CHECK LIST ESR DOCUMENT

Transcription

1 CHECK LIST ESR DOCUMENT Site Name : HALIM GOLF Relocation Site ID : - Candidate : LAT : 6 16'38.3"S ; LONG : '23.5"E Proposed By : PT. XL AXIATA No DOCUMENT COMPLETENESS Remark OK NOK 1 Site Information ESR 2 Radio Frequency Data & Information ESR 3 Transmission Data & Information ESR 4 Civil Infrastructure Data & Information ESR 5 Power Availability Information ESR 6 Site situation, access, existing facilities, etc Photos & Sketch 7 Photo GPS Photos 8 Surroundings tower (radius 200 m) Google MapS & Sketch degree panorama, each 30 degree Photos 10 Obstacle objects & near field obstruction Photos 11 Existing facing sites Photos & Sketch 12 Proposed site & Area Photos & Sketch 13 Actual centerline, North on sketch Sketch 14 Location and size of column and beam, existing and additional Photos & Sketch 15 Proposed Location and Shelter, Tower, AC, Power meter, etc Photos & Sketch 16 Proposed routing of cables (co-axial, power, grounding, lightening conductor) Photos & Sketch 17 Antenna type, location, level and direction, present, future Sketch 18 Site Outline Drawing Hard Copy Other Comment by PIC Sitac XL : PIC Sitac XL Name : Sign : Date : 28 Juni 2016

2 APPROVAL SHEET ENGINEERING SURVEY REPORT SITE ID - SITE NAME CANDIDATE SITE ADDRESS PROJECT TYPE PROPOSE BY HALIM GOLF Relocation LAT : 6 16'38.3"S ; LONG : '23.5"E Jln. Basudewo komplek Dirgantara II Colo PT. XL AXIATA Note: SLA Routing Approval per Department is 1 (one) working day Routing Approval: Approval Doc ESR In Doc ESR Out Date Time Date Time Remark Sign PIC Name Sitac BSS RND TRM Civil Eng Power Eng Approval 006 Doc ESR Received by Admin NDC Doc Copy ESR Received by Vendor

3 REQUEST FOR APPROVAL (Tower Rental Project) Date : 28 Juni 2016 SITE ID : - Site ID Site Info Provider Remark Site Name : HALIM GOLF Relocation Tower Height : 20 M Tower Type : Pole Project Deff : Location Photograph Site Search Report Site Address : Jln. Basudewo komplek Dirgantara II Candidate Proposed Coordinate LAT : 6 16'38.3"S LONG : '23.5"E (harus sama dgn info koordinat di halaman 1) LOI Property Document NOM Coordinate LATITUDE : S LONGITUDE : E Distance NOM to Candidate :...mtr Bearing NOM to Canditate :...degree Prepared By : Review By : Approved by XL: PT. XL AXIATA PIC : Name : Name : Date : 28 Juni 2016 Date : Date :

4 ENGINEERING SURVEY REPORT Prepared by : PT. XL AXIATA Project : Tower Rental New Build / Collocation Existing Document response / approved : (by provider) Checked : Doc No : Revision : Site No. : - Site Name : HALIM GOLF Relocation Visit Date : 28-Jun-2016 I. GENERAL INFORMATION Area : Jabodetabek Site Address : Jln. Basudewo komplek Dirgantara II Contact Person : Phone Number : Contact Person Address : Access to site : Available Not Available Need a new additional access Remarks : detail information (car entry or by walking or need ladder etc) Access 24 hours/day : Yes Not identify hours :.to.. II. GEOGRAPHIC INFORMATION NOM Coodinates LATITUDE : S ; LONGITUDE : E GPS Coordinates LAT : 6 16'38.3"S ; LONG : '23.5"E candidate A harus sama dengan sampul muka halaman depan Map Datum : WGS 84 Mark position on map A4 sketch from above III. PHOTOGRAPH DOCUMENTARY Photos taken GPS Photo 2 photos Surroundings tower (google maps) 1 captures & sketch 360 degree panorama, each 30 degree 12 photos Proposed site location 4 photos Site Access 8 photos Obstacle objects - photos At approximately level 42 m.a.g.l (meter above ground level) Taken on Ground Exist. Tower Building Tree Altitude 5 m.a.s.l (meter above sea level) Mark position on map A4 sketch from above

5 ENGINEERING SURVEY REPORT Prepared by : PT. XL AXIATA Project : Tower Rental New Build / Collocation Existing Document response / approved : (by provider) Checked : Doc No : Revision : Page 1 of 7 IV. RADIO FREQUENCY ( RF ) DATA RBS Antenna Height : 20 / 20 / 20 magl RBS Antenna Direction : Surroundings : OBSTACLE Direction (deg) Distance (m) Height (m) ANTENNA TYPE V-POL X-POL RBS TYPE INDOOR OUTDOOR MODEL : Note : Diisi oleh PIC RND XL berdasarkan info & data di SSR IN GRID /OFF GRID : at OTHER COMMENTS BY XL: Note : Diisi oleh PIC RND XL RF RECOMMENDATION : OK NOT OK PIC BSS-RND Name : V. TRANSMISSION DATA Page 2 of 7

6 ENGINEERING SURVEY REPORT Prepared by : PT. XL AXIATA Project : Tower Rental New Build / Collocation Existing Document response / approved : (by provider) Checked : Doc No : Revision : SITE FACING PLAN FACING SITES SITE ADDRESS LATITUDE LONGITUDE ALTITUDE (masl) TRM CONFIGURATION DATA (*) FACING SITES DISTANCE (km) BEARING (degree) ANTENNA HEIGHT (m) DIAMETER (M) (*) Diisi hanya untuk Project XL Own Build / oleh Vendor Sitac Regular SURROUNDINGS (Including Panoramic Photograph) OBSTACLE DIRECTION (deg) DISTANCE (km) HEIGHT (m) OTHER COMMENTS BY XL: TRM RECOMMENDATION : OK NOT OK PIC TRM Name : page 3 of 7 VI. CIVIL INFRASTRUCTURES DATA SITE CATEGORY : Green Field Roof Top Existing GREEN FIELD

7 ENGINEERING SURVEY REPORT Prepared by : PT. XL AXIATA Project : Tower Rental New Build / Collocation Existing Document response / approved : (by provider) Checked : Doc No : Revision : General Topographi : Flat Swamp Slope Hilty Soil General Classification : Normal Rocky Sandy Clay / Muld Obstruction No Trees Building.. Site Improvement required : Clearing Stripping Cut / Fill Demolist existing ACCESS TO SITE Distance from public road : Meter Width : Meter Type of pavement : Hotmix Asphalt Concrete Paving Block Macadam Aggregate Soil.. Length of private access : Meter Width : Meter Type of pavement : Hotmix Asphalt Concrete Paving Block Macadam Aggregate Soil.. Improvement required : Bridge Pavement Other PROPOSED AREA TO BE ACQUIRED (GREEN FIELD) (*) Lot Size : Rent Area : Access To Site : (*) Diisi hanya untuk Project XL Own Build / oleh Vendor Sitac Regular ROOF TOP - BUILDING STRUCTURE Height Structure Type : Stories number Roof Top meter Penthose meter Other meter Old of Building : Years Building Structure Type : Reinforcr Concrete Steel Other Building Using : Home Office Mall/Shop School/hospital Potential Obstacle When Construction or Operation : page 4 of 7 ROOF TOP ACCESS Access for Crane : Yes No Stairway available : Yes No - Dimension : m wide X m height Passenger Lift : Yes No - Capacity : persons, from.. Trough Floor

8 ENGINEERING SURVEY REPORT Prepared by : PT. XL AXIATA Project : Tower Rental New Build / Collocation Existing Document response / approved : (by provider) Checked : Doc No : Revision : Material Lift : Yes No - Capacity : kg, from. Trough Floor - Dimension : m wide m height Ladder Yes No - Dimension m Wide m Depth m Height Potential Obstacle for Material Equipment delivery : ADDITIONAL SUPPORTING STRUCTURE REQUIRED (*) Beam :. m length Access Ladder :. m length. m wide Other :.. (*) Diisi hanya untuk Project XL Own Build / oleh Vendor Sitac Regular GROUNDING and LIGHTNING PROTECTION SYSTEM in BUILDING Is grounding system available? : No Yes Type and size Is it possible to use? : No Yes Is lightning protect available? : No Yes Type and size Is it possible to use? : No Yes SHAFT and CABLE ROUTING Is cable shaft available? : Yes No Routing cables/feeder : Tray Clamped Other : : length :. M (including Routing Drawing) PROPOSED AREA TO BE ACQUIRED (ROOF TOP) (*) Lot Size : Rent Area :.... Meter X. Meter =.. Meter² Access To Site : Meter X. Meter =.. Meter² (*) Diisi hanya untuk Project XL Own Build / oleh Vendor Sitac Regular page 5 of 7 TOWER DATA Tower Height : 20 M From Ground Level From Roop Top Level Tower Type : Self Supporting Tower Monopole/Single Pole : Guyed Tower Three Camouflage LEASING & PERMIT INFORMATION (*) Lease Space : L 10 Meter X W 10 Meter X H Estimated Rent? Can the site be Leased? : Yes No Can the site be Permitted? : Yes No

9 ENGINEERING SURVEY REPORT Prepared by : PT. XL AXIATA Project : Tower Rental New Build / Collocation Existing Document response / approved : (by provider) Checked : Doc No : Revision : (*) Diisi hanya untuk Project XL Own Build / oleh Vendor Sitac Regular OTHER COMMENTS BY XL: CIVIL RECOMMENDATION : OK NOT OK PIC Civil Eng Name : VII. POWER & ELECTRICITY POWER SOURCE Power Availability (PLN) For XL Available Not Available Capacity : 13,2 KVA Distance From Existing PLN Pole : 40 meter nearest Traffo --- m Provided by building / PLN, Capacity : 150 KVA ( FOR ROOF TOP SITE) Additional facilities required (*) : Poles Cable Transformer Other (*) Diisi hanya untuk Project XL Own Build / oleh Vendor Sitac Regular OTHER COMMENTS BY XL: POWER RECOMMENDATION : OK NOT OK PIC Power Eng Name : page 6 of 7 VII. ATTACHMENT DOCUMENT INDICATION Photo GPS Photos Surroundings tower (radius 200 m) Google maps & Sketch 360 degree panorama, each 30 degree Photos Site situation, access, existing facilities, etc Photos & Sketch Obstacle objects & near field obstruction Photos Existing facing sites Photos & Sketch Proposed site & Area Photos & Sketch

10 ENGINEERING SURVEY REPORT Prepared by : PT. XL AXIATA Project : Tower Rental New Build / Collocation Existing Document response / approved : (by provider) Checked : Doc No : Revision : Actual centerline, North on sketch Location and size of column and beam, existing and additional Proposed Location and Shelter, Tower, AC, Power meter, etc Proposed routing of cables (co-axial, power, grounding, lightening conductor) Antenna type, location, level and direction, present, future Site Outline Drawing Sketch Photos & Sketch Photos & Sketch Photos & Sketch Sketch Hard Copy page 7 of 7

11 PHOTOGRAPH DOCUMENTARY Site No. : - Project : XL Site Name : HALIM GOLF Relocation Location : Jabodetabek Visit Date : 28-Jun-16 Prepared by : PT. Dayamitra Telekomunikasi Surveyor : Yusril Foto GPS

12 PHOTOGRAPH DOCUMENTARY Site No. : - Project : XL Site Name : HALIM GOLF Relocation Location : Jabodetabek Visit Date Surveyor : 28-Jun-16 : Yusril Prepared by : PT. Dayamitra Telekomunikasi

13 PHOTOGRAPH DOCUMENTARY Site No. : - Project : XL Site Name : HALIM GOLF Relocation Location : Jabodetabek Visit Date Surveyor : 28-Jun-16 : Yusril Prepared by : PT. Dayamitra Telekomunikasi Degree View Panorama View Remarks 0 30

14 PHOTOGRAPH DOCUMENTARY Site No. : - Project : XL Site Name : HALIM GOLF Relocation Location : Jabodetabek Visit Date Surveyor : 28-Jun-16 : Yusril Prepared by : PT. Dayamitra Telekomunikasi Degree View Panorama View Remarks 60 90

15 PHOTOGRAPH DOCUMENTARY Site No. : - Project : XL Site Name : HALIM GOLF Relocation Location : Jabodetabek Visit Date Surveyor : 28-Jun-16 : Yusril Prepared by : PT. Dayamitra Telekomunikasi Degree View Panorama View Remarks

16 PHOTOGRAPH DOCUMENTARY Site No. : - Project : XL Site Name : HALIM GOLF Relocation Location : Jabodetabek Visit Date Surveyor : 28-Jun-16 : Yusril Prepared by : PT. Dayamitra Telekomunikasi Degree View Panorama View Remarks

17 PHOTOGRAPH DOCUMENTARY Site No. : - Project : XL Site Name : HALIM GOLF Relocation Location : Jabodetabek Visit Date Surveyor : 28-Jun-16 : Yusril Prepared by : PT. Dayamitra Telekomunikasi Degree View Panorama View Remarks

18 PHOTOGRAPH DOCUMENTARY Site No. : - Project : XL Site Name : HALIM GOLF Relocation Location : Jabodetabek Visit Date Surveyor : 28-Jun-16 : Yusril Prepared by : PT. Dayamitra Telekomunikasi Degree View Panorama View Remarks

19 PHOTOGRAPH DOCUMENTARY Site No. : - Project : XL Site Name : HALIM GOLF Relocation Location : Jabodetabek Visit Date : 28-Jun-16 Prepared by : PT. Dayamitra Telekomunikasi Surveyor : Yusril PANORAMA 90 PANORAMA 210 PANORAMA 330

20 PHOTOGRAPH DOCUMENTARY Site No. : - Project : XL Site Name : HALIM GOLF Relocation Location : Jabodetabek Visit Date Surveyor : 28-Jun-16 : Yusril Prepared by : PT. Dayamitra Telekomunikasi TAMPAK DEPAN TAMPAK BELAKANG

21 PHOTOGRAPH DOCUMENTARY Site No. : - Project : XL Site Name : HALIM GOLF Relocation Location : Jabodetabek Visit Date Surveyor : 28-Jun-16 : Yusril Prepared by : PT. Dayamitra Telekomunikasi TAMPAK KIRI TAMPAK KANAN

22 PHOTOGRAPH DOCUMENTARY Site No. : - Project : XL Site Name : HALIM GOLF Relocation Location : Jabodetabek Visit Date : 28-Jun-16 Prepared by : PT. Dayamitra Telekomunikasi Surveyor : Yusril PROPOSED ANT. SECTOR ELV.± magl AZIMUTH : 90⁰/210⁰/330⁰ PROPOSED MW ANTENNA SIZE: 0.6 AZIMUTH: 0⁰ ELV.±. 20mAGL Proposed Antenna Proposed RBS

23 PHOTOGRAPH DOCUMENTARY Site No. : - Project : XL Site Name : HALIM GOLF Relocation Location : Jabodetabek Visit Date : 28-Jun-16 Prepared by : PT. Dayamitra Telekomunikasi Surveyor : Yusril SITE ACCESS TO SITE SITE ACCESS TO SITE SITE ACCESS TO SITE

24 PHOTOGRAPH DOCUMENTARY Site No. : - Project : XL Site Name : HALIM GOLF Relocation Location : Jabodetabek Visit Date : 28-Jun-16 Prepared by : PT. Dayamitra Telekomunikasi Surveyor : Yusril PLN/POWER POLE PLN TRAFO Kapasitas 100 KVA / 3 phase ( --- m dari site)

25 PHOTOGRAPH DOCUMENTARY Site No. : - Project : XL Site Name : HALIM GOLF Relocation Location : Jabodetabek Visit Date Surveyor : 28-Jun-16 : Yusril Prepared by : PT. Dayamitra Telekomunikasi SITE SITUATION 1 SITE SITUATION 2

26 BILL OF QUANTITY (BOQ) BIDANG PEKERJAAN TOWER PEKERJAAN PERKUATAN TOWER DAN SARANA PENUNJANGNYA Type Tower : GF - POLE 20M Site Name : HALIM GOLF Relocation Type Pondasi : BTS Outdoor SITE ID : Nama Mitra : PT. SANJIWAHANA PERSADA CLUSTER : JABODETABEK ITEM DESKRIPSI SATUAN VOLUME A A1 PRA IMPLEMENTASI SITE INVESTIGATION SURVEY (SIS) - Pra SITAC & PRA CME LS - A2 SITE ACQUISITION (SITAC) A.2.1 Site Acquisition dan Jasa Perolehan lahan LS - A.2.2 Jasa Perolehan Ijin Mendirikan Bangunan (IMB) tower dan Perijinan LS - A.2.3 BIAYA SEWA / BELI LAHAN Ukuran Lahan 2.0x2.0 (Outer) LS - B B.1 IMPLEMENTASI CME Standar Work TOWER (Erection, Finishing) MCP 20 M LS - B.2 PONDASI TOWER GREEN FIELD MCP 20 M LIGHT (Volume Pondasi = 2.12 m3) Bore Pile ø100 Cm (Panjang Keseluruhan = 2.00 m' = 1.57m3) LS - LS - B.3 BTS OUTDOOR Pondasi Base Frame BTS Outdoor (Volume Pondasi = 1,3 m3) LS - B.4 MECHANICAL & ELECTRICAL MCP 20 M Ls 1 B.5 PANEL Panel ACPDB Outdoor / Indoor Panel KWH Ls 1 Ls 1 B.6 PAGAR DAN HALAMAN TYPE E FENCE & YARD : x m LS - B.7 TRANSPORTASI TOWER MCP 20 M LS 1 C C.1 PLN CONNECTION & ACCESORIES Penyambungan Daya Listrik (PLN ) 4.4 KVA ls 1 D D.1 ADDITIONAL Mounting Bracket Sector & Microwave (3m) ls 1 Dibuat oleh : Diperiksa oleh : Disetujui oleh : PT. Uptrans Telekomunikasi PT. Daya Mitra Telekomunikasi PT. Daya Mitra Telekomunikasi Tgl. Tgl. Tgl.

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