Title Page
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TV Site Survey Job Number
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Business Name
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Conducted on
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Prepared by
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Parking Information (Location and cost)
Health and Safety
Health and Safety
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Can the visit be complete within Sky Health and Safety guidelines
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Why is it Health and Safety impossible?
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Add photos to support this
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What Risk Assessment form needs to be completed?
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What type of property is this?
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Please specify property type
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How many floors?
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Can the visit proceed?
Dish location
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Dish location
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Add wide angle photos of dish location
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Select dish type
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LNB Type
STB 1 Location
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Detail STB 1 location
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Add wide angle photo of STB location
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Is there an existing cable in place that has passed your meter test?
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Using Skitch, show cable route from Dish to STB in RED (underline route in ORANGE if trunking will be used)
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How many TV's will connect to STB 1
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How many screens to be connected?
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Is there an STB 2?
STB 2 Location
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Detail STB 2 location
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Add wide angle photo of STB 2 location
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Is there an existing cable in place that has passed your meter test?
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Using Skitch, show cable route from Dish to STB in RED (underline route in ORANGE if trunking will be used)
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How many TV's will connect to STB 2
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How many screens to be connected?
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Is there an STB 3?
STB 3 Location
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Detail STB 3 location
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Add wide angle photo of STB 3 location
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Is there an existing cable in place that has passed your meter test?
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Using Skitch, show cable route from Dish to STB in RED (underline route in ORANGE if trunking will be used)
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How many TV's will connect to STB 3
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How many screens to be connected?
Screen 1
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Detail screen location
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Add wide angle photo of Screen location
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Which STB is this screen connected to?
- STB 1
- STB 2
- STB 3
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Connection type
- UHD
- HD
- RF
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Is there an existing cable in place that has been tested as fit for use? (If cable is to be installed by 3rd party, choose which cable will be installed)
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Using Skitch, show cable route from STB to TV in BLUE (underline route in ORANGE if trunking will be used)
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Is there a Screen 2
Screen 2
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Detail screen location
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Add wide angle photo of Screen location
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Which STB is this screen connected to?
- STB 1
- STB 2
- STB 3
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Connection type
- UHD
- HD
- RF
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Is there an existing cable in place that has been tested as fit for use? (If cable is to be installed by 3rd party, choose which cable will be installed)
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Using Skitch, show cable route from STB to TV in BLUE (underline route in ORANGE if trunking will be used)
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Is there a Screen 3
Screen 3
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Detail screen location
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Add wide angle photo of Screen location
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Which STB is this screen connected to?
- STB 1
- STB 2
- STB 3
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Connection type
- UHD
- HD
- RF
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Is there an existing cable in place that has been tested as fit for use? (If cable is to be installed by 3rd party, choose which cable will be installed)
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Using Skitch, show cable route from STB to TV in BLUE (underline route in ORANGE if trunking will be used)
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Is there a Screen 4<br>
Screen 4
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Detail screen location
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Add wide angle photo of Screen location
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Which STB is this screen connected to?
- STB 1
- STB 2
- STB 3
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Connection type
- UHD
- HD
- RF
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Is there an existing cable in place that has been tested as fit for use? (If cable is to be installed by 3rd party, choose which cable will be installed)
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Using Skitch, show cable route from STB to TV in BLUE (underline route in ORANGE if trunking will be used)
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Is there a Screen 5<br>
Screen 5
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Detail screen location
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Add wide angle photo of Screen location
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Which STB is this screen connected to?
- STB 1
- STB 2
- STB 3
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Connection type
- UHD
- HD
- RF
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Is there an existing cable in place that has been tested as fit for use? (If cable is to be installed by 3rd party, choose which cable will be installed)
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Using Skitch, show cable route from STB to TV in BLUE (underline route in ORANGE if trunking will be used)
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Is there a Screen 6<br>
Screen 6
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Detail screen location
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Add wide angle photo of Screen location
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Which STB is this screen connected to?
- STB 1
- STB 2
- STB 3
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Connection type
- UHD
- HD
- RF
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Is there an existing cable in place that has been tested as fit for use? (If cable is to be installed by 3rd party, choose which cable will be installed)
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Using Skitch, show cable route from STB to TV in BLUE (underline route in ORANGE if trunking will be used)
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Is there a Screen 7<br>
Screen 7
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Detail screen location
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Add wide angle photo of Screen location
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Which STB is this screen connected to?
- STB 1
- STB 2
- STB 3
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Connection type
- UHD
- HD
- RF
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Is there an existing cable in place that has been tested as fit for use? (If cable is to be installed by 3rd party, choose which cable will be installed)
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Using Skitch, show cable route from STB to TV in BLUE (underline route in ORANGE if trunking will be used)
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Is there a Screen 8<br>
Screen 8
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Detail screen location
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Add wide angle photo of Screen location
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Which STB is this screen connected to?
- STB 1
- STB 2
- STB 3
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Connection type
- UHD
- HD
- RF
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Is there an existing cable in place that has been tested as fit for use? (If cable is to be installed by 3rd party, choose which cable will be installed)
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Using Skitch, show cable route from STB to TV in BLUE (underline route in ORANGE if trunking will be used)
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Is there a Screen 9<br>
Screen 9
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Detail screen location
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Add wide angle photo of Screen location
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Which STB is this screen connected to?
- STB 1
- STB 2
- STB 3
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Connection type
- UHD
- HD
- RF
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Is there an existing cable in place that has been tested as fit for use? (If cable is to be installed by 3rd party, choose which cable will be installed)
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Using Skitch, show cable route from STB to TV in BLUE (underline route in ORANGE if trunking will be used)
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Is there a Screen 10<br>
Screen 10
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Detail screen location
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Add wide angle photo of Screen location
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Which STB is this screen connected to?
- STB 1
- STB 2
- STB 3
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Connection type
- UHD
- HD
- RF
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Is there an existing cable in place that has been tested as fit for use? (If cable is to be installed by 3rd party, choose which cable will be installed)
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Using Skitch, show cable route from STB to TV in BLUE (underline route in ORANGE if trunking will be used)
Van Stock Items Required
STB
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How many Sky HD STB's are required?
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How many Sky+ HD STB's are required?
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How many Sky Q STB's are required?
Cable
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How many metres of CT63 is required?
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How many metres of CT100 is required?
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How many metres of CAT 5 cable is required?
Leads
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How many 1m HDMI cables are required?
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How many 5m HDMI cables are required?
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How many 10m HDMI cables are required?
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How many 20m HDMI cables are required?
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How many HDMI extenders are required?
Splitters
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How many 2 Way HDMI splitters are required?
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How many 4 Way HDMI splitters are required?
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How many 2 Way RF 120 splitters are required?
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How many 4 Way RF 140 splitters are required?
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How many I/O links are required?
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How many TV links are required?
Non van stock items (Please ensure these are all added to the iPad survey questionnaire)
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Are any non van stock items required?
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Do you require any audio / visual connectors?
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How many 'F' to Phono connectors are required?
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How many Scart to RCA adaptors are required?
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Do you require any HDMI over Cat 5 converter sets?
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How many HDMI to CAT 5 converter sets are required?
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Do you require any HDMI over Cat 6 converters sets?
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How many HDMI to CAT 6 converter sets are required?
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Do you require any CT125 cable?
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How many metres of CT125 is required?
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How many CT125 'F' connectors are required?
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Will you require a CT125 crimp tool? (please add this to the iPad survey)
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Is a HDMI matrix required?
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How many inputs and outputs are required?
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Do you require any Cat 6 cable? (UHD installs only)
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How many metres of Cat 6 cable do you require?
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Is Fire Sealant required?
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What type of Fire Sealant is required?
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Do you require any trunking?
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Which colour trunking do you require?
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How many metres of trunking is required?
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Are any other special order items required? (ie. PSU's etc)
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Please list any other special order items required (ie Trunking)
Additional information
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Any additional job specific comments to support the installation
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Will any work be carried out by 3rd party contractors?
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Detail work to be carried out by 3rd party contractor
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Estimated time required to complete the visit?