Tower Survey & Anchor Assessment Name * First Name Last Name Email * Phone (###) ### #### Date MM DD YYYY Asset Name * Gate Access Coordinates * Road Access * Approx. Length x width & Surface Type Tower Info * Tower Type Guy Tower Self-Supporting Tower Monopole Other Additional Inspection Notes on Tower * Anchor A1 Type * Solid Rod Elevated Tie-Back I-Beam Other NA Anchor A1 Notes * Accessibility, proximity, & other info Anchor A2 Type * Solid Rod Elevated Tie-Back I-Beam Other NA Anchor A2 Notes * Accessibility, proximity, & other info Anchor B1 Type * Solid Rod Elevated Tie-Back I-Beam Other NA Anchor B1 Notes * Accessibility, proximity, & other info Anchor B2 Type * Solid Rod Elevated Tie-Back I-Beam Other NA Anchor B2 Notes * Accessibility, proximity, & other info Anchor C1 Type * Solid Rod Elevated Tie-Back I-Beam Other NA Anchor C1 Notes * Accessibility, proximity, & other info Anchor C2 Type * Solid Rod Elevated Tie-Back I-Beam Other NA Anchor C2 Notes * Accessibility, proximity, & other info GUWT Analysis Notes * Other Inspection Notes Form Submitted, Thank You!
