Site Monitoring Detail

NOTE: For more than one site, please make additional copies of this page and include them with the contract.

SITE INFORMATION * required fields | ** required if FCC/ASR # not available

Company Name / *
Site Name / *
FCC/ASR / *
Company Site ID
Company Region / Company Area
Site Primary Contact Email / *
Latitude / **
Longitude / **
Overall Structure Height Above Ground (in feet) / **
Overall Height above ground w/o Appurtenances / **
Elevation of Site Above Mean Sea Level (in feet) / **
Overall Structure Height Above Mean Sea Level
Tower Type (Guyed, Monopole, Self-Support, etc.)
FCC Registered “Avian Friendly” (no markers on A2/E2) / ** / YES / NO
Site Address
City / State / Zip Code
County / Gate Combo / Shelter Combo

LIGHTING SYSTEM TYPE

Check ** / Description / Type / FAA Chapters
(70/7460-1K) / Day Marking / Night Marking
Medium Intensity Red only / A1, A2, A3, etc. / 3, 4, 5, 12 / Paint or none / Red
Medium Intensity White only / D1, D2 / 4, 6, 12 / White / White
Medium Intensity Red and White / E1, E2 / 4, 8, 12 / White / Red
High Intensity / C3, C4, F3, F4, etc. / 4, 9, 12 / HI White / White or Red
# of Units on Tower
Incandescent / Halogen / Xenon / LED / Manufacturer / Model
Red-only Beacon (L864)
White-only Beacon (L865 / L866)
Dual (Red/White) Beacon(L864/865)
Markers (L810)

NOTE: If Dual lighting is split system (separate Red and White beacons), please fill out both Red-only and White-only section instead of Dual.

OTHER EQUIPMENT TO BE MONITORED AT THIS LOCATION:

Generator / Temperature / HVAC / Security System
Fire/Smoke Detectors / Power / Door / Other
COMMENTS:

Attachment D – Site Monitoring Detail rev 2.7

Revised 7/21/16