APPENDIX A
SITE SURVEY
STATION INFORMATION FORMS
(To be filled during site survey)
Home Base Station
Date:_______
Prepared by:
Name:______ e-mail:__________ Phone:_______
Gas station info:
Company name __________________ Tel: ____________
Contact person: __________________ Mobile Phone:_____
Fax: ____________
A. STATION INFORMATION
• Power line 110VAC 220VAC Other____
• Power stabilizer/UPS available? ______________ Spec _________________
• Station name __________________________
• Location _________________________
• FCC Tel. No._____________ / Direct connect _____________
• Internet connectivity method (Modem, GPRS, cable, frame relay,
SAT,ADSL etc) ______________
• Number of dispensers (to be connected to FCC): ______
• Number of nozzles (to be connected to FCC): ______
• Number of Authorizers required _____
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