Tower Questionnaire
Please Complete or check all Applicable spaces. The more information you can supply, the more accurate your quote will be.
Customer:_____________________________________Telephone:_________________________
Address:_______________________City______________State______________Zip___________
Tower Site:____________________City______________State_______________Zip___________
Customer Contact:_______________________________Tepephone:_________________________
This Tower is for: ( ) Material Only ( ) Material & Installation by SANDOWN WIRELESS
SANDOWN WIRELESS assumes normal site & access
Design assumes normal soil and rigidity per E. I. A. , 80% guy radius on level ground
FOUNDATION INSTALLATION ( ) By Others ( ) By SANDOWN WIRELESS
Type of Tower: ( ) Guyed ( ) Bracketed ( ) Self Supporting ( ) Roof Mounted
Tower Height:__________________
Base of Tower: ( ) Ground ( ) Roof at ________ feet above grade
DESIGN LOAD: Wind_________________ Ice_______________
E.I.A. Operational Requirements: ( ) Yes ( ) No ( ) Other, Explain: _______________________
I. Step Bolts Or Ladders: ( ) None Quantity: __________________________________
( ) Inside ( ) Face ( ) Standard
( ) Outside ( ) Corner ( ) Heavy
( ) Step Bolts ( ) Leg ( ) Other
Safety Device ( ) Rohn-Loc ( ) Other, Explain: __________________________________
II. Obstruction Marking and Lighting: ( ) None
Aircraft Warning Lights: ( ) Yes ( ) No ( ) By Others, Explain: __________________
If Yes, ( ) FAA - or - ( ) ICAO
Strobe Lights: ( ) Yes ( ) No ( ) By Others, Explain: _____________________________
Beacon Plate Required: ( ) FAA ( ) Strobe Mfr. _________________________________
Paint: ( ) Factory Applied ( ) Sufficient Paint For Field Application
III. Vertical Waveguide Support: ( ) None ( ) Ladder ( ) Brackets
( ) Conduit ( ) Brackets ( ) Other ___________________
Location of Vertical Waveguide Support ( If Preference) ___________________________________
Waveguide Bridge: Provide Sketch & Explanation ________________________________________
________________________________________________________________________________
IV. Platforms: ( ) Not Required ( ) Required (Provide elevation and description)
________________________________________________________________________________
________________________________________________________________________________
V. Lightning Protection: ( ) None
Lightning Rod Required: ( ) Yes ( ) No If Yes, quantity ____________________________
E. I. A. Grounding ( ) Yes ( ) No ( ) Special, explain ______________________________
VI. Antenna Information:
VHF/UHF mounts must state type of mount and length of side arm, if applicable. Attach a separate sheet if necessary.
This information is absolutely necessary for us to be able to quote your tower. We must know the load!
If this is a cellular carrier tower, how many carriers is the structure going to support? _________________
For Each Antenna On The Tower:
Quantity
Model Number, size and manufacturer
Frequency
Elevation on tower above ground
Azimuth if Applicable
Antenna Mount Required? ( ) Yes ( ) No ( ) Supplied by Others
Number of Tiebacks
Ice Shield?
Feed Line, Size, Model & Qty.
VII. THE FOLLOWING DATA IS REQUIRED FOR SPECIAL FOUNDATION DESIGNS:
Allowable bearing capacity
Boring log showing composition and variation with depth
Water table depth and variation
Type of foundation recommended (pile, spread footing, mat etc.)
Uplift recommendations, pertinent to the type or types of foundations recommended
Consistency of soil:
A. Unconfined compression strength of cohesive soil (clay)
B. Standard penetration - blows per foot
C. Rock quality designation for rock
Allowable passive pressure in pounds per square foot per foot of depth (PSF/FT)
Backfill considerations
Factors of safety included in allowable design values
NOTES:
1. Before soil boring work begins, the soils engineer should contact Sandown Wireless for tower reactions, preferred boring locations, and any other data the soils engineer may require.
A detailed soils report, with proper foundation recommendations, will produce the most economical and safe foundation design.
VIII. ADDITIONAL INFORMATION, COMMENTS, OR SPECIAL REQUIREMENTS:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Submitted By: _____________________________ Date: _____________________
Fax This Form To: 603-887-2117
Or Mail To:
Keith S. Clark
Sandown Wireless
P.O. Box 564
East Hampstead, NH 03826
Toll Free: 866-379-8437
Tel: 603-974-0725
Office Fax: 603-887-2117
