MCMC JENDELA SURVEY FORM
SITE SURVEY CHECKLIST
PRELIMINARY DATA
Date Survey
-
Month
-
Day
Year
Site ID
*
JENDELA Site ID
Site Name
*
District
*
State
*
Perak
Kedah
Sabah
Select Region
Nominal Site Latitude
GPS Lat
Nominal Site Longitude
GPS Long
Elevation ( MSL)
GPS Data
Estimate Population
SURROUDING ACCESS PHOTO
2KM from nominal site
SAP 1
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2KM from nominal site
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of
SAP 2
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1.5km from nominal site
Cancel
of
SAP 3
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1km from nominal site
Cancel
of
SAP 5
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500m from nominal site
Cancel
of
SAP 6
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0M from nominal site
Cancel
of
Remark
State here any issues regarding surrounding site access
POWER SUPPLY INFO & PHOTO
Source Of Power
TNB
SESB
NOT AVAILABLE
Nearest Point
Nearest TNB/SESB pole to proposed site in Meter
Photo of TNB/SESB Pole
Browse Files
Nearest pole to nominal site
Cancel
of
Remark
State here any issues regarding power supply
NOMINAL SITE CONDITION
Nominal Site Status
OK
NOT OK
The proposed site by MCMC is suitable to build tower?
If Not OK - Reason
If nominal site is not ok, take photo and add to nominal site photo 1 and 2 below
Site Access
Car
4WD
Motocycle
Walking
No Access
Distance From Nominal
Meter
Access From Main Road
Meter
Access From Entrance Road
Meter
Nominal Site Photo 1
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Cancel
of
Nominal Site Photo 2
Browse Files
Cancel
of
PROPOSED NEW SITE LOCATION
If nominal site by MCMC is not suitable
New Location Lat
GPS Data
New Location Long
GPS Data
Elevation (MSL)
GPS Data
GPS Photo
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GPS screen photo
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of
Proposed Site Photo 1
Browse Files
Cancel
of
Proposed Site Photo 2
Browse Files
Cancel
of
SELECTED SITE CONDITION
Selected site either nominal site or proposed site.
Land Ownership
Private
Company
Government
Other
Owner Name
Owner Contact No
Email
example@example.com(if any)
Land Used
Agriculture Land
Housing Land
Vacant Land
Other
Land Condition
Hilly
Flat
Wet
Other
Special Access
Bridge
Culvert
Concrete Slab
NO
Access required bridge, culvert or concrete slab
Land Additional Requirement
Major Cut/Fill
Imported Soil/Fill
Slope Protection
Piling
Rock Excavation
None of Above
Double Handling
Other
Remark
state site condition or special requirement. ie. build access road(meter) or etc
PROPOSE COVERAGE OBJECTIVE
Objective
Villages Population
State/Federal Road
Recreations Park/Activity
Learning Center
Other
360 DEGREE VIEW
For the selected site
TELCO NETWORK COVERAGE
Existing Coverage availability
CELCOM
High
Intermittent
Low
Not Available
Verify Signal
DIGI
High
Low
Intermittent
Not Available
Verify Signal
MAXIS
High
Low
Intermittent
Not Available
Verify Signal
U-MOBILE
High
Low
Intermittent
Not Available
Verify Signal
WEBE
High
Low
Intermittent
Not Available
Verify Signal
OPEN SIGNAL PRINT SCREEN
Location Map
Browse Files
Cancel
of
Status 1
Browse Files
Network Stat
Cancel
of
Status 2
Browse Files
Network Stat
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of
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