ANNEX-A

FORMAT FOR CERTIFICATION OF BTS FOR COMPLIANCE OF THE EMF EXPOSURE LEVELS (CALCULATION OF EIRP/EIRPth)

A-I : SITE DATA & TECHNICAL PARAMETERS Name of the BTS : Date :

Item Units Operator 1 Operator 2 Operator n REMARKS

Site ID

Name

Date of Commissioning

Address

Lat / Long

RTT / GBT

Building Height AGL (m)

SIT

E D

ATA

Antenna Height AGL (m)

System Type (GSM/CDMA/UMTS)

Base Channel Frequency (MHz)

Carriers / Sector (Worst)

Make and Model of Antenna

Antenna Gain (dBi)

Total Tilt (Deg)

Vertical Beamwidth (Deg)

Side Lobe Attenuation (db)

Tx Power (dBm) TEC

HN

ICA

L P

AR

AM

TER

S

Combiner Loss (db)

RF Cable Length (m)

Unit Loss (dB/100m)

EIRP (Base Channel) (W)

DTX factor

ATPC factor

EIRP (TCH) incl DTX , ATPC (W)

EIRP (Total) (W)

A-II : EIRP/EIRPth CALCULATION

Building 0 (B0) EIRPth at the Building Roof Top Corners and other points on the periphery of exclusion zone

Lat Long Building Top Corners C1 C2 C3 C4 Remarks

Operator 1 Operator 2 Operator 3

Overall EIRP/EIRPth NORMALLY COMPLIANT (YES/

NO)

Building 1 (B1) EIRPth at various floors of the building Azimuth Distance from BTS

I II III

IV Remarks

Operator 1 Operator 2

Co

mp

uta

tio

n o

f o

f EIR

P/

EIR

Pth

at

ad

jace

nt

bu

ild

ing

s/ c

on

spic

uo

us

loca

tio

ns

wit

hin

20

m

ete

rs r

ad

ius.

Operator 3

Overall EIRP/EIRPth NORMALLY COMPLIANT (YES/

NO)

Building 2 (B2) EIRPth at various floors of the building Azimuth Distance from BTS Lat Long

I II III

IV Remarks

Operator 1 Operator 2 Operator 3

Overall EIRP/EIRPth

NORMALLY COMPLIANT (YES/ NO)

Building 3 (B3) EIRPth at various floors of the building Azimuth Distance from BTS Lat Long

I II III

IV Remarks

Operator 1 Operator 2 Operator 3

Overall EIRP/EIRPth NORMALLY COMPLIANT (YES/

NO)

Building 4 (B4) EIRPth at various floors of the building Azimuth Distance from BTS Lat Long I II III

IV Remarks

Operator 1

Co

mp

uta

tio

n o

f o

f EIR

P/

EIR

Pth

at

ad

jace

nt

bu

ild

ing

s/ c

on

spic

uo

us

loca

tio

ns

wit

hin

20

m

ete

rs r

ad

ius

Operator 2

Operator 3 Overall EIRP/EIRPth

NORMALLY COMPLIANT (YES/ NO)

EIRPth on the ground

Operator 1 Operator 2 Operator 3

Overall EIRP/EIRPth

NORMALLY COMPLIANT (YES/ NO)

ANNEX-B

FORMAT FOR CERTIFICATION OF BTS FOR COMPLIANCE OF THE EMF EXPOSURE LEVELS (SOFTWARE SIMULATION)

B-I : SITE DATA & TECHNICAL PARAMETERS Name of the BTS : Date :

Item Units Operator 1 Operator 2 Operator n

Site ID

Name

Date of Commissioning

Address

Lat / Long

RTT / GBT

Building Height AGL (m)

SIT

E D

ATA

Antenna Height AGL (m)

System Type (GSM/CDMA/UMTS)

Frequency of operation (MHz)

Make and Model of Antenna

Antenna Gain (dBi)

Electrical Tilt (Deg)

Mechanical Tilt (Deg)

Tx Power (dBm)

TEC

HN

ICA

L P

AR

AM

TER

S

B-II :ORTHOSLICE AT GROUND LEVEL

POWER DENSITY AT 2 M ABOVE THE GROUND LEVEL

OR

TH

OS

LIC

E A

T G

RO

UN

D L

EV

EL

 

 

B-III :ORTHOSLICE AT ROOF TOP LEVEL

POWER DENSITY AT 2 M ABOVE THE ROOF TOP LEVEL

OR

TH

OS

LIC

E A

T R

OO

F TO

P L

EV

EL

 

 

B-IV :EXCLUSION ZONES

EXCLUSION ZONES AND SAFETY SIGNAGE AT ROOFTOP

EX

CLU

SIO

N D

ISTA

NC

ES

 

 

              

ANNEX-C

FORMAT FOR CERTIFICATION OF BTS FOR COMPLIANCE OF THE EMF EXPOSURE LEVELS (BROADBAND MEASUREMENT)

C-I : SITE DATA & TECHNICAL PARAMETERS

Name of the BTS : System Type:

Item Units Operator 1 Operator 2 Operator n REMARKS

Site ID

Name

Date of Commissioning

Address

Lat / Long

RTT / GBT

Building Height AGL (m)

Antenna Height AGL (m)

Make and model of Antenna

System Type (GSM/CDMA/UMTS)

Base Channel Frequencies (MHz) Sec 1, Sec2, Sec 3

Sec 1, Sec2, Sec 3

Sec 1, Sec2, Sec

3

Carriers / Sector Sec1, Sec 2, Sec 3

Sec1, Sec 2, Sec 3 Sec1, Sec

2, Sec 3

SIT

E D

ATA

Tx Power (dBm)

  C-II : BROADBAND MEASUREMENT OF POWER DENSITY (W/Sqm)

Building 0 (B0) Own Building Top Corners and other points on the periphery of exclusion

zone Lat Long C1 C2 C3 C4 Remarks Dis. From Tower Base (m)

ICNIRP Limit (W/Sqm) *

Measured Value (W/Sqm)

Ratio (Measured / ICNIRP)

COMPLIANT (YES/ NO)

Building 1 (B1) Measurement at various floors of the adjacent building Azimuth Distance from BTS Lat Long I II III

 IV Remarks

ICNIRP Limit (W/Sqm) * Measured Value (W/Sqm)

Ratio (Measured / ICNIRP)

COMPLIANT (YES/ NO)

Building 2 (B2) Measurement at various floors of the adjacent building Azimuth Distance from BTS Lat Long I II III

 IV Remarks

Measu

red

valu

e o

f P

ow

er

Den

sity

(W

/S

qm

) at

ad

jace

nt

bu

ild

ing

s/

con

spic

uo

us

loca

tio

ns

wit

hin

20

mete

rs r

ad

ius.

ICNIRP Limit (W/Sqm) *

Measured Value (W/Sqm) Ratio (Measured / ICNIRP)

COMPLIANT (YES/ NO)

Building 3 (B3) Measurement at various floors of the adjacent building Azimuth Distance from BTS Lat Long I II III

 IV Remarks

ICNIRP Limit (W/Sqm) * Measured Value (W/Sqm)

Ratio (Measured / ICNIRP)

COMPLIANT (YES/ NO)

SPOT LANDMARK

Spot 1 Spot 2 Spot 3 Spot 4 Spot 5

Lat

Long

Azimuth

Distance from BTS

ICNIRP Limit (W/Sqm) *

Measured value of Pow

er Den

sity (W

/Sqm

) at ad

jacent buildings/ conspicuou

s location

s within 20

 meters radius.   

OTH

ER

CO

NS

PIC

UO

US

LO

CA

TIO

NS

ON

TH

E G

RO

UN

D

Measured Value (W/Sqm)

Ratio (Measured / ICNIRP Limit)

RES

ULT

COMPLIANT (YES/ NO)

             

NOTE :* ICNIRP Limit will be for the worst case among all the bands present on the Site

ANNEX-D

FORMAT FOR CERTIFICATION OF BTS FOR COMPLIANCE OF THE EMF EXPOSURE LEVELS (FREQUENCY SELECTIVE MEASUREMENT)

D-I : SITE DATA & TECHNICAL PARAMETERS

Name of the BTS : Date:

Item Units Operator 1 Operator 2 Operator n REMARKS

Site ID

Name

Date of Commissioning

Address

Lat / Long

RTT / GBT

Building Height AGL (m)

Antenna Height AGL (m)

Make and model of Antenna

System Type (GSM/CDMA/UMTS)

Base Channel Frequencies (MHz) Sec 1, Sec2, Sec 3

Sec 1, Sec2, Sec 3 Sec 1, Sec2,

Sec 3

SIT

E D

ATA

Carriers / Sector Sec1, Sec 2, Sec 3

Sec1, Sec 2, Sec 3 Sec1, Sec 2,

Sec 3

Tx Power (dBm)

D-II : FREQUENCY SELECTIVE MEASUREMENT OF ELECTRIC FILED/ POWER DENSITY

Building 0 (B0) Own Building Top Corners and other points on the periphery of exclusion zone

Lat Long C1 C2 C3 C4 Remarks

EBCCH1

EBCCH2

Op

1

EBCCH3

EBCCH1

EBCCH2

Op

2

EBCCH3

EBCCH1

EBCCH2

Measu

red

Valu

e

Op

3

EBCCH3

Operator 1

Operator 2 Exposure Index

Operator 3

Measu

red

valu

e o

f Ele

ctri

c fi

eld

(V

/m

) o

r P

ow

er

Den

sity

(W

/m

2)

at

ad

jace

nt

bu

ild

ing

s/ c

on

spic

uo

us

loca

tio

ns

wit

hin

20

mete

rs r

ad

ius.

Aggregate of Exposure Index

COMPLIANT (YES/ NO)

Building 1 (B1) Measurement at various floors of the adjacent building

Azimuth Distance from BTS

Lat Long I II III

IV Remarks

BCCH1

BCCH2

Op

1

BCCH3

BCCH1

BCCH2

Op

2

BCCH3

BCCH1

BCCH2

Measu

red

Valu

e

Op

3

BCCH3

Operator 1

Operator 2 Exposure Index

Operator 3

Aggregate of Exposure Index

Measu

red

valu

e o

f Ele

ctri

c fi

eld

(V

/m

) o

r P

ow

er

Den

sity

(W

/m

2)

at

ad

jace

nt

bu

ild

ing

s/ c

on

spic

uo

us

loca

tio

ns

wit

hin

20

mete

rs r

ad

ius

COMPLIANT (YES/ NO)

2) at

ad

j Building 2 (B2) Measurement at various floors of the adjacent building

Azimuth Distance from BTS

Lat Long I II III

IV Remarks

BCCH1

BCCH2

Op

1

BCCH3

BCCH1

BCCH2

Op

2

BCCH3

BCCH1

BCCH2

Measu

red

Valu

e

Op

3

BCCH3

Operator 1

Operator 2 Exposure Index

Operator 3

Aggregate of Exposure Index

COMPLIANT (YES/ NO)

den

sity

(W

/m

2)

at

ad

jace

nt

bu

ild

ing

s/

OTH

ER

LO

CA

TIO

NS

O

N T

HE

GR

OU

ND

SPOT LANDMARK

Spot 1 Spot 2 Spot 3 Spot 4 Spot 5

Azimuth

Distance from BTS

Lat

Long

BCCH1

BCCH2

Op

1

BCCH3

BCCH1

BCCH2

Op

2

BCCH3

BCCH1

BCCH2

Measu

red

Valu

e

Op

3

BCCH3

Operator 1

Operator 2 Exposure Index

Operator 3

Aggregate of Exposure Index

COMPLIANT (YES/ NO)