TV Site Survey

• Job Number

• Business Name

• Conducted on

  Date

• Prepared by

• Parking Information (Location and cost)

• New install or upgrade?

  New Install

  Upgrade

Dish location

• Dish location

• Add wide angle photos of dish location

  Media

• Select dish type

  Zone 1

  Zone 2

  Communal

  Fibre

• LNB Type

  Quad

  Octo

  Wideband

  Hybrid

  Fibre

STB 1 Location

• Detail STB 1 location

• Add wide angle photo of STB location

  Media

• Show cable route from dish to STB 1 (Using Skitch)

  Media

• How many TV's will connect to STB 1

  None

  1

  2

  3

  4+

• How many screens to be connected?

• Is there an STB 2?

  Yes

  No

STB 2 Location

• Detail STB 2 location

• Add wide angle photo of STB 2 location

  Media

• Show cable route from dish to STB 2 (Using Skitch)

  Media

• How many TV's will connect to STB 2

  None

  1

  2

  3

  4+

• How many screens to be connected?

• Is there an STB 3?

  Yes

  No

STB 3 Location

• Detail STB 3 location

• Add wide angle photo of STB 3 location

  Media

• Show cable route from dish to STB 3 (Using Skitch)

  Media

• How many TV's will connect to STB 3

  None

  1

  2

  3

  4+

• How many screens to be connected?

• Is there an STB 4?

  Yes

  No

• Detail STB 4 location

• Add wide angle photo of STB 4 location

  Media

• Show cable route from dish to STB 4 (Using Skitch)

  Media

• How many TV's will connect to STB 4?

  None

  1

  2

  3

  4+

• How many screens will be connected?

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

Van Stock Items Required

STB

• Do you require any Sky HD STBs?

  Yes

  No

  N/A

• How many Sky HD STB's are required?

• Do you require and Sky+ HD STB's?

  Yes

  No

  N/A

• How many Sky+ HD STB's are required?

• Do you require any SkyQ STB's?

  Yes

  No

  N/A

• How many Sky Q STB's are required?

Cable

• Do you require CT63 cable?

  Yes

  No

  N/A

• How many metres of CT63 is required?

• Do you require CT100 cable?

  Yes

  No

  N/A

• How many metres of CT100 is required?

• Do you require Cat 5 cable?

  Yes

  No

  N/A

• How many metres of CAT 5 cable is required?

LNB

• What LNB will you be required?

  None

  Quad

  Octo

  Wideband

  Hybrid / Smart

Leads

• Do you require 1m HDMI leads?

  Yes

  No

  N/A

• How many 1m HDMI cables are required?

• Do you require 5m HDMI leads?

  Yes

  No

  N/A

• How many 5m HDMI cables are required?

• Do you require 10m HDMI leads?

  Yes

  No

  N/A

• How many 10m HDMI cables are required?

• Do you require 20m HDMI leads?

  Yes

  No

  N/A

• How many 20m HDMI cables are required?

• Do you require any HDMI extenders?

  Yes

  No

  N/A

• How many HDMI extenders are required?

Splitters

• Do you require any 2 Way HDMI splitters?

  Yes

  No

  N/A

• How many 2 Way HDMI splitters are required?

• Do you require any 4 Way HDMI splitters?

  Yes

  No

  N/A

• How many 4 Way HDMI splitters are required?

• Do you require any 2 way RF120 splitters?

  Yes

  No

  N/A

• How many 2 Way RF 120 splitters are required?

• Do you require any 4 Way RF140 splitters?

  Yes

  No

  N/A

• How many 4 Way RF 140 splitters are required?

• Do you require any I/O Links?

  Yes

  No

  N/A

• How many I/O links are required?

• Do you require any TV Links are required?

  Yes

  No

  N/A

• How many TV links are required?

Non van stock items

• Are any non van stock items required?

  Yes

  No

  N/A

• Do you require any audio / visual connectors?

  Yes

  No

  N/A

• How many 'F' to Phono connectors are required?

  2

  4

  6

  8

  10

• How many Scart to RCA adaptors are required?

  None

  1

  2

  3

  4+

• Do you require any HDMI over Cat 5 converter sets?

  Yes

  No

  N/A

• How many HDMI to CAT 5 converter sets are required?

• Do you require any HDMI over Cat 6 converters sets?

  Yes

  No

  N/A

• How many HDMI to CAT 6 converter sets are required?

• Do you require any CT125 cable?

  Yes

  No

  N/A

• How many metres of CT125 is required?

• How many CT125 'F' connectors are required?

• Is a HDMI matrix required?

  Yes

  No

  N/A

• Please state the number of inputs and number of outputs required? (example 4 inputs and 8 outputs)

• Do you require any Cat 6 cable? (UHD installs only)

  Yes

  No

  N/A

• How many metres of Cat 6 cable do you require?

• Is Fire Sealant required?

  Yes

  No

  N/A

• What type of Fire Sealant is required?

• Are any other special order items required? (ie Trunking)

  Yes

  No

  N/A

• Please list any other special order items required (ie Trunking)

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?