Communication Site Technical Data Report - U.s. Department Of The Interior Page 2

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TRANSMITTER EQUIPMENT TECHNICAL INFORMATION
16. Transmitter:
Mfg._____________________
Model No.___________________________
Type Accepted
No. _____________________
Serial No.__________________________
Age ___Years__________New
Model No.___________________________
17. Transmitter Isolators or Circulators used:
Mfg__________________________________
Model No._______________________________
Age_____Years_____________________New
Serial No.______________________________
Number ISO used:________________________
Total isolation achieved _______________db.
18. Antenna and Cable System used:
Antenna Mfg.____________________________
Cable Mfg.________________________________
Type____________________________________
Cable Dia.________________________________
Model___________________________________
Cable length inside Bldg.________________Ft
Cable length outside Bldg._______________Ft
Gain___________db Age______Years____New
Cable fittings type N____UHF_____BNC_____
Direction__________ Degrees
Cable Type_______________________________
Height(AGL) Top_________Ft
Bottom_______Ft.
Polarization Horizontal_____________
Vertical___________ Circular____________________
Number of Fitting adapters used in transmitter systems________________________________
19. Emission:
Call sign__________________
Emission Type___________________________
True Power_____________Watts
Emission Bandwidth_________________Watts
ERP____________________Watts
20. Frequencies in Mhz, Ghz, Khz
I understand that the transmitter will not be placed in service until it is properly licensed by the FCC______________
INITIAL
RECEIVER EQUIPMENT TECHNICAL INFORMATION
21. Receiver
Mfg. _____________________________
Model No.____________________________
Type Accepted No._________________
Serial No.___________________________
Age_____Years
New _____
Model No._____________
22. Multi-coupler
Mfg._____________________________
Model No.____________________________
2

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