Commercial Site Survey Form

Commercial Site Survey Form
Today's Date

MonthDayYear
Date
Project/Business Name
Date of Site Inspection

MonthDayYear
Date
Site Inspection Completed By:*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Was an Electrician involved in Site Survey?

YesNo
Name of Electrician's Company
Name of Electrician

First NameLast Name
Electrician's Phone Number
Please enter a valid phone number.
Does the Project / Site / Property have a Parent Company?

YesNo
Parent Company of Project
Parent Company Contact Name

First NameLast Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Is Project in Partnership with another Company / Person / Affiliate?

YesNo
Partnership Contact Name for Project

First NameLast Name
Company Name
Title
Relationship to Project
How is this Company/Person related to this project?
Phone Number
Please enter a valid phone number.
Email
example@example.com
Name of On Site Engineer

First NameLast Name
Mobile Phone Number
Please enter a valid phone number.
Name of On Site Contact

First NameLast Name
Title of On Site Contact
Phone Number
Please enter a valid phone number.
Email
example@example.com
Site Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Your current location should be auto-detected and filled in. If location is blank, this is due to your device's location settings. It's OK if left blank.
Name of County Site Located In
Power Utility Provider
Type of Property
Type of Parking Lot
Total Number of Parking Levels
Total Number of EVSE Locations Planned for Project?*
How many locations on the property will there be an EVSE install? For every location there will be a set of questions in the following pages.
Total Number of EVSE Units
How many total EVSE units will be installed for this project?

	AT&T	Sprint	T-Mobile	Verizon
Signal Strength Reading

	AT&T	Sprint	T-Mobile	Verizon
Signal Strength Reading

	AT&T	Sprint	T-Mobile	Verizon
Signal Strength Reading

	AT&T	Sprint	T-Mobile	Verizon
Signal Strength Reading

	AT&T	Sprint	T-Mobile	Verizon
Signal Strength Reading

	AT&T	Sprint	T-Mobile	Verizon
Signal Strength Reading

	AT&T	Sprint	T-Mobile	Verizon
Signal Strength Reading

General Information Related to Site / Project
Utility Power Bill

Cancelof
Parking Lot Plans

Cancelof
Electrical Engineering Plans

Cancelof
EVSE Specifications Sheet

Cancelof
Any Additional Photos, Diagrams, Files Related to Project

Cancelof
Additional Information
Technician Name

First NameLast Name
Signature

Clear
Should be Empty:

Commercial Site Survey Form

EVSE Information & Location(s)

Electrical Information

Electrical Run Information

Cellular Booster

Electrical Information

Cellular Booster

Electrical Information

Cellular Booster

Electrical Information

Cellular Booster

Electrical Information

Cellular Booster

Electrical Information

Cellular Booster

Electrical Information

Cellular Booster

General Information Related to Site / Project