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pdfBPA F 6530.16e
(02-2022)
US DEPARTMENT OF ENERGY -BONNEVILLE POWER ADMINISTRATION (BPA)
APPLICATION FOR A WIRELESS SITE UPGRADE CO-LOCATED ON BPA FACILITIES
OMB Control Number:1910-XXXX
Expiration Date:xx/xx/xxxx
General Information for a Wireless Site Upgrade:
When space and structural capacity allow, the Bonneville Power Administration (“BPA”) will consider requests to upgrade and/or modify
existing wireless facilities located on BPA transmission facilities. These changes may require modifications to the site’s existing Facility
Lease Agreement. Upgrade requests will be evaluated with emphasis on BPA’s security requirements, available resources, and outage
constraints.
The BPA Wireless Customer (“Customer”) must submit a complete upgrade application package to wirelessapplications@bpa.gov
including, but not limited to, the Upgrade Application Form (including Site Maintenance Ticket), construction drawings for current
facilities, RH data, and equipment cut sheets for any new proposed equipment. Upon receipt of the complete application package, BPA
will provide Customer with the project’s agreement number.
FEES: Customer must submit an application fee of $20,000 to BPA within 90 days following submission of this application. All fees
must be submitted to BPA directly by Customer and per BPA Payment Instructions. The BPA provided agreement number must be
referenced in the payment description field. BPA will hold the fee in an account established for the project specified herein, and will use
it for preliminary design and engineering work associated with Customer’s application. The cost of performing preliminary design and
engineering activities by BPA at Customer’s expense will be the actual cost of performing the activities, plus applicable overhead rates.
If BPA determines that the proposed project is not feasible, BPA will refund unexpended funds in the project account to Customer. If
BPA determines that the proposed project is feasible, BPA will tender a reimbursable agreement (Agreement) to Customer to provide
for construction activities and for additional funding associated with those activities. If Customer executes the Agreement, BPA will
apply the $20,000 application fee, minus any expenses BPA has incurred prior to execution of the Agreement, towards the Agreement.
BPA’s Fiscal Year Construction and Reimbursable Non‐Direct Rates in effect at the time the Agreement is offered to Customer will
apply. If, at any time, Customer informs BPA that it does not intend to pursue the project or execute the Agreement, BPA will make a
full accounting to Customer and either return any unexpended balance in the account to Customer or bill for any costs in excess of the
deposit in the account. Customer must pay any excess costs within 30 days of the date of the bill.
Required Information:
Type of Upgrade:
Name of BPA Transmission Line/Facility:
Latitude:
Tower #:
Longitude:
BPA Name of Existing Wireless Site:
Customer Site ID:
Detailed description of work request:
Customer (Legal) Name:
Customer Contact Name:
Email:
Phone:
(IF SUBMITTED BY CUSTOMER REPRESENTATIVE)
Customer Representative Company Name:
Customer Representative Contact Name:
Email:
Phone:
RF engineer that BPA may contact for technical information if necessary (Name, Address, Tel, Email):
File code; FE-1200 Retention; Destroy 5 years after the records are closed, approved, submitted, or become inactive.
Page 1 of 6
BPA F 6530.16e
(02-2022)
U.S. DEPARTMENT OF ENERGY-BONNEVILLE POWER ADMINISTRATION (BPA)
APPLICATION FOR A WIRELESS SITE UPGRADE CO-LOCATED ON BPA FACILITIES
OMB Control Number:1910-XXXX
Expiration Date:xx/xx/xxxx
The following is for the purpose of project closeout:
Customer Contact - Submit Invoice
Customer Contact - Submit Refund
Name:
Name:
Email Address:
Email Address:
Phone Number:
Phone Number:
Street Address:
Street Address:
Does Customer require additional space on the site for:
Shelter?
Outdoor Cabinets?
If yes, give dimensions (L, W, H)
A New Pole?
Pole or tower dimensions: Height:
or New Tower?
Base:
Electrical power requirements: Voltage (e.g. 120/240 VAC, 60 Hz, 1 Ph., 3 Wire)
Average Watts
Peak Watts
Is BPA Emergency backup power requested?
Does Customer propose to install additional utility services such as power service, telephone line or leased line for control?
If yes, describe:
List of racks or cabinets to be placed within BPA building and dimensions of each (W, D, H):
Rack
Width
Depth
Height
Rack
1
3
2
4
Width
Depth
Height
List antennas to be placed on BPA tower (attach cutsheets):
Ant.
Height on
tower
Azimuth
(or Omni)
Antenna
Gain †
3dB
Beamwidth
††
Weight
(pounds)
Dimensions, Make &
Model
Tx? *
1
2
3
4
5
6
7
8
9
10
11
12
* If antenna is used for TRANSMITTING, mark “yes” under Tx? Be sure to answer the questions below
† Enter Gain value and specify whether this number is expressed in dBi or dBd, lowest transmit frequency
†† Lowest Transmit frequency
Page 2 of 6
BPA F 6530.16e
(02-2022)
U.S. DEPARTMENT OF ENERGY -BONNEVILLE POWER ADMINISTRATION (BPA)
APPLICATION FOR A WIRELESS SITE UPGRADE CO-LOCATED ON BPA FACILITIES
OMB Control Number:1910-XXXX
Expiration Date:xx/xx/xxxx
List number, manufacturer, and size of all coaxial cables to be placed on BPA tower:
Type of
Size of
Ant.
# of Coax
Weight/Ft
Coax
Coax
Other Coaxial Information
Available
Tx? *
1
2
3
4
5
6
7
8
9
10
11
12
Proposed Receive Frequencies (list):
#
Receive Frequency (MHz)
#
1
5
2
6
3
7
4
8
Receive Frequency (MHz)
Proposed Transmit Frequencies, RF Output Power, Emission, Equipment (list):
#
Freq. (MHz)
Tx Power †
Power (E.R.P.)‡
C or I*
1
2
3
4
5
Emission Type
Equipment Make & Model
† Transmitter RF Output, watts
‡ Eff. Radiated Pwr. at Antenna
* C=Continuous; I=Intermittent
(Include all types of transmitters including microwave links via dish. Attach additional sheets if necessary.)
For evaluating near-field RF/EMF exposure to workers:
What is the maximum number of transmitters delivering RF power to any one antenna?
transmitters.
What is the total actual RF power in watts, not ERP, delivered to that antenna for that number of transmitters?
{Number of Tx
times Watts per Tx
(allowing for coaxial line losses), =
RF watts, total)
Page 3 of 6
BPA F 6530.16e
(02-2022)
U.S. DEPARTMENT OF ENERGY-BONNEVILLE POWER ADMINISTRATION (BPA)
APPLICATION FOR A WIRELESS SITE UPGRADE CO-LOCATED ON BPA FACILITIES
OMB Control Number:1910-XXXX
Expiration Date:xx/xx/xxxx
Will other types of antennas be placed on BPA tower (Such as GPS, microwave dish, Rx calibration antenna, etc.)?
If yes, list below, using more paper if necessary.
Ant.
Type
Height
Azimuth (or
Omni)
Weight
Dimensions
Tx?*
1
2
3
4
5
*If antenna is used for TRANSMITTING, mark “yes” under Tx?
Provide contact information for any Customer employee or contractor that will require access to the site:
How often would Customer or Customer representative expect to visit the site?
Any additional information to be considered in BPA's review of this Upgrade Application:
If supplemental sheets, maps, sketches, etc. are attached in response to the above questions, please list below:
Signature:
EMAIL TO: WirelessApplications@bpa.gov
Date:
Upon receipt of this application, BPA will provide an Agreement number, which must be referenced on the
payment.
See BPA Payment Instructions for payment procedure.
Page 4 of 6
U.S. DEPARTMENT OF ENERGY-BONNEVILLE POWER ADMINISTRATION(BPA)
BPA F 6530.16e
(02-2022)
BPA WIRELESS PROGRAM- SITE MAINTENANCE TICKET
OMB Control Number:1910-XXXX
Expiration Date:xx/xx/xxxx
BPA USE ONLY
TICKET NUMBER:
CUSTOMER TO COMPLETE
Customer Name
Date of Request
Requester Name
Office Phone Number
Mobile Phone Number
FAX Number
E-Mail Address
Address
City
State
Zip Code
Name of BPA Site, Tower Number or coordinates if name is not known
Site Name
Site Number
Tower Number
Latitude
Longitude
Contact for De-Energizing Site
Is Site now operating?
Phone 1
Is Site on the Air?
Yes
No
Maintenance Checklist (Check all that apply)
Site Upgrade
Transmission Line Name
Phone 2
Maintenance Category
Yes
No
LNA Problems
Antenna Swap (How Many)
Site Escort
Maintenance Requested (Provide detailed description)
Planned Maintenance
Emergency Maintenance
Down-Tilt Adjustments
Coax Change
TMA Problems
Azimuth Adjustments
Other Maintenance Items
Preferred Maintenance Date (If known)
Can work be done during normal business hours?
Yes
No
Overtime or weekend work approved?
Yes
No
Estimate of crew hours
BILL TO:
Name
Title
Company
Address
City
State
Name
Zip Code
Title
Date
Approved For Work:
BPA USE ONLY
TLM District
Date TLM Notified
TLM Estimate
PSC District
Date PSC Notified
PSC Estimate
Date Maintenance Scheduled
Maintenance Amount
Date Billed
DEPT ID
ABM
WORK ORDER
TASK
DCE
GL ACCOUNT
SAFETY WATCHER (If Needed)
Page 5 of 6
BPA F 6530.16e
(02-2022)
U.S. DEPARTMENT OF ENERGY-BONNEVILLE POWER ADMINISTRATION(BPA)
BPA WIRELESS PROGRAM- SITE MAINTENANCE TICKET OMB Control Number:1910-XXXX
Expiration Date:xx/xx/xxxx
Paperwork Reduction Act Burden Disclosure Statement
This data is being collected to consider the space and structural capacity requirements to allow upgrades or
modifications to existing wireless facilities located on BPA transmission facilities. The data you supply will be used by
BPA’s Transmission Planning division to identify and respond to requests for upgrades or modifications of wireless
facilities located on BPA transmission facilities. Public reporting burden for this collection of information is estimated to
average 1.5 hours per response, including the time for reviewing instructions, searching existing data sources,
gathering and maintaining that data needed, and completing and reviewing the collection of information.
Send comments regarding this burden estimate or any other aspect of this collection of information, including
suggestions for reducing this burden, to Office of the Chief Information Officer, Enterprise Policy Development &
Implementation Office, IM-22, Paperwork Reduction Project (OMB control number 1910-XXXX), U.S. Department of
Energy, 1000 Independence Ave SW, Washington, DC, 20585-1290; and to the Office of Management and Budget
(OMB), OIRA, Paperwork Reduction Project (OMB control number 1910-XXXX), Washington, DC 20503.
Notwithstanding any other provision of the law, no person is required to respond to, nor shall any person be subject to a
penalty for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act
unless that collection of information displays a currently valid OMB control number.
The Paperwork Reduction Act (PRA) of 1995 requires each Federal agency to seek and obtain approval from the Office
of Management and Budget (OMB) before undertaking a collection of information directed to 10 or more persons of the
general public, including persons involved in or supporting the operations of Government-owned, contractor-operated
facilities.
Submission of this data is required.
Page 6 of 6
File Type | application/pdf |
File Modified | 2022-08-11 |
File Created | 2021-09-21 |