Site Survey Report
SITE SURVEY REPORT
PT. TOWER BERSAMA GROUP
REKAPITULASI LAPORAN SITAC Site ID Site Name Area Latitude Longitude Search Radius
Center Point Rencana Type / Tinggi Tower Rencana Type / Ukuran Shelter
ALTERNATIVE Latitude Longtitude Ground Elevation ( m ) Jarak dari Center Point Link to BSC / Transmission Alamat Site
Nama / Alamat / No. Tlp Pemilik Lahan
P -6.951120° 113.156170° 101 Meter 86 Meter
Dsn. Tapaan, Kec. Banyuates, Kab. Sampang Matberi/Dsn. Tapaan, Kec. Banyuates, Kab. Sampang/'+6285851823264
Nama / Alamat / No. Tlp Perantara Ukuran Luas Lahan ( P x L ) m2 Jenis Lahan Perlu Pengurukan / Tidak Kepadatan Bangunan di Sekitar Site Lebar Jalan Masuk Jenis Permukaan Jalan Masuk Kondisi Akses Jalan Masuk Kondisi Masyarakat Sekitar. Status Surat Kepemilikan Lahan Cara Perolehan Lahan.
20 x 20 meter Pekarangan Tidak Kurang Padat 4 meter Jalan Aspal Baik Kondusif Leter C Langsung
Harga Beli / Sewa Lahan Jarak ke Sumber Listrik PLN Kondisi Tanah
Sewa 11 tahun Rp. 120 jt 60 meter
Rata-rata kedalaman Air Tanah di Sekitar Site Perizinan Yang diperlukan Apakah Lahan merupakan Area Banjir
20 meter
Datar
Ijin Prinsip, IMB & HO Tidak
SPG049 Kembang Jeruk Banyuates (Tapaan) DMT Regional 6 - Jatim -6.95187° 113.15600° 100 meter SST-72 Meter Shelter Knock Down
Q Meter Meter
R Meter Meter
Site Survey Report
SITE SURVEY REPORT
PT. TOWER BERSAMA GROUP
Site ID Alternative
SPG049
P
Site Name
embang Jeruk Banyuates (Tapaan) DM
Region / Area
Regional 6 - Jatim
Survey Date ( Tanggal Survey )
15-Sep-12
Site Address
Dsn. Tapaan, Kec. Banyuates, Kab. Sampang
( Alamat Lokasi ) Owners Name / Address / Tlp / Fax ( Nama Pemilik / Alamat / Tlp / Fax )
Matberi/Dsn. Tapaan, Kec. Banyuates, Kab. Sampang/'+6285851823264
Contact Person / Address / Tlp / Fax ( Orang yg bisa dihubungi / Alamat / Tlp / Fax )
Latitude Longtitude Ground Elevation Distant From Centre Point Link To BSC / Transmission
-6.951120° 113.156170° 101 86
Luas Lahan
20 x 20 meter
Type of Ownership ( Status Kepemilikan Lahan )
Single Owner / Milik Perorangan Corporation / Perusahaan Government / Pemerintah Partnership Community Association Unclear / Tidak Jelas Other / Lain - lain
Certificate of Ownership ( Sertifikat Kepemilikan )
Girik / Persil / Segel SPPT Sertifikat Hak Milik Sertifikat Hak Guna Bangunan Akte Jual Beli Akte Hibah Other / Lain - lain
Type of Site ( Jenis Lahan )
Tanah Kosong Ada Bangunan Roof Top
Land Condition ( Kondisi Lahan )
Normal Lunak / Gembur ( Crumble ) Keras / Padat ( Hard ) Berbatu / Karang ( Rocky Soil ) Lain - lain
Nearest Power Line / PLN ( Jarak ke Sumber Listrik PLN ) Land Water Level ( Kedalaman Air Tanah )
60 meter 20 meter
Meter Meter
Site Survey Report
SITE SURVEY REPORT
PT. TOWER BERSAMA GROUP
Site ID Alternative Access Road Condition ( Kondisi Jalan Masuk )
Type of Acquisition ( Cara Akuisisi )
SPG049
P
embang Jeruk Banyuates (Tapaan) DM
Site Name
Regional 6 - Jatim
Region / Area Hotmix Concreate / Beton Aspal Tanah Padat Very Good
Good
OK
Buy / Beli Rental / Sewa 11 Year / Tahun Other / Lain-lain
Site Acqisition Price ( Harga Akuisisi ) Site Rental Price ( Harga Sewa Lahan ) Planned Tower Type ( Rencana Type Tower )
SST - 42 SST - 62 SST - 72 SST - 72 BB SST - 82 SST - 92 Other
Planned Shelter Type ( Rencana Type Shelter )
Shelter Permanent Shelter Knock Down 3 x 2 x 3 Roof Top 4 x 2 x 3 Roof Top and Greenfield 4 x 3 x 3 Dual Band Standart 5 x 3 x 3 BSC, BTS 5 x 4 x 3 Back Bone
Permit Requirement ( Perijinan yang diperlukan )
Izin Warga Izin Prinsip IMB Izin Lokasi Izin HO ( Gangguan ) Izin Dephub / Bandara
Additional Information / Comments …………………………………………………………………………………………………………………………………. …………………………………………………………………………………………………………………………………. …………………………………………………………………………………………………………………………………. …………………………………………………………………………………………………………………………………. …………………………………………………………………………………………………………………………………. …………………………………………………………………………………………………………………………………. …………………………………………………………………………………………………………………………………. ………………………………………………………………………………………………………………………………….
Bad
Site Survey Report
SITE SURVEY REPORT
PT. TOWER BERSAMA GROUP
Site ID Alternative
SPG049
P
Site Name Region / Area
Akses Jalan Primer 1
Akses Jalan Primer 2
Akses Jalan Primer 3
Akses Jalan Primer 4
Lokasi Tampak Depan ( Timur )
Lokasi Tampak Kiri ( Utara )
Lokasi Tampak Belakang ( Barat )
Lokasi Tampak Kanan ( Selatan )
SPG049 Regional 6 - Jatim
Site Survey Report
SITE SURVEY REPORT
PT. TOWER BERSAMA GROUP
Site ID
SPG049
Q
Alternative O
Site Name
Kembang Jeruk Banyuates (Tapaan) DMT
Region / Area O
Panorama O
Panorama 30
Panorama 6OO
Panorama 9OO
O
O
Panorama 12O
Panorama 15O
Panorama 18OO
Panorama 21OO
Regional 6 - Jatim
Site Survey Report
SITE SURVEY REPORT
PT. TOWER BERSAMA GROUP
Site ID Alternative
SPG049
P,Q,R
Site Name
Kembang Jeruk Banyuates (Tapaan) D
Region / Area
Panorama 24OO
Panorama 270
Panorama 30OO
Panorama 330O
Center Point
O
Pole PLN 20 meter
Regional 6 - Jatim
Site Survey Report
SITE SURVEY REPORT
PT. TOWER BERSAMA GROUP
Site ID
SPG049
Alternative
Site Name
P,Q,R
Kembang Jeruk Banyuates (Tapaan) D
Region / Area
Regional 6 - Jatim
N
S
Kebun Ketela
Kebun Ketela
KAN DIDA T KOORDINAT: LAT : -6.986460° LONG : 113.008350° Distan : 43 m Elev : 112 meter
Kebun Ketela
N OM KOORD INAT : LA T : -6.951870° LONG : 113.156000°
Sungai
