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CCTV Site Survey Report

Application of System
Indoor
Outdoor
Location on Cameras
Hallways
Interior
Parking Lot
Perimeter
Building
Light Levels (Worst Case)
Lens
Wide angle
Normal
Telephoto
Camera Power
120 V AC
24 V AC
Number of Total Cameras
Pan & Tilts or Swivel
Indoor
Light Duty
Medium Duty
Heavy Duty
Outdoor
Light Duty
Medium Duty
Heavy Duty
Housings
Indoor
Outdoor
Special
Mounts
Wall
Ceiling
Parapet
Control Systems
Pan & Tilt
Zoom Lens
Indoor
Outdoor
Sequential Switchers,
Quads, Multiplexers
Monitors
9”
12”
17”
Other
Time Lapse Recorders
24 hr
Other
Cable Requirements
Coax
Fiber Optics
Surge Suppression
Other Requirements
Send to SES Specialist. Please copy and use
this form or equivalent for site layout diagram. Note scale size = ______________ ft.

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