Tower Site Evaluation Form

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TOWER SITE EVALUATION FORM
1.
Location (provide maps if possible):
State: _____
County: ___________________ Latitude/Longitude/GPS Grid: _______
City and Highway Direction (2 miles W on Hwy 20, etc.)
___________________________________________________________________________
___________________________________________________________________________
2.
Elevation above mean sea level: __________
3.
Will the equipment be co-located on an existing FCC licensed tower or other existing structure
(building, billboard, etc.)? (y/n)__ If yes, type of structure: ___________________________
If yes, no further information is required.
4.
If no, provide proposed specification for new tower:
Height: __________
Construction type (lattice, monopole, etc.): ___________________
___________________________________________________________________________
Guy-wired? (y/n) __
Number of bands: __________ Total Number of Wires: __________
Lighting (Security and Aviation):__________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
If tower will be lighted or guy-wired, complete 5-19. If not, complete only item 19 and 20.
5.
Area of tower footprint in acres or square feet: ___________________
6.
Length and width of access road in feet: ________________________
7.
General description of terrain – mountainous, rolling hills, flat to undulating, etc. Photographs
of the site and surrounding area are beneficial:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
8.
Meteorological conditions (incidence of fog, low ceilings, etc): _________________________
___________________________________________________________________________
___________________________________________________________________________
9.
Soil type(s): _________________________________________________________________
10.
Habitat types and land use on and adjacent to the site, by acreage and percentage of total:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Print Form
TOWER SITE EVALUATION FORM
1.
Location (provide maps if possible):
State: _____
County: ___________________ Latitude/Longitude/GPS Grid: _______
City and Highway Direction (2 miles W on Hwy 20, etc.)
___________________________________________________________________________
___________________________________________________________________________
2.
Elevation above mean sea level: __________
3.
Will the equipment be co-located on an existing FCC licensed tower or other existing structure
(building, billboard, etc.)? (y/n)__ If yes, type of structure: ___________________________
If yes, no further information is required.
4.
If no, provide proposed specification for new tower:
Height: __________
Construction type (lattice, monopole, etc.): ___________________
___________________________________________________________________________
Guy-wired? (y/n) __
Number of bands: __________ Total Number of Wires: __________
Lighting (Security and Aviation):__________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
If tower will be lighted or guy-wired, complete 5-19. If not, complete only item 19 and 20.
5.
Area of tower footprint in acres or square feet: ___________________
6.
Length and width of access road in feet: ________________________
7.
General description of terrain – mountainous, rolling hills, flat to undulating, etc. Photographs
of the site and surrounding area are beneficial:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
8.
Meteorological conditions (incidence of fog, low ceilings, etc): _________________________
___________________________________________________________________________
___________________________________________________________________________
9.
Soil type(s): _________________________________________________________________
10.
Habitat types and land use on and adjacent to the site, by acreage and percentage of total:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
11.
Dominant vegetative species in each habitat type: __________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
12.
Average diameter breast height of dominant tree species in forested areas: ______________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
13.
Will construction at this site cause fragmentation of a larger block of habitat into two or more
smaller blocks? (y/n) __
If yes, describe: ________________________________________
___________________________________________________________________________
___________________________________________________________________________
14.
Is evidence of bird roosts or rookeries present? (y/n) __
If yes, describe: _____________
___________________________________________________________________________
___________________________________________________________________________
15.
Distance to nearest wetland area (forested swamp, marsh, riparian, marine, etc.), and
coastline if applicable: _______________________
16.
Distance to nearest telecommunications tower: _________________________
17.
Potential for co-location of antennas on existing towers or other structures: _______________
___________________________________________________________________________
___________________________________________________________________________
18.
Have measures been incorporated for minimizing impacts to migratory birds? (y/n) __
If yes, describe: _____________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
19.
Has an evaluation been made to determine if the proposed facility may affect listed or
proposed endangered or threatened species or their habitats as required by FCC regulation at
47 CFR 1.1307(a)(3)? (y/n) __
If yes, present findings: _____________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
20.
Additional information required: _________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________

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