Cctv Site Survey Form
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1CCTV Site Survey Form
Customer #
_____________________
Name
_____________________
Phone number
_____________________
Please fax completed form to our sales department at 864-
Email address
_____________________
286-4942. Or call 1-800-964-8994 with any questions.
How would you describe your current video surveillance
Camera Power
needs?
120VAC
Looking for a new system
24VAC
Looking to expand current system
12DC
Looking to replace current system
Is Vandal proofing required?
System Application
Yes
Indoors only
No
Outdoors only
Both indoors and outdoors
What transmission method will you be using?
Not sure
Coaxial
Fiber Optics
Twisted Pair
Location of Cameras - indicate number required at each
Not sure
location.
Interior
Parking Lot
What are your DVR storage requirements?
Perimeter
5-10 days
Hallways
10-30 days
Building
30-45 days
Other ( please specify)
45+ (please specify)
Do you require IP cameras?
Will any of these be Pan/Tilt/Zoom (PTZ) cameras?
Yes
Yes (please indicate qty)
No
No
Will remote viewing be required?
Yes
Total number of cameras your system will require
1-3
No
4-7
8-15
Will this system be used with Point of Sale?
16-31
Yes
32+ (please specify)
No
What lighting conditions will you need to record in?
Monitor Size
Daylight/continuously lit
9" - 14"
Night
15'' - 19"
Day and Night
20" - 26"
Not sure
26'' - 32"
Lens type (specify qty of each)
What is your estimated budget for this video surveillance
Wide Angle
system?
Normal
$2,000 - 4,999
Telephoto
$5,000 - $9,999
$10,000 - $24,999
Camera Housings/Brackets (specify qty of each)
$25,000+
Indoor
Not sure
Outdoor
What is your buying timeframe for this system?
Camera Mounting (specify qty of each)
ASAP
Wall
Within the next month
Ceiling
Within the next two months
More than two months
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