Sample Sweep Submission Form

Document 24782-000-3PS-EFYO-00001, Rev.0 Page _____ of _____

GSM Overlay Antenna System Site Submission/Turn Over Form Site Identification Information Market/City: Jacksonville

Site ID:

Site Name: Switzerland

Site Phone:

Site Type: 850 / 1900 / Dual / Comb. (Circle one) Sweep Test Results HOST

Equipment Model No.:

ANTENNA ID

(NEW) ANTENNA

Tested By: Joe Anderson Telcom Construction Signature:

J083 Equip.S331B Serial No.:

Calibration Date: 6/15/02

JUMPER SWEEPS ONLY

(NEW & EXISTIN G) Antenna Frequency Range(s)

(NEW) Antenna Gain(s)

(NEW) Antenna Azimuth / DownTilt(s)

(NEW & EXISTING) Feedline System Cable Type(s)

Single or Dual Band

Phone: (904) 646-4575 Date: 1/30/03 Antenna Height: (AGL) (Feet)

(NEW & EXISTING) Feedline System Cable Length(s)

(NEW & EXISTING) Feedline System Return Loss(es)

NEW & EXISTING) Antenna System Return Loss(es)

(DTF)

(50 Ω Load)

SECTIONS (3.2.1)

SECTION (3.1.1)

SECTION (3.1.3)

(Ft)

(dB)

(dB)

N/A

(NEW & EXISTING)TMA/ MHA Included

(S/N of new TMA) TX/RX

(Model & Serial #)

(MHz)

(dB)

(DEG-E/M)

(Mfg Model #)

A-1-1

N/A

850 S

N/A

N/A

N/A

N/A

-37.7

N/A

N/A

A-4-1

N/A

850 S

N/A

N/A

N/A

N/A

-30.5

N/A

N/A

B-1-1

N/A

850 S

N/A

N/A

N/A

N/A

-34.9

N/A

N/A

B-4-1

N/A

850 S

N/A

N/A

N/A

N/A

-28.2

N/A

N/A

G-1-1

N/A

850 S

N/A

N/A

N/A

N/A

-35.4

N/A

N/A

G-4-1

N/A

850 S

N/A

N/A

N/A

N/A

-34.9

N/A

N/A

Notes:      

18

© 2002 Bechtel Corporation