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Site Survey Report: Globe Phase - Capacity and Coverage Enhancement Project Site Facility Preparation

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SITE EVALUATION FORM

GLOBE PHASE __
CAPACITY AND COVERAGE
ENHANCEMENT PROJECT

SITE FACILITY PREPARATION

SITE SURVEY REPORT

SITE NAME: BRGY.TUBIGTANAH_BONGAO_TAWI-TAWI


LOCATION Lot#:
Street:
Barangay/ City: PASIAGAN, BONGAO
Region/ Island: TAWI-TAWI /ARMM

SURVEY DATE: 6-20-19


SITE EVALUATION FORM

FOR GLOBE TELECOMS


Name
Telephone Number
Mobile Number
Email
Signature

FOR CONTRACTOR : MJ VILLANUEVA CONSTRUCTION


Name ROSARIO D. BANDIGAN / AMJAD O. MAGDAR
Telephone Number
Mobile Number 09176332398 / 09176332347
Email rosariodulabandigan@yahoo.com
Signature

SITE CONTRACTOR

Lot Owner
Name SURAYA M. QUE
Address BONGAO, TAWI-TAWI
Telephone Number
Mobile Number 09778230828

Lot Owner’s Representative


Name BENHUR ABDULWAHAB / RAUL F. REBOLLOS
Address PASIAGAN, BONGAO, TAWI-TAWI
Telephone Number
Mobile Number 09555836087

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SITE EVALUATION FORM

Barangay
Name of Barangay Chairman AMIN MUKATTIL
Address
Telephone Number
Mobile Number

City/ Town Mayor


Name of Mayor JEMUEL QUE
Address
Telephone Number
Mobile Number

LOT SIZE AND DIMENSION (Check /verify with Segragation Plan)


Length 12M
Width 12M
Area 144 SM

No seg. Plan yet


Soil Test Report?
Yes No

LOT SIZE DESCRIPTION: Indicate landmarks i.e. Highways, Provincial/ Barangay


Roads (type of road) Building/ Business establishments, River, Creek, Canal, Bridge etc.

North Side: RESIDENTIAL


South Side: VACANT LOT OWNED BY THE LESSOR
East Side: RESIDENTIAL
West Side: NATIONAL ROAD
SITE ACCESSIBILITY TO MATERIALS DELIVERY

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SITE EVALUATION FORM

Delivery Trucks: Distance


4 x 4 Pick-up: Distance
Manual Hauling: Distance
New Access Road: Distance

PROXIMITY TO AIRPORT & OTHER TELECOMMUNICATION FACILITIES


Is there any airport or other telecommunication facilities near the site?
Specific distance from the site 15 KMS

FLOODING HISTORY OF SITE AREA (for a 3-year Period)


Insure from the neighbors and/or local government offices about the flooding history of
the locality within a 3-year period. Otherwise, specify latest flood occurred.
NO

POWER SUPPLY TO THE SITE


Distance from the nearest power supply for permanent connection.
<100m 100M – 500M >1km

Type of power supply during construction.


LOCAL COOP NEIGHBOR GENSET

WATER SUPPLY TO THE SITE


Distance from the nearest water supply
<100m 100M – 500M >1km
Type of water supply during construction

GENERAL SITE INFORMATION

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SITE EVALUATION FORM

Other pertinent site information to be considered in anticipation of variation/ change


orders (i.e. Retaining structures, culverts: open canals; dewatering works, cut & fill: size
& number of trees to be cut, etc.

1. Possible de-watering
2. Possible hard rock excavation.

OTHER COMMENTS
1. Sand is from Zamboanga
2. Site is 482 kms via sea/boat, and 12 kms from pier of Bongao, Tawi-tawi,
byland, or by truck concrete pavement road.

SITE LOCATION SKETCH (Related to Lot Site Description)

Sketch the site location with respect to the respect to the provided orientation
approximately 300m radius with reference to the site.

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SITE EVALUATION FORM

W E

(SEE PHOTOS)
SUBMIT PHOTOS SHOWING THE LANDMARKS/ NEAREST POWER AND
WATER SOURCES/ ACCESS ROADS OR TRAILS/ POSSIBLE VARIATION OR
CHANGE ORDERS AND OTHER PERTINENT PICTURES TO SUBSTANTIAL (AS-
SURVEYED SITE CONDITION.

OTHER VARIATIONS NOTED:

A. DEMOLITION OF STRUCTURES (PLEASE INDICATE DIMENSION AND DRAW


STRUCTURE.

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SITE EVALUATION FORM

MASONRY:
CONCRETE:
STEEL

B. CUTTING OF TREES:
6-15” DIA:

15 AND ABOVE IN DIA:

C. EARTHFILL
Is site within agricultural land and foreseen to be flooded by irrigation?

D. IS ACCESS ROAD NECESSARY TO BE DEVELOPED?


State extent of development needed. What is the agreed length and width to be
developed?

E. GROUNDWATER TABLE DEPTH(PLEASE REFER TO SOIL TEST REPORT)

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SITE EVALUATION FORM

Power tapping

Access
road Lessor gate

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