Communications Tower Data Entry Form -- HEADER SHEET
Unit:
Comm.Tower ID # :
Comm.Tower Name:
Location:
Catagory:
Size (LF Height):
Maintenance Level:
Remoteness Factor:
1
Historic Status:
Inspector Name:
Inspection Date:
Year Constructed:
Year Surveyed:
Benefitting Function:
(Fill in: If Roaded Remote, 1.15; Wilderness/Primitive Remote, 1.5; Historic,
1.5; Roaded Remote & Historic, 1.65; Wilderness Remote & Historic, 2.00)
(Fill in: E=eligible, I=ineligible, L=listed, U=undetermined)
NFFA
(Fill in: NFFA(facilities), QMQM(quarters), NFRM(recreation),
NFFV(reforestation), NFRV(range), NFHR(heritage), etc.)
NOTE: Information entered on this sheet is automatically transferred to the following spreadsheets.
Comm.Tower Data Entry Form -- ANNUAL MAINTENANCE
Unit:
Benefitting function:
Maintenance Level:
Remoteness Factor =
0
NFFA
0
1
Catagory: 0
Location: 0
ID #:
Name:
Size (LF Height):
Historic :
0
0
0
2 Safety Hazard
3 Structural Hazard
4 Not According to Code
PRIORTITY for FUNDING: 1 High Safety Hazard
5 Critical Maintenance 6 Energy Conservation 7 Routine Maintenance 8 Outdated/Nice to Have
CSI Division
Measurements
Description
Quantity
101000 GENERAL AND SITE WORK
Inspector Name: 0
Inspection Date: 01/00/00
Year Constructed:
0
Year Surveyed:
0
0
Units
Cost/unit
General and Site Work Totals:
Annual Maint Cost
H&S
Res
$0
$0
Priority for
Funding
Mis
$0
Division 1 - General
General
Management
Other
Other
Division 2 - Site Work
Driveways, Parking
Sidewalks, Trails
Signage, Exterior
Site Drainage
Landscaping
Fences, Guard rails
Other
Other
Misc. Annual Maintenance and Repair (Small Items, Break Downs) Costs are per l.f.
of tower height
Direct costs only including specific proj prep, procurement, and, Contract
Administration ( .50 s.f. of tower height)
Seal Coat, Repaving, Restripping, Grading, Rock Replacement, etc ( .04 / s.f. of
driveway)
PMR&R ( .18 / s.f. of walk or trail)
PMR&R ( actual-site specific )
Culvert, Catch Basin, Ditch Clearing ( actual-site specific )
Tree Removal, Trimming, Plant Replacement ( actual-site specific ) (not lawn mowing
or upkeep of grounds)
PMR&R ( actual-site specific )
202000 ARCHITECTURAL WORK (Divisions 3 to 14)
Division 3 - Concrete - Incl w/Tower
Other
Division 4 - Masonry
Other
Division 5 - Metals
Metal Tower
Other
Division 6 - Wood
"Telepnone" Poles
Other
Division 7 - Thermal & Moisture Protection
Other
Division 8 - Doors & Windows
Other
Division 9 - Finishes
Other
Division 10 - Specialties
Other
Division 11 - Equipment
Antennas
Filtering Equipment
Other
Division 12 - Furnishings
Other
Division 13 - Special Construction
Other
Division 14 - Conveying Systems
Other
0 LF-Twr.Height
$1.50
$0
7
0 LF-Twr.Height
$0.50
$0
$0
$0
$0
7
7
7
$0.04
$0.18
$0
$0
$0
$0
7
7
7
7
$0
$0
$0
$0
7
7
7
7
SF
SF
EA
Site
Site
LF
Architectural Totals:
$0
PMR&R
EA
$20.00
PMR&R
EA
$33.00
PMR&R
PMR&R
EA
EA
315000 MECHANICAL WORK
Mechanical Totals:
Page 2
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$75.00
$50.00
$0
$0
7
7
7
7
7
7
7
7
7
7
7
7
7
7
7
7
$0
9/3/2004
Comm.Tower Data Entry Form -- ANNUAL MAINTENANCE
Unit:
Benefitting function:
Maintenance Level:
Remoteness Factor =
0
NFFA
0
1
Catagory: 0
Location: 0
ID #:
Name:
Size (LF Height):
Historic :
Inspector Name: 0
Inspection Date: 01/00/00
Year Constructed:
0
Year Surveyed:
0
0
0
0
0
2 Safety Hazard
3 Structural Hazard
4 Not According to Code
PRIORTITY for FUNDING: 1 High Safety Hazard
5 Critical Maintenance 6 Energy Conservation 7 Routine Maintenance 8 Outdated/Nice to Have
CSI Division
Measurements
Description
Quantity
Units
Cost/unit
Annual Maint Cost
H&S
Res
Division 15 - Mechanical
Other
$0
$0
416000 ELECTRICAL WORK
Electrical Totals:
Division 16 - Electrical
Power Distribution, Cables, Transformers
Meters, Switchgear, Breakers, Fuses
Solar Panels
Grounding System
Battery System
Other
Location Factor or Multiplier =
Priority for
Funding
Mis
$0
$0
PMR&R, (smaller panels:$50/yr/ea, larger panels $60/yr/ea)
PMR&R (regular:$12.50/yr/ea, large: $25/yr/ea)
PMR&R (small: $50, reg.: $100, large: $350, XL: $400)
EA
EA
EA
$0
$0
$0
$0
$0
$0
$0
$0
PMR&R ( actual-site specific )
$50.00
$12.50
7
7
7
7
7
7
7
1
TOTAL
Page 3
$0
$0
$0
9/3/2004
Communnications Tower Data Entry Form -- DEFERRED MAINTENANCE
Unit:
Remoteness Factor =
Benefitting Function: NFFA
0
Catagory:
Location:
Maintenance Level: 0
1
0
0
ID #: 0
Name:
Size (LF): 0
Historic :
Inspector Name: 0
Inspection Date: 1/0/1900
0
Year Constructed:
0
Year Surveyed:
0
0
2 Safety Hazard
3 Structural Hazard
4 Not According to Code
PRIORTITY for FUNDING: 1 High Safety Hazard
5 Critical Maintenance 6 Energy Conservation 7 Routine Maintenance 8 Outdated/Nice to Have
CSI Division
Measurements
Description
Deficiencies
Quantity
Units
Cost/unit
101000 GENERAL AND SITE WORK
General and Site Work Totals:
Priority for
Funding
Deferred Maint Cost
H&S
Res
Mis
$0
$0
$0
Division 1 - General
Other
Other
Division 2 - Site Work
Driveways, Parking
Sidewalks, Trails
Signage, Exterior
Site Drainage
Landscaping
Fences, Guard rails
Other
0
0
Seal Coat, Repaving,
Restripping, Grading,
Rock Replacement, etc
(.89 s.f. of driveway)
( 4.38 / s.f. of walk or
trail)
( actual-site specific )
Culvert, Catch Basin,
Ditch Clearing (actualsite specific )
Tree Removal,
Trimming, Plant
Replacement ( actualsite specific ) (not lawn
mowing or upkeep of
grounds)
( actual-site specific )
202000 ARCHITECTURAL WORK (Divisions 3 to 14)
SF
$0.89
0
SF
EA
$4.38
0
0
Site
0
EA
LF
0
0
0
Architectural Totals:
$0
$0
$0
Division 3 - Concrete
Foundations, Slabs
Retaining Walls
Precast, etc.
Other
Other
Division 4 - Masonry
( 3.00 s.f of floor area if
crawl space - 8.00 s.f if
basement)
( actual-site specific )
( actual-site specific )
0 SF-Flr Area
SF
SF
Page 4
0
0
0
0
0
9/3/2004
Communnications Tower Data Entry Form -- DEFERRED MAINTENANCE
Unit:
Remoteness Factor =
Benefitting Function: NFFA
0
Catagory:
Location:
Maintenance Level: 0
1
0
0
ID #: 0
Name:
Size (LF): 0
Historic :
Inspector Name: 0
Inspection Date: 1/0/1900
Year Constructed:
0
Year Surveyed:
0
0
0
PRIORTITY for FUNDING: 1 High Safety Hazard
2 Safety Hazard
3 Structural Hazard
4 Not According to Code
5 Critical Maintenance 6 Energy Conservation 7 Routine Maintenance 8 Outdated/Nice to Have
Measurements
CSI Division
Description
Deficiencies
Quantity
Units
Cost/unit
Retaining Walls
Other
Other
Division 5 - Metals
Metal Tower
Rails, Posts, etc.
Other
Other
Division 6 - Wood
"Telephone" Poles
Other
Other
Division 7 - Thermal & Moisture Protection
Other
Other
Division 8 - Doors & Windows
Other
Division 9 - Finishes
Painting-Exterior
Other
Other
Division 10 - Specialties
Other
Division 11 - Equipment
Antennas
Filtering Equipment
Specialty Equipment
Other
Other
Division 12 - Furnishings
Other
Division 13 - Special Construction
Other
Division 14 - Conveying Systems
Other
Tuck Pointing, Silicone
Sealer, Expansion Joint
Caulking (actual-site
specific)
SF
(small: $500, large: $600)
( actual-site specific )
EA
EA
Deferred Maint Cost
H&S
Res
Mis
Priority for
Funding
0
0
0
$500.00
0
0
0
( actual-site specific )
EA
$500.00
0
0
0
0
0
0
0
.77 per s.f of wall area
SF-Wall Area
$0.77
0
0
0
0
(small: $500, large: $750)
( actual-site specific )
( actual-site specific )
EA
Ea
$500.00
$500.00
0
0
0
0
0
0
0
0
Page 5
9/3/2004
Communnications Tower Data Entry Form -- DEFERRED MAINTENANCE
Unit:
Remoteness Factor =
Benefitting Function: NFFA
0
Catagory:
Location:
Maintenance Level: 0
1
0
0
ID #: 0
Name:
Size (LF): 0
Historic :
Inspector Name: 0
Inspection Date: 1/0/1900
Year Constructed:
0
Year Surveyed:
0
0
0
PRIORTITY for FUNDING: 1 High Safety Hazard
2 Safety Hazard
3 Structural Hazard
4 Not According to Code
5 Critical Maintenance 6 Energy Conservation 7 Routine Maintenance 8 Outdated/Nice to Have
Measurements
CSI Division
Description
Deficiencies
Quantity
Units
Cost/unit
315000 MECHANICAL WORK
Mechanical Totals:
Deferred Maint Cost
H&S
Res
Mis
$0
$0
Priority for
Funding
$0
Division 15 - Mechanical
Other
0
416000 ELECTRICAL WORK
Electrical Totals:
Division 16 - Electrical
Power Distribution, Cables, Transformers
Meters, Switchgear, Breakers, Fuses
Solar Panels
Battery Systems
Grounding System
Other
Location Factor or Multiplier =
$0
$0
$0
( actual-site specific )
(smaller panels: $500, larger panels: $600)
(small: $500, reg.: $1000, large: $3500, XL: $4000)
(regular: $500, large: $1000)
EA
EA
EA
0
0
0
0
0
0
$500.00
$1,000.00
$500.00
1
TOTAL
Page 6
$0
$0
$0
9/3/2004
Building Data Entry Form -- W.O. Summary
ID #:
Name:
Catagory:
Benef.Funct.:
Item
Size (GSF):
Inspection Date:
Inspector Name:
0
0
0
NFFA
Description
Quantity
Unit Cost
Maintenance Level:
Year Surveyed:
Cost Data: Means
0
1/0/1900
0
Annual Maint. Cost
Total
H&S
Res.
Mis.
0
0
Year constructed:
Historical:
Age (years):
Deferred Maint. Cost
H&S
Res.
Total
0
0
0
9/3/2004
Critical
Mis.
Project Number
101000 SITE WORK
$0
$0
$0
$0
$0
$0
$0
$0
$0
202000 ARCHITECTURAL WORK (Divisons 3 to 14)
$0
$0
$0
$0
$0
$0
$0
$0
$0
315000 MECHANICAL WORK
$0
$0
$0
$0
$0
$0
$0
$0
$0
416000 ELECTRICAL WORK
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
Total
Annual Maintenance Grand Total =
$0
$0 = Deferred Maintenance Grand Total
Form adapted from Means Facilities Maintenance Standards, 1988 edition by R.S. Means Company, Inc.
Page 7
9/3/2004