DSI - Site Survey Report

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel attending test

Job site information

• Job #

• Name of location: ( Courthouse name, Facility Name)

• Location address:

• Onsite point of contact information (email address, phone numbers)

• Hours of access:

• Onsite job waste removal policy: Room cleaning policy:

Room Information (Add rooms as needed):

Room

• Room name referred to by client:

• Enter room Misc information.

• What is the approximate ceiling height?

• What is the cable pulling path?

• Document any pictures here showing access points, cable paths, etc!!!

  Media

• Draw any custom paths here:

  Drawing

• Photograph overall room here:

  Media

Rack Information:

• Is a rack part of the scope?

  Yes

  No

  Other

• Is the rack being built onsite?

  Yes

  No

  Other

• Explain "Other" here:

• What is the rack power drop amperage?

  20amp

  15amp

• Measurements of rack room (Door H/W/D)

• Enter any Rack related information here:

• What is the Rack room ventilation?

• Photograph Rack Room

  Media

Audio Devices Information:

• Audio part of Job Specification?

  Yes

  No

  Other

• Explain "Other" here:

• Notate anything Audio related here that needs to be documented:

• Is there OFE Audio equipment designed into this job?

  Yes

  No

  Other

• Add Audio Equipment

OFE Audio Device

• Manufacture and Model of device

• Enter Information about device here:

• Photograph OFE Audio equipment to be used here:

  Media

Video Devices Information:

• Video part of Job Specification?

  Yes

  No

  Other

• Explain "Other" here:

• Notate anything Video related here that needs to be documented:

• Is there OFE Video equipment designed into this job?

  Yes

  No

  Other

• Add OFE Video Device

OFE Video Device

• Manufacture and Model of device

• Enter information about OFE Video equipment to be used here:

• Photograph OFE Video equipment to be used here:

  Media

Control Devices Information:

• Control part of the Job Specification?

  Yes

  No

  Other

• Explain "Other" here:

• Notate anything Control related here that needs to be documented:

• Is there OFE Control equipment designed into this job?

  Yes

  No

  Other

• Add OFE Control Device

OFE Control device

• Manufacture and Model number of device

• Information about OFE Control equipment to be used here:

• Photograph OFE Control equipment to be used here:

  Media

Plate Details (Add Plate locations as needed):

• What is the desired plate color?

  Black

  Aluminum

  Brass

  White

  Other

• What Color?

• Use this section to document any information needed specifically for field plates:

Plate Location

• Plate location name:

• What is Plate Gang size?

  Select 1 Gang 2 Gang 3 Gang 4 Gang 5 Gang N/A Other

  • 1 Gang
  • 2 Gang
  • 3 Gang
  • 4 Gang
  • 5 Gang
  • N/A
  • Other

• Is a surface mount box needed?

  Yes

  No

  Other

• Photograph Plate location:

  Media

• Plate location information:

Locations details:

• Add specific location information here:

• Attorney table whip lengths needed: ( From floor plate to table, Input cables, Monitor cable lengths)

• Attorney table whip length needed from floor plate to table?

  10 ft

  12 ft

  15 ft

  20 ft

  Other

• What is needed length?

• Attorney table input cables length?

  6 ft

  10 ft

  15 ft

  20 ft

  Other

• What is needed length?

• Attorney table Monitor cable length?

  10 ft

  12 ft

  15 ft

  20 ft

  Other

• What is needed length?

• Bench lengths needed: ( From floor plate to table, Input cables, Monitor cable lengths)

• Bench whip length needed from floor plate to device ?

  10 ft

  12 ft

  15 ft

  20 ft

  Other

• What is needed length?

• Bench input cables length?

  6 ft

  10 ft

  15 ft

  20 ft

  Other

• What is needed length?

• Bench Monitor cable length?

  10 ft

  12 ft

  15 ft

  20 ft

  Other

• What is needed length?

• Misc. lengths needed: ( From floor plate to table, Input cables, Monitor cable lengths)

• Add Misc Whip length:

Misc Length

• Name Misc. items here:

• Misc. whip length needed from floor plate to device ?

  10 ft

  12 ft

  15 ft

  20 ft

  Other

• What is needed length?

Misc. Information needing to be documented:

• Add any information not included in other sections here:

• Add photos of Misc items here:

Misc. Photo

• Describe photo here:

• Any photos not included in other sections here:

  Media

• Add Misc. items here:

Misc. Item

• Misc. item Name:

• Describe the item:

• Photograph the item if needed:

  Media

• Add Supply items needed here:

Misc. Item

• Supply item Name:

• What is this needed for? Anything special?

• Photograph the item if needed:

  Media