 111.18219 (longitude)
7.36989 (lattitude) Company : TB
Operator 1; Name : NTS
Antenna Type
No Description
Sektoral 1 Sektoral 2 Sektoral 3 Sektoral 4 Sektoral 5 Sektoral 6 MW1 MW2 MW3
1 Height (m) (Center antenna) 61.00 61.70 61.70 42.60
2 Leg (A, B, C, D) A B C A
3 No. of Antenna 1 1 1 1
4 Antenna Manufacture Kathrein Kathrein Kathrein Siemen
5 Antenna Model Single Band Single Band Single Band
6 Antenna Weight (kg)
7 Antenna Dimension (LxWxD) 2100 x 160 x 90 2100 x 160 x 90 2100 x 160 x 90 0.6
8 Antenna Azimuth (degr.)
30 180 270 75
9 Feeder / Coax quant 2 2 2 1
10 Diameter Feeder / Coax 7/8" 7/8" 7/8" 1/4"
11 Mounting Dimension (LxWxD) 2.60 2.60 2.60 0.60
12 Transmission Frequency
13 Received Frequency
Ground Area (mxm) :
Shelter Dimension (lxWxh) :
Cabinet Dimension (lxWxh) :

Operator 1; Name : BTEL


Antenna Type
No Description
Sektoral 1 Sektoral 2 Sektoral 3 Sektoral 4 Sektoral 5 Sektoral 6 MW1 MW2 MW3
1 Height (m) (Center antenna) 64.80 64.80 64.80 67.7 66 62.6
2 Leg (A, B, C, D) A B C B D D
3 No. of Antenna 1 1 1 1 1 1
4 Antenna Manufacture Tongyu Tongyu Tongyu Ericsson Ericsson Ericsson
5 Antenna Model
6 Antenna Weight (kg)
7 Antenna Dimension (LxWxD) 1850x270x170 1850x270x170 1850x270x170 1.2 0.6 1.2
8 Antenna Azimuth (degr.) 85 148 240 180 285 245
9 Feeder / Coax quant 2 2 2 1 1 1
10 Diameter Feeder / Coax 7/8" 7/8" 7/8" 1/4" 1/4" 1/4"
11 Mounting Dimension (LxWxD) 3.00 3.00 3.00 1.45 0.60 1.45
12 Transmission Frequency
13 Received Frequency
Ground Area (mxm) :
Shelter Dimension (lxWxh) :
Cabinet Dimension (lxWxh) :
Operator 1; Name : HCPT
Antenna Type
No Description
Sektoral 1 Sektoral 2 Sektoral 3 Sektoral 4 Sektoral 5 Sektoral 6 MW1 MW2 MW3
1 Height (m) (Center antenna) 52.40 52.40 52.40 42.5
2 Leg (A, B, C, D) A C D B
3 No. of Antenna 1 1 1 1
4 Antenna Manufacture Kathrein Kathrein Kathrein NEC
5 Antenna Model Single Band Single Band Single Band
6 Antenna Weight (kg)
7 Antenna Dimension (LxWxD) 1900 x 150 x 80 1900 x 150 x 80 1900 x 150 x 80 0.6
8 Antenna Azimuth (degr.) 50 185 290 90
9 Feeder / Coax quant 2 2 2 1
10 Diameter Feeder / Coax 1 1/4" 1 1/4" 1 1/4" 1/4"
11 Mounting Dimension (LxWxD) 2.60 2.60 2.60 0.60
12 Transmission Frequency
13 Received Frequency
Ground Area (mxm) :
Shelter Dimension (lxWxh) :
Cabinet Dimension (lxWxh) :
Operator 1; Name : M8
Antenna Type
No Description
Sektoral 1 Sektoral 2 Sektoral 3 Sektoral 4 Sektoral 5 Sektoral 6 MW1 MW2 MW3
1 Height (m) (Center antenna) 71.00 71.00 71.00 48
2 Leg (A, B, C, D) A B C A
3 No. of Antenna 1 1 1 1
4 Antenna Manufacture High Gain High Gain High Gain High Gain
5 Antenna Model Single Band Single Band Single Band Single Band
6 Antenna Weight (kg)
7 Antenna Dimension (LxWxD) 1900x200x190 1900x200x190 1900x200x190 1900x200x190
8 Antenna Azimuth (degr.) 50 185 290 185
9 Feeder / Coax quant 1 1 1 1
10 Diameter Feeder / Coax 5/8" 5/8" 5/8" 1/2"
11 Mounting Dimension (LxWxD) 3.00 3.00 3.00 3.2
12 Transmission Frequency
13 Received Frequency
Ground Area (mxm) :
Shelter Dimension (lxWxh) :
Cabinet Dimension (lxWxh) :
PHOTOGRAPH DOCUMENTARY

Site ID : 120199106
Site Name : Ciburuy
Site Address : Jl.Babakan Pasir Angin Rt.01 Rw.15
Kel.Ciburuy Kec.Padalarang Kab.Bandung Barat

E. Microwave Antenna
MW1 Oprtr : AXIS Height: 32.6 m Diameter: 0.6 m Leg: D

MW2 Oprtr : AXIS Height: 30.2 m Diameter: 0.6 m Leg: D

MW3 Oprtr : HCPT Height: 34.5 m Diameter: 1.2 m Leg: A


PHOTOGRAPH DOCUMENTARY

Site ID : 120199106
Site Name : Ciburuy
Site Address : Jl.Babakan Pasir Angin Rt.01 Rw.15
Kel.Ciburuy Kec.Padalarang Kab.Bandung Barat

E. Microwave Antenna
PHOTOGRAPH DOCUMENTARY

Site ID : 120199106
Site Name : Ciburuy
Site Address : Jl.Babakan Pasir Angin Rt.01 Rw.15
Kel.Ciburuy Kec.Padalarang Kab.Bandung Barat

E. Microwave Antenna
MW4 Oprtr : AXIS Height: 34 m Diameter: 0.3 m Leg: C

MW5 Oprtr : Height: Diameter: Leg:


PHOTOGRAPH DOCUMENTARY

Site ID : 120199106
Site Name : Ciburuy
Site Address : Jl.Babakan Pasir Angin Rt.01 Rw.15
Kel.Ciburuy Kec.Padalarang Kab.Bandung Barat

F. Sectoral Antenna
Operator: AXIS Sector : A Height : 50.60 m Operator: AXIS Sector : B Height : 50.60 m

Operator: AXIS Sector : D Height : 50.60 m


PHOTOGRAPH DOCUMENTARY

Site ID : 120199106
Site Name : Ciburuy
Site Address : Jl.Babakan Pasir Angin Rt.01 Rw.15
Kel.Ciburuy Kec.Padalarang Kab.Bandung Barat

F. Sectoral Antenna
Operator: HCPT Sector : A Height : 46.50 m Operator: HCPT Sector : B Height : 46.50 m

Operator: HCPT Sector : D Height : 46.50 m

Operator: Sector : Height : Operator: Sector : Height :

Operator: Sector : Height :


PHOTOGRAPH DOCUMENTARY

Site ID : 120199106
Site Name : Ciburuy
Site Address : Jl.Babakan Pasir Angin Rt.01 Rw.15
Kel.Ciburuy Kec.Padalarang Kab.Bandung Barat

F. Sectoral Antenna
PHOTOGRAPH DOCUMENTARY

Site ID : 120199106
Site Name : Ciburuy
Site Address : Jl.Babakan Pasir Angin Rt.01 Rw.15
Kel.Ciburuy Kec.Padalarang Kab.Bandung Barat

F. Sectoral Antenna

Operator: Sector : Height : Operator: Sector : Height :

Operator: Sector : Height :

Operator: Sector : Height : Operator: Sector : Height :

Operator: Sector : Height :


PHOTOGRAPH DOCUMENTARY

Site ID : 120199106
Site Name : Ciburuy
Site Address : Jl.Babakan Pasir Angin Rt.01 Rw.15
Kel.Ciburuy Kec.Padalarang Kab.Bandung Barat

F. Sectoral Antenna
PHOTOGRAPH DOCUMENTARY

Site ID : 120199106
Site Name : Ciburuy
Site Address : Jl.Babakan Pasir Angin Rt.01 Rw.15
Kel.Ciburuy Kec.Padalarang Kab.Bandung Barat
B. View Tower (Normal View)
Leg A Leg B

Leg C Leg D
PHOTOGRAPH DOCUMENTARY

Site ID : 120199106
Site Name : Ciburuy
Site Address : Jl.Babakan Pasir Angin Rt.01 Rw.15
Kel.Ciburuy Kec.Padalarang Kab.Bandung Barat

B. View Tower (Zoom)


Leg A Leg B

Leg C Leg D
PHOTOGRAPH DOCUMENTARY

Site ID : 120199106
Site Name : Ciburuy
Site Address : Jl.Babakan Pasir Angin Rt.01 Rw.15
Kel.Ciburuy Kec.Padalarang Kab.Bandung Barat
PHOTOGRAPH DOCUMENTARY

Site ID : 120199106
Site Name : Ciburuy
Site Address : Jl.Babakan Pasir Angin Rt.01 Rw.15
Kel.Ciburuy Kec.Padalarang Kab.Bandung Barat

E. Top to bottom view (normal)

View A View B

View C View D
PHOTOGRAPH DOCUMENTARY

Site ID : 120199106
Site Name : Ciburuy
Site Address : Jl.Babakan Pasir Angin Rt.01 Rw.15
Kel.Ciburuy Kec.Padalarang Kab.Bandung Barat

E. Top to bottom view (Zoom)

View A View B

View C View D
PHOTOGRAPH DOCUMENTARY

Site ID : 120199106
Site Name : Ciburuy
Site Address : Jl.Babakan Pasir Angin Rt.01 Rw.15
Kel.Ciburuy Kec.Padalarang Kab.Bandung Barat

C. Shelter & Cable Tray

Shelter & Cable Tray : HCPT

Bending jumper to feeder at tray

Cabinet Outdoor

Fedeer 1 1/4" x6
Coax 1/4" x3
PHOTOGRAPH DOCUMENTARY

Site ID : 120199106
Site Name : Ciburuy
Site Address : Jl.Babakan Pasir Angin Rt.01 Rw.15
Kel.Ciburuy Kec.Padalarang Kab.Bandung Barat
Shelter & Cable Tray : Tower Pondasi
PHOTOGRAPH DOCUMENTARY

Site ID : 120199106
Site Name : Ciburuy
Site Address : Jl.Babakan Pasir Angin Rt.01 Rw.15
Kel.Ciburuy Kec.Padalarang Kab.Bandung Barat
Shelter & Cable Tray : AXIS

Bending jumper to feeder at tray

Cabinet Outdoor
PHOTOGRAPH DOCUMENTARY

Site ID : 120199106
Site Name : Ciburuy
Site Address : Jl.Babakan Pasir Angin Rt.01 Rw.15
Kel.Ciburuy Kec.Padalarang Kab.Bandung Barat

Shelter & Cable Tray : TELKOMSEL

horisontal tray

Cabinet Outdoor

vertical tray
PHOTOGRAPH DOCUMENTARY

Site ID : 120199106
Site Name : Ciburuy
Site Address : Jl.Babakan Pasir Angin Rt.01 Rw.15
Kel.Ciburuy Kec.Padalarang Kab.Bandung Barat

H. Power Supply

Pole PLN terdekat = 15 m


HCPT

TSEL
AXIS
PHOTOGRAPH DOCUMENTARY

Site ID : 120199106
Site Name : Ciburuy
Site Address : Jl.Babakan Pasir Angin Rt.01 Rw.15
Kel.Ciburuy Kec.Padalarang Kab.Bandung Barat

I. Other (APD, GPS, Skets, GND, Aircond., etc)

Alat Pelindung Diri(APD) Koordinate Site

SKETCH LAYOUT

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