Site Survey Form
BTCPower, Inc.
1719 S. Grand Ave. Santa Ana, CA 92705
09-Mar-20
Annex A
–
Site Survey Form
Page
59
of
59
Connection Points between the Power Supply to Modem to PC and Antenna to Modem
Nominal Voltage Out of Power Supply
to Modem
Ethernet Cat5 Cable Connection
Antenna SMA Connectors
Contractor’s Information
Technician Name :
Technician Signature :
Technician Company Name :
