Todays Date

Colocation Application Form

Survey Date
Revision

SITE NAME INDOSAT SITE ID INDOSAT Province City

SANDAI 16KTP010 West Kalimantan Pontianak

Latitude (Decimal/DMS) Longitude (Decimal/DMS) Site Type * Tower Type *

-1.245555° 110.52774° GF SST 4 LEG

Building Height Tower Height Site ID TLP Site Name TLP

100

1. SECTORAL ANTENNAS
ANTENNA DETAILS CABLES AND FEEDERS
Item e - exist
Antenna Dimensions (mm)
n - new Quant Manufacturer Model Leg (AxBxCxD) Azim (0) Quant Size (")
Height (LxWxD)
r -remove
1.1 E 1 70 Mobi MB4B_MFMF-65-17 2490 x 296 x 244 A 75 1 Hybrid Trunk
1.2 E 1 70 Mobi MB4B_MFMF-65-17 2490 x 296 x 244 B 150 1 Hybrid Trunk
1.3 E 1 70 Mobi MB4B_MFMF-65-17 2490 x 296 x 244 D 350 1 Hybrid Trunk
1.4
1.5
1.6
1.7
1.8
1.9
Remarks:

2 . MICROWAVE ANTENNAS
ANTENNA DETAILS CABLES AND FEEDERS
Item e - exist
Antenna Leg
n - new Quant Manufacturer Model Diameter (m) Azim (0) Quant Size (")
Height (AxBxCxD)
r -remove
2.1
2.2
2.3
2.4
Remarks:

3 . OTHER EQUIPMENT
RRU/FILTER/JUNCTION BOX/ODU DETAILS CABLES AND FEEDERS
Item e - exist
Placement Dimensions (mm) Leg
n - new Quant Manufacturer Model Azim (0) Quant Size (")
Height (LxWxD) (AxBxCxD)
r -remove
3.2 E 1 70 Nokia Solutions and Networks FXDB 50 x 50 x30 C 6 Jumper 1/2 "
3.3 E 1 70 Nokia Solutions and Networks FXDB 50 x 50 x30 C 6 Jumper 1/2 "
3.7 N 1 70 Nokia Solutions and Networks FXDA 50 x 50 x30 C 6 Jumper 1/2 "
3.10 N 1 70 Nokia Solutions and Networks FXDA 50 x 50 x30 C 6 Jumper 1/2 "
3.11 N 1 70 Nokia Solutions and Networks AHEGC 50 x 50 x30 A 4 Jumper 1/2 "
3.12 N 1 70 Nokia Solutions and Networks AHEGC 50 x 50 x30 B 4 Jumper 1/2 "
3.13 N 1 70 Nokia Solutions and Networks AHEGC 50 x 50 x30 D 4 Jumper 1/2 "
3.13
3.14
3.15
3.16
Remarks:

4. Mini CME REQUIREMENTS

Dimensions (m)
Item MINI CME DETAILS
Length Width
5.1 Pondasi (Shelter / Shelterless) □ New x Existing
5.2 Vertical Tray □ New x Existing
5.3 Horizontal Tray □ New x Existing
5.4 ACPDB □ New x Existing
5.5 PLN (Power Capacity) □ Need Upgrade x Existing PLN to be (KVA) : ….....…..]
5.6 Others : 1 □ New □ Existing
5.7 2 □ New □ Existing
5.8 3 □ New □ Existing
5.9 4 □ New □ Existing
5.10 5 □ New □ Existing
5.11 6 □ New □ Existing
5.12 7 □ New □ Existing
Remarks :

RESULT FROM TLP

STRENGTHENING □ Need □ No Need Target : days

MINI CME Target : days
TOWER EXTENSION □ Need □ No Need Target : days

CONCLUSION

□ APPROVED ( Vendor to continue Installation )

□ APPROVED WITH STRENGTHENING ( Vendor to continue Installation parallel with strengthening )
□ WAIT FOR STRENGTHENING
□ WAIT FOR MINI CME
□ WAIT FOR TOWER EXTENSION

RFI TARGET DATE (dd/mm/yyyy) :

Remarks :

TLP TLP INDOSAT INDOSAT

Date Date Date Date