TV Site Survey

• Job Number

• Conducted on

  Date

• Prepared by

• Business Name

• Location
  Address

• Additional address information (if require)

• Parking Information (Location and cost)

• New install or upgrade?

  None

  RAMS

  Escalated RAMS

Dish location

• Dish location

• Add wide angle photos of dish location

  Media

• Select dish type

  Zone 1

  Zone 2

  Communal

  Fibre

  No dish in place

• What dish to be used?

  Zone 1

  Zone 2

  Communal

  Fibre

• LNB Type

  Quad

  Octo

  Wideband

  Hybrid

  Fibre

• LNB Type

  Quad

  Octo

  Wideband

  Hybrid

  Fibre

STB 1 Location

• Detail STB 1 location

• Add wide angle photo of STB location

  Media

• How many TV's will connect to STB 1

  1

  2

  3

  4

  5+

• Is there an STB 2?

  Yes

  No

STB 2 Location

• Detail STB 2 location

• Add wide angle photo of STB 2 location

  Media

• How many TV's will connect to STB 2

  1

  2

  3

  4

  5+

• Is there an STB 3?

  Yes

  No

STB 3 Location

• Detail STB 3 location

• Add wide angle photo of STB 3 location

  Media

• How many TV's will connect to STB 3

  1

  2

  3

  4

  5+

• Add wide angle photo of STB location

  Media

Screen 1

• Detail screen location

• Add wide angle photo of Screen location

  Media

• Which STB is this screen connected to?

  Select STB 1 STB 2 STB 3

  • STB 1
  • STB 2
  • STB 3

• Connection type

  Select UHD HD RF

  • UHD
  • HD
  • RF

• Show cable route from screen to STB(s)

  Media

• Is there a Screen 2

  Yes

  No

Screen 2

• Detail screen location

• Add wide angle photo of Screen location

  Media

• Which STB is this screen connected to?

  Select STB 1 STB 2 STB 3

  • STB 1
  • STB 2
  • STB 3

• Connection type

  Select UHD HD RF

  • UHD
  • HD
  • RF

• Show cable route from screen to STB(s)

  Media

• Is there a Screen 3

  Yes

  No

Screen 3

• Detail screen location

• Add wide angle photo of Screen location

  Media

• Which STB is this screen connected to?

  Select STB 1 STB 2 STB 3

  • STB 1
  • STB 2
  • STB 3

• Connection type

  Select UHD HD RF

  • UHD
  • HD
  • RF

• Show cable route from screen to STB(s)

  Media

• Is there a Screen 4<br>

  Yes

  No

Screen 4

• Detail screen location

• Add wide angle photo of Screen location

  Media

• Which STB is this screen connected to?

  Select STB 1 STB 2 STB 3

  • STB 1
  • STB 2
  • STB 3

• Connection type

  Select UHD HD RF

  • UHD
  • HD
  • RF

• Show cable route from screen to STB(s)

  Media

• Is there a Screen 5<br>

  Yes

  No

Screen 5

• Detail screen location

• Add wide angle photo of Screen location

  Media

• Which STB is this screen connected to?

  Select STB 1 STB 2 STB 3

  • STB 1
  • STB 2
  • STB 3

• Connection type

  Select UHD HD RF

  • UHD
  • HD
  • RF

• Show cable route from screen to STB(s)

  Media

• Is there a Screen 6<br>

  Yes

  No

Screen 6

• Detail screen location

• Add wide angle photo of Screen location

  Media

• Which STB is this screen connected to?

  Select STB 1 STB 2 STB 3

  • STB 1
  • STB 2
  • STB 3

• Connection type

  Select UHD HD RF

  • UHD
  • HD
  • RF

• Show cable route from screen to STB(s)

  Media

• Is there a Screen 7<br>

  Yes

  No

Screen 7

• Detail screen location

• Add wide angle photo of Screen location

  Media

• Which STB is this screen connected to?

  Select STB 1 STB 2 STB 3

  • STB 1
  • STB 2
  • STB 3

• Connection type

  Select UHD HD RF

  • UHD
  • HD
  • RF

• Show cable route from screen to STB(s)

  Media

• Is there a Screen 8<br>

  Yes

  No

Screen 8

• Detail screen location

• Add wide angle photo of Screen location

  Media

• Which STB is this screen connected to?

  Select STB 1 STB 2 STB 3

  • STB 1
  • STB 2
  • STB 3

• Connection type

  Select UHD HD RF

  • UHD
  • HD
  • RF

• Show cable route from screen to STB(s)

  Media

• Is there a Screen 9<br>

  Yes

  No

Screen 9

• Detail screen location

• Add wide angle photo of Screen location

  Media

• Which STB is this screen connected to?

  Select STB 1 STB 2 STB 3

  • STB 1
  • STB 2
  • STB 3

• Connection type

  Select UHD HD RF

  • UHD
  • HD
  • RF

• Show cable route from screen to STB(s)

  Media

• Is there a Screen 10<br>

  Yes

  No

Screen 10

• Detail screen location

• Add wide angle photo of Screen location

  Media

• Which STB is this screen connected to?

  Select STB 1 STB 2 STB 3

  • STB 1
  • STB 2
  • STB 3

• Connection type

  Select UHD HD RF

  • UHD
  • HD
  • RF

• Show cable route from screen to STB(s)

  Media

Parts required

Cable

• How many metres of CT63 cable is required?

• How many metres of CT100 cable is required?

• How many metres of CT125 is required?

• How many metres of CAT5 cable is required?

• How many metres of CAT6 cable is required? (UHD ONLY)

Leads

• How many 1m HDMI leads are required?

• How many 5m HDMI leads are required?

• How many 10m HDMI leads are required?

• How many 20m HDMI leads are required?

Splitters

• How many 2 Way HDMI splitters are required

• How many 4 Way HDMI splitters are required?

• How many 2 Way RF Amps (F120) are required?

• How many 4 Way RF Amps (F140) are required?

• How many TV Links are required?

• How many I/O Links are required?

Non van stock items

• Are any non van stock items required?

  Yes

  No

• How many HDMI/CAT5 converter sets are required?

• How many HDMI/CAT6 converter sets are required? (UHD only)

• Is a HDMI matrix required?

  Yes

  No

• Please state the number of inputs and number of outputs required?

• Please list any other special order items required

Additional information

• What type of paper risk assessment form will need to be completed?

  None

  RAMS

  Escalated RAMS

• Any additional job specific comments to support the installation

• Estimated time required to complete the visit?