Wireless Survey Questionnaire

Please complete as thoroughly as possible and return to AbeTech along with scaled site maps.

Following receipt AbeTech will review and contact you to schedule a requirements gathering meeting to review the details prior to providing a Statement of Work for the survey.

Client: Click here to enter text.

Contact Name: Click here to enter text.

Contact Email: Click here to enter text.	Contact Phone: Click here to enter text.

Site Address: Click here to enter text.

Site Contact: Click here to enter text.

Site Email: Click here to enter text.	Site Phone: Click here to enter text.

Requested Completion Date: Click here to enter text.

Site Work Hours: Click here to enter text.

Application Description: Click here to enter text.

Wireless Infrastructure:

Manufacturer: Click here to enter text.

Controller Based? Yes	No

Radio Frequency:

2.4 GHz:

5.0 GHz:

Special Requirements: Click here to enter text.

Mobile Device Specifications:

Mobile Computer Model: Click here to enter text.

Vehicle Mounted Computer Model: Click here to enter text.

Laptop and/or Desktop Computer Model: Click here to enter text.

Wireless Printer and/or Print Server: Click here to enter text.

Facility Specifications:

Number of buildings? Click here to enter text.

Estimated square footage? Click here to enter text.

Estimated ceiling height? Click here to enter text.

Number of floors? Click here to enter text.

Mezzanines?	Yes	No

Stock:

Material stored/manufactured: Click here to enter text.

Are there areas that stock level extend to the ceiling?	Yes	No

Are there I-Safe areas?	Yes	No

If so, please indicate on scaled map

Are there a freezer and/or cooler environments that requires coverage?	Yes	No

Highest Temp: Click here to enter text.

Lowest Temp: Click here to enter text.

Are cordless phones used within the facility?	Yes	No

Are microwaves used within the facility?	Yes	No

Are welders used within the facility?	Yes	No

Are any facility modifications in the plans that may affect the wireless coverage? Click here to enter text.

Is this a union facility?	Yes	No

Is coverage needed throughout the whole facility?	Yes	No

If no, please indicate any areas that are NOT to be surveyed for coverage on the scaled map

Is outdoor coverage required?	Yes	No

If Yes, please indicate on scaled map the areas to be surveyed

If engineer completes an onsite visit, can the engineer take pictures of the facility (IE: Ceiling, IDF/MDF, Patch panel types/brands, available patch panel capacity etc.) as needed	Yes	No

Safety Requirements:

Class Required:	Yes	No

Steel-toed Boots:	Yes	No

Safety Vest:	Yes	No

Safety Glasses:	Yes	No

Hardhat:	Yes	No

Other: Click here to enter text.

Lift or Scissor Lift:

Facility has a lift truck/scissor lift available?	Yes	No

If no, can a lift be rented and cost be passed onto your company?	Yes	No

Lift has ability to reach ceiling?	Yes	No

Lift can be operated by certified AbeTech employee?	Yes	No

Facility operating hours – (Please indicate below the hours that AbeTech Engineer(s) can complete a site visit if needed) Click here to enter text.

Other Considerations: Click here to enter text.