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HIT-NOT Site Assessment
Tool for FEP Dealers
Dealer
Dealer Name
*
Dealer Email
*
End User Information
Company Name
*
City
*
State
Site Assessment Information
Date of Site Assessment
*
+
Last Name of Site Assessor
*
Customers Interest:
*
Pedestrian Detection
Collision Avoidance
Structure Damage Prevention
Additional Facility Solutions
Other
Other
Number of Mobile Equipment to be Outfit:
*
Mount Type(s)
*
Standard
Front
Top
Weathershield
Number of Mobile Equipment needing DC/DC Converters:
*
Number of Pedestrians to be Outfit:
*
Number of PAD Charging Locations:
*
How to Wear PADs
*
Vest
Pouch
# of Shifts
*
1
2
3
Number of PAD Check Out Stations or PAD Test Devices:
*
Number of Silent Zones Needed:
*
Number of Area Monitors/Access Monitors/Other Accessory Devices Needed:
*
Area(s) for Silent Zones:
*
Conference Room
Office
Workstation
Walkway
Other
Other
Areas of High Levels of Detected EMI (Rapid Blink of EMI PAD)
*
None
Electrical Rooms
Large Facility Equipment
Pedestrian Walkways
Conference Rooms
Other
Other
Devices Operating on the 900 MHz Band in Facility:
*
None
Radio
Location Positioning System
Industrial Control System
Other
Other
Installation to be Performed By:
*
End Customer Internal Maintenance
HIT-NOT Dealer
End Customer’s Forklift Dealer
Third Party Installer
Please Upload Facility Map. Mark Locations of EMI and Facility Mounted Devices(ie Relay, Silent Zones, Chargers, etc)
Remote Event Monitoring Information (Optional)
Best Cellular Carrier for Facility
ATT
Verizon
Other
Other
REM Features of Interest
Equipment Usage
System Validation
Safety Risk Trending
MAC Events
Shock Events
Access Control Events
Location Events
Number of Relays
1
2
3
4
5+
Email Address for Reports
*