FM-STP-019

TECHNICAL SITE SURVEY REPORT ( TSSR )

SITE ID :

SITE NAME :

REGION :

SITE TYPE :

We Hereby guarantee that approval proccess for ESSR can be conducted, for there shall be no

significant difficulties in applying for the IMB For this site

Title Name Signature Date

Contractor PT LAMEDDEKOM PRATAMA INDONESIA

(By Contactor)
Prepared By

Project Manager YUSUF K

(IBS Regional
Checked By

SITAC HO
(Initial by Sitac & CME
Reg)

RF
Approved By
(Operator)

TX

Site ID : Site Name : 1 Of 9

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SITE IDENTIFICATION

Site ID NBDG_0088
Operator Request

Site Name CILAKU

Nominal (Long / Lat) 107.12562/-6.88324

Search Radius

Antena Height 36M

Candidate Information
Candidate A

Coordinate (Long / Lat) 107.12796/-6.874483

Distance From NOM .. m Azimuth .. Degree

Site Address Kp.Karulung RT 001/007 kel.sukasari kec.cilaku kotamadya cianjur

City / Province JAWA BARAT

Office Remote Area

Propose Candidate

Site Location Commercial Others.

Residential

Self Support Tower Pole Mount Mini Tower

Tower Type
Monopole Tower Wall Mount Others

Building Height (m) .. m Floor No .. f

Pole / Tower Height (m) .. m

Space Dimension

Access Road

24/7 Access Yes No If No : .

Owner Information
Name (Institution) AYI DEDIN

Address (Owner) Kp.Karulung RT 001/007 kel.sukasari kec.cilaku kotamadya cianjur

PIC (if institution) ADI SUDIRO

Phone Number / HP

Site ID : NBDG_0088 Site Name : CILAKU 2 of 9

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SITE LOCATION / MAP

Notes : Fill with scale site location / map drawing within 300 meters radius from candidate included existing other TP / O

Site ID : Site Name : 3 of 9

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SITE LAYOUT

Notes : Fill with scale site layout / situation drawing at Rooftop or Greenfield (include access road) with scale.

Site ID : Site Name : 4 of 9

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SITE CONTOUR

N
1
2 2

3
3

4 4
1

Public Road / Main Road

0.00m

Note : - North Direction

- Main Road Elevation as Datum ( + 0.00m )

Notes : Fill with scale site elevation / contour drawing.

Site ID : Site Name : 5 of 9

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Site Photographs - Panoramic Photograph

Panoramic 00 Panora

Panoramic 600 Panora

Site ID : Site Name : 6 of 9

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Panoramic 1200 Panoram

Site Photographs - Panoramic Photograph

Panoramic 1800 Panoram

Site ID : Site Name : 6 of 9

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Panoramic 2400 Panoram

Panoramic 3000 Panoram

Site ID : Site Name : 6 of 9

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phs - Panoramic Photographs

Panoramic 300

Panoramic 900

Site ID : Site Name : 6 of 9

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Panoramic 1500

phs - Panoramic Photographs

Panoramic 2100

Site ID : Site Name : 6 of 9

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Panoramic 2700

Panoramic 3300

Site ID : Site Name : 6 of 9

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Site Photographs - View Of Site

Front View Of Building / Land (Front View) Front View Of Buildin

Left View of Building Right View

Site ID : Site Name : 7 of 9

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Main Access road / Stairway 1 Main Access ro

Site Photographs - Panoramic Photograph

Rooftop Situation 1 Rooftop S

Site ID : Site Name : 7 of 9

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Rooftop Situation 3 Rooftop S

Existing Nearest PLN Pole Existing Nea

Site ID : Site Name : 7 of 9

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tographs - View Of Site

Front View Of Building / Land (Back View)

Right View of Building

Site ID : Site Name : 7 of 9

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Main Access road / Stairway 2

phs - Panoramic Photographs

Rooftop Situation 2

Site ID : Site Name : 7 of 9

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Rooftop Situation 4

Existing Nearest PLN Pole

Site ID : Site Name : 7 of 9

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Site Photographs - Building Structure

Kolom 1 Balo

Kolom 2 Balo

Site ID : Site Name : 8 of 9

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Kolom 3 Balo

Site ID : Site Name : 8 of 9

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raphs - Building Structure

Balok 1

Balok 2

Site ID : Site Name : 8 of 9

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Balok 3

Site ID : Site Name : 8 of 9

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Site Photographs - Potential Market

. m/Degree from Nominal . m/De

. m/Degree from Nominal . m/De

Site ID : Site Name : 9 of 9

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. m/Degree from Nominal . m/De

Site ID : Site Name : 9 of 9

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graphs - Potential Market

. m/Degree from Nominal

. m/Degree from Nominal

Site ID : Site Name : 9 of 9

 FM-STP-019

. m/Degree from Nominal

Site ID : Site Name : 9 of 9

 SURROUNDING SITE CANDIDAT

DU U

SU R

A O

H W

Candidate
W

DU U

SU R

A O

H W

DU = Dense Urban A = Agriculture

O = Open U = Urban
H = Hilly SU = Sub Urban
W = Water R = Rural
TE CANDIDATE CONDITION

DU U

SU R

A O

H W

Candidate
E

DU U

SU R

A O

H W
Sketch Map

330

Tower
Telkomsel
300

Tower
Exelcomindo

270

100m

200m
240

300m

400m
210

500m 180
 0
N
30

Tower
Telkomsel

60

Tower Axis

Tower
protelindo
90

100m

200m

120
300m

400m
150

500m 180
 CIVIL INFRASTRUCTURE

Site Category Gr
Distance From Public Road Distance (m) 100

Green Field Public Road - Type of Pavement

Hot mix
Access

Macadam
Access Road to Location Public Access
Hot mix
Type of Pavement
Macadam
Improvement Required Bridge

General Topography Flat

Normal
Green Field Site

Any cut & fill required

Soil General Classification
Ground Water Level : ..m
Elevation from fooding level: ..m
Obstruction No
Clearing
Site Improvement Required
Approximate cost of improvement: IDR
Site Near the Gulch Yes , Deepness
Site Near the River Yes , Distance .

Grounding System Available Yes, Resistance.Ohm

Possible to Use (< 1 Ohm) Yes
Grounding

Possible to improve the existing ( if > 1

Yes
Ohm)
Lightning Protect Available Yes

Cable Shaft Available Yes

Existing Power Source

New PLN Connection
Electricity

Power Source Not Available, Genset Requirement :

Power

Nearest 3 Phase Trafo Yes, ..Meters

Additional Facilities Required Poles
FRASTRUCTURE

Greenfield

Asphalt Concrete Paving Block

Aggregate Soil Others ______
Private Access Length (m) 100 Width (m) 3
Asphalt Concrete Paving Block
Aggregate Soil Others ______
Pavement Others
Swamp Slope, Gradient o Approximate) Hilly
Rocky Sandy Clay / Mould
ired Yes No
el : ..m
oding level: ..m
Trees Building Others
Stripping Cut / Fill Demolish Existing
of improvement: IDR.
Deepness No
Distance . No

ance.Ohm No (need to install new grounding system)

No

No (need to install new grounding system)

No Type and Size :

No

Source Capacity : KVA

ection Closest PLN Pole / Transformer : M

lable, Genset Requirement :..KVA,.Unit
s, ..Meters No, Genset Requirement :KVA
Cable Transformer Others