CCTV Site Survey Form

Customer#
Name
rboor number
Email addren

How would you drscribe your current ,•ldeo surnillance Camera Power
needi? 120VAC
Looking for a new system 24VAC
Looking to expand current system 12DC
Looking to replace current system
Is Vandal proofing required?

E3
System Application Yes
Indoors only No
Outdoors only
J3oth indoors and outdoors Wbat transmission mechod will you be usini?
Not sure Coaxial
F ibcr Optics
Loention or Cameras - indicate number required at each Twisted Pair
location. Not sure
Interior
Parking Lot What ■rt your l>\'R stonge requlremrnls?
l'crimctcr S-10 days
lluliways 10-30 days
Building 30-45 days
Other ( pleas.: sp,:cify) 45+ (please specify)

Do )OU require IP umera8'!

E3
Will any or thue be Pan/filc/Z.oom (PTZ.) cameras? Yes

E3
Yes (please indicatc qty) No
No
Wiil n-"mole ,·lewtni: be requlrt-d?

E3
"l'otal number or cameras your sySlem will require Yes
1-3 No
4-7
8-15 Will chis S)1iltm be used with Point orSalt?

E3
16-31 Yes
32+ (please specify) No

What lighting conditions will you need to record In? i\lonilorSlzc

Daylight/continuously lit 9" • 14"
Night IS"-19"
Day and Night 20· • 26"
Not sure 26" • 32"

Lens type (speclry qty or each) What is your estimated budget for this video sun•t-illance
Wide Angle s�·stem?
Normal S2.000 • 4,999
Telephoto SS.000. $9,999
SI0,000- S24.999
Camera Houslngs/Bracktts (specify qty or e11ch) S2S,OOO+

E3
Indoor Not sure
Outdoor
What is your bu)ing limdrame ror this system?
Camera Mounting (specify qty or each) ASAr

E3
Wall Within the next month
Ceiling Within the next two months
More than two months

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