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)