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Annex A-1 Antenna Technical Specification Form
FDA technical specification form for antenna
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Annex A-1
RFR Facility Owner:
Telecommunications Company____________________ RFR Facility Authorized Contractor: _________________________________________
Broadcasting Network __________________________ Contractor’s Authorized Officer: ____________________________________________
Others: ______________________________________ Contractor’s Address: ____________________________________________________
______________________________________________________________________
Designated RFR Safety Officer: _____________________________________________
Classification of RFR Facility:
Mobile Telephone Base Station
Type of Application:
Proposed Site
T.V. Broadcast Station
Upgraded Site
AM/ FM Broadcast Station
Others: _______________________________ Type of Antenna:
Outdoor Antenna
Indoor Antenna
Specific Site Name and/or ID: _______________________________________
Specific Site Address: ______________________________________________
Site Coordinates; Longitude: ______________ Latitude: _________________
I.
Existing Antenna
Link Antenna
Band/Service 1
Assigned Frequency
(MHz), 2
Transmit
Receive
Antenna Brand
and Model
Diameter for parabolic
antenna, meters
Antenna Gain,
dBi
Antenna
Transmitted Power,
watts
Antenna
Height (AGL)3,
meters
Type of Antenna
Installation 4
Co-Location 5
# of Antenna per sector : Type
of Antenna Installation 4
Sector
Sector
Sector
1
2
3
Co-Location 5
Cellular Antenna
Band/Service 1
Assigned Frequency
(MHz), 2
Transmit
Receive
Antenna
Brand and
Model
Dimension for
panel
antenna,
meters
Antenna
Gain, dBi
Antenna
Transmitted
Power, watts
Antenna Height (AGL)3,
meters
Sector Sector
Sector
1
2
3
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II. New/additional antenna for upgraded sites
Link Antenna
Band/Service 1
Assigned Frequency
(MHz), 2
Transmit
Receive
Antenna Brand
and Model
Diameter for parabolic
antenna, meters
Antenna Gain,
dBi
Antenna
Transmitted Power,
watts
Antenna
Height (AGL)3,
meters
Type of Antenna
Installation 4
Co-Location 5
# of Antenna per sector : Type
of Antenna Installation 4
Sector
Sector
Sector
1
2
3
Co-Location 5
Cellular Antenna
Band/Service
1
Assigned Frequency
(MHz), 2
Transmit
Receive
Antenna
Brand and
Model
Dimension for
panel
antenna,
meters
Antenna
Gain, dBi
Antenna
Transmitted
Power, watts
Antenna Height (AGL)3,
meters
Sector Sector
Sector
1
2
3
I hereby declare that all the information provided on the form and in support of this application is to the best of my knowledge, complete and true in every particular.
Note:
For Link Antenna:
1 - Specify (for example - Point-to-Point [Parabolic]/Point-to-Multipoint[Panel])
2 - Specify assigned frequency by NTC in MHz
3 - Indicate from centerline/midline of antenna to the ground level (see Annex 1A for guide)
4 - Specify number of antenna per sector and type of antenna installation per sector
For antenna installation, indicate whether: Tower Mounted, Wall Mounted, Aesthetic Mounted, Fixed Structure Mounted
5 – Indicate if it is co-located with other network carriers and identify the network carrier
For Cellular Antenna:
1 - Specify (for example - GSM 900, GSM 1800, 3G 850, 3G 2100, UMTS, etc.)
2 - Specify assigned frequency by NTC in MHz
3 - Indicate from centerline/midline of antenna to the ground level (see Annex 1A for guide)
4 - Specify number of antenna per sector and type of antenna installation per sector
For antenna installation, indicate whether: Tower Mounted, Wall Mounted, Aesthetic Mounted, Fixed Structure Mounted
5 - Indicate if it is co-located with other network carriers and identify the network carrier
FOR NEW SITES, PROVIDE DATA FOR NO. II only.
FOR UPGRADED SITES; PROVIDE DATA FOR BOTH I and II.
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