Form 442

0054-EX-PL-2002 Text Documents

Jack G. Jones MD Inc.

2002-03-28ELS_54781

°EDERAL COMMUNICATIONS COMMISSION APPROVED BY OMB ‘vvashington, DC 20554 3060—0065 Expires 9/30/08 APPLICATION FOR NEW OR MODIFIED RADIO STATION AUTHORIZATION UNDER PART 56 OF FCC RULES — EXPERIMENTAL RADIO SERVICE (OTHER THAN BROADCAST) L. Applicant‘s Name and Post Office address DO NOT WRITE IN THIS BLOCK (Street address, city, state, and 2ZIP Code. See instruction File No No. 4 Jack@G, Jmes mo /nc: 3te. 101 16@ M-V%th‘m/é d > 6054AEX—PL200L A—('lM)Ofil‘O H‘-fal_g 2a). Application for (check only one box) D) For Modifilcation indicate below: Z New station D Modification of existing authorization File No.: WA Call Sign: MeOne E. Application for Modification: Check the box beside all particulars to be modified. Check elther addition or re— slacement to indicate whether the change is an addition or a replacement of parameters in the current authorization. C1 reeoueney — ) emission — O rower — 0 rocarion — |_] aadtion or []] replacement? [] addition or [|] repiacement? []J addition or {(] replcement? []J adarion or [C] reptacement? E} OTHER PARTICULARS — addftion or replacement? (Describe below o in attached CXHIBIT No. ) 4. frequency (sixie MODULAT ING NECESSARY BANCWIOTH w hether kHz or MHz] SIGNAL (KHz) tA} 0 L (A) List each frequenoy or frequency band sepaerately. (If more space is required, attach es EXHIBIT No (E) iInsert maximum RF. output power at the transmitter terminals. Specify unlits . (C) Insert maximum effective rediated power from the antenna (If pulsed emission,. specify peak power). Specify units. ([)) Insert "MEAN® or "PEAK® (See definitions in Part 5) (E) List each type of emission separately for eacoh Ffrequency. (See Section 2201 of FCC Rulea) (F) —Insert as appropriate for the type of modulation: () the maximum speed of keying in bauds (2) maximum audio modulating frequency: (8) frequency deviation of carrier; (4) puise duration and repetition rate. For complex emissions, desoribe in detail in the space provided below. (2) Deseribe how the necessary bandwidth was determined in space provided below. FCC Form 442 ~ Page 2 March 19986

1§.zo. Proposed location of transmitter and transmitting antenne (check only one box to indicate type of operation): FIXED/BASE D MOBILE []J BASE AND MOBILE E 1)). If permanently located at a FIXED location, give below: Kc). If mobile, describe the exact area of Stite County ~; City or Town operation OH Su mm t ro ia Sumber and street (or other indication of location) t6G0 _A’WO‘V\‘ YQ(’AAH/\SM) & Vzoo > 5‘!3X1}. Enter geographical coordiantes exact to the nearest second (see instruction 10) ACXLEnter geographical coordinates of the approximate _ center of mobile oparation (see instruction 10) votth Latitude (OO—MM—SS) West Longituds (DD—MM—SS) North Latitude Wost Longitude ° 3 er . o ® ar o > 2s o r . #r . Lom. 8i°° 32"° Q* west . @1). Datum (see instruction 1O0) .................. O xanaz K xapss Lat; UI" $‘ worlh,. ut mnog Is a directional antenna (other than radar) used? [] yp5 B xo If "YES", give the following information: (a) Width of beam in degrees at the half—power point (b) Orientation in horizontal plane (c) Orientation in vertical plane 7. is this authorization to be used for fulfilling the requirement of a government contract with an agency of the United States CGovernment? D yES E NO If "YES", attach as EXHIBIT No. ___ & nerretive statement describing the government projeot, agency and contact number. E, Is this authorization to be used for the excilus!ive purpose of developing radio equipment for export to be employed by stations under the Jurisdiction of a foreign government? 0 vses K] no If "YREBS", attach as EXHIBIT Na _______________ the following information: Provide the contract number and the name of the foreign government concerned. €. Is this authorization to be used for providing communications essentlal to a research project? (The radio communi— cation is not the objective of the research project). . K vEs J xo If "YES", attach as EXHIBIT No. _.___._.L____._. & narrative statement provding the following information: (a) A description of the nature of the researoh project being conducted. (b) A showing that the communications facillities requested are necessary for the research project involved. (c) A showing that existing communioations facilities are inadequate. 11. If all the answers to Items 7, 8, and 9, are "NO", attach as EXHIBIT No. ____‘_________a nerrative statement deseribling in detaill the following: (a) The complete program of research and experimentation proposed including description of equipment &nd theory of operation. (b) The specific objectives sought to be rccomplished. | (c) How the program of experimentation has a reasonable promise of contribution to the development, extension, _ expansion, or utllization of the radio art, or is along line not already in vestigeted. lWa). Give an estimate of the length of time that will be required to complete the program of experimentation proposed in this application: 72. yns. — (D) If lees than 2 years, give the length of time in months that the authorization requested in this application will be raquirsed: li. Would a Commission grant of this application come withln Section L1GO7 of the PCC Rules, such that it may have a significant environmental impact (see instruction 1D? D 7E3 E No If "YES", attach as EXHIBIT No. _________________an Environmental Assessment as required by Section LSlL 15. List below transmitting equipment to be instelled (if experimental, so state): MANUFACTURER MODEL NUMBER No. oF UNITs AFJ Switching Power sugoly C Cam.— 10+7‘8 BE TraucGivee (1) <G (7— 23%)] Smarlun@ HF Antemna (up\())a\,()) CBq— {,(,u\,, w i r@ 'C\h“-mho"\ —hme tewer 03[“”)’ ‘}’)/Pc) ¥ FCC Form 442 — Page 3 March 1896

is the equipment listed in Item 16 capable of station identification pursuant to Seotion SIS2? YES [Q] xo W11 the antenna exterd more than 6 meters above the ground, or if mounted on an existing bullding, will it extend more than 6 meters above the buillding, or will the proposed antenna be mounted on an existing structure other than a buillding? . E] yE3 ,g No If "YES", give the following (see instruction 9): (a) Overall height above ground to tip of antenna is _________ meters. (b) Hievation of ground at antenna site above mean sea level is ________________ moters (c) Distance to nearest alrcreft landing area is kilometers, (€) List any natural formations of existing man—made structures (hills, trees, water tanks, towers, etc) which, in the opinion of the applicant, would tend to shield the antenna from alrcraft end thereby minimize the aerongruticoal hazard of the antenna. (e) Submit as EXHIBIT No. __. & verticel profile sketch of total structure including supporting bullding, If any, giving heights in meters above ground for all signifilcant features, Clearly indicate existing portion, noting particulars of evlation obstruction lighting already available. Applicent is (/Check oeniy ene bex! J mopmvipuar J associatiowr J rartNuErsHmP CORPORATION D OTHER (describe in space provided below) JE appliceni a foreign government or a representative of a foreign government? D YES E NO Has epplicant or any party to this application had any PCC station liscense or permit revoked or had any application for permit, license or renewal denied by this Commis«ion? D yBs '@, xo If "YES", attech as EXHIBIT Na. ______________. & statement giving call sign of license or permit revoked and relate circumstances. Will applicant be owner and operator of the station? E YES D NO CGive naeme, title, and telephone number (inolude area code), and Internet e—mail address (If applicable) of person who can best handle Iinquiries pertaining to this application. Jack‘G-Jcnes mio lc 2%30— TZLO —[6G6 APPLICANT ANT}—DRUG ABUSE CERTFICATION: By checking "YES", the individusl applicant certifies that he or she is eligible for this license. This requires that he or she is not subject to a denial of federal benefits, Including FCC benefits, as a result of a drug offense conviction pursuant to Section 5801 of the Ant!i— Drug Abuse Act of 1988, 21 USC. 862 A non— individual applicant, eg. corporation, partnership or other unincorporated essociation, certifies that no party to the application is subject to a denial of federal benefits, pursuant to that section. For definition of a "party" for these purposes, see 47 CFR L2002(b). E 7Es D Xo 122 List below all exhibits in numerical sequence and the item number of form requiring the exhibit ldentified. EXHMIBIT NLUMBER ITFM NDO. Of FORM EXMIBIT MUMBER IM NQ. OF FORM EXMB!T NUMBER IM ND. DF FORM 1 FCC Form 442 — Page 4. March 1996

iB3 CERTIFICATION: — Attention: Read this certification carefuilly before signing this application. THE APPLICANT CERTFIES THAT: (2 ~ (a) Coples of FCC Rule Parts 2 and Gbare on hand; and (b) Adequate financlal appropriations have been made to carry on the program of experimentation which wiil be conduoted by qualified personnel; and (o) All operations will be on an experimental basis in accordance with Part 5 and other applicable rules, and will} be sconducted in such a manner and at such a time as to preciude hermful interference to any aeuthorized station: and (d) Grant of the authorization requested herein will not be construed as e finding on the part of the Comnmission: (1) that the frequenoles and other technilcal perameters specified in the authorization are the best suited for the proposed program of experimentation, and (2) thet the applicant will be authorized to opereate on any basis other than experimental, and (8) thet the Commission is abligated by the resuits of the experimental program to make provision in its rules including Its table of frequency allocations for applicant‘s type of operation on a regularly lcensed basic. APPLICANT CERTFIES FURTHER THAT: (e) All the statements in the application and attached exhibits are true, complete and oorrect to the best of the a@pplicants knowledge, and (£) The applicant is wiiling to finance and conduct the experimental program with full knowledge and understanding of the above limitations end (g) The applicant waives any claim to the use of any particrula.r frequency or of the electromagnetic spectrum as against the regulatory poewer of the VSA. <f ' 2002 Signed and dated this day of rmarch 40 Name of Applicant Jack GJdones mo Inc ‘ laust correspend with n,ne pago ?) By J n.gl‘\- ("" A{‘.V\e& in 10 )nc " flf/ce (printi (ugnotore) Title pye s ¢AemrTt f/ / Check appropriate classification: D Individual applicant D Memper of applicant partnership D Authorized employee & Offilce of applicant corporation or asgociation ;\lLLFUL FALSE STATEMENTS MADE ON THIS FORM ARE PUNISHABLE BY FINE AND/OR IMPRISONMENT {U.S. Code, Title ‘I3 Section 100 1}, AND/OR REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION PERMIT (U.S. Code, Title 47. action 31Z(al1}, AND/OR FORFEITUREIU.S. Code, Title 47, Section 5031. NOTIFICATION TO INDIVIDUALS UNDER PRIVACY ACT OF 1974 AND THE PAPERWORK REDUCTION ACT OF 19860 Information requested through this form is authorized by the Communications Act of 19894, as amended, and specified by Section @068 therein. The information will be used by Federal Communications Commission staff to determine w.igibility for Issuing authorizations in the use of the frequency spectrum and to effect the provisions of regulatory i@spopsibilities rendered by the Commiwwion by the Act Information requested by this form will be aveillable to the iblic unless otharwisse requested pursuant to 47 CFE 8486 of the FCC Rules and Regulations. Your response is required ic obitain this authorization. l‘ublic reporting burden for this collection of information is estmated to average four (4) hours per response, including the time ~or reviewing Instructions, searching existing data sources, gathering and maintaining the data needed, and completing and review—, —~g the collection of information. Send comments regarding this burden estmate or amy other aspect of this collection of information, includimg suggestions for reducing the burden to the Federal Communications Commission, Records Management lt:anch, Paperwoark Reduction Project (3060—0065), Washington, NOC 20554. DO NOT send completed applications to this nidress. ndviduals are not required to respond to this collection unless i displays a currenty valid OMB control number. "‘HBE FOREGOING NOTICE IS REQUIRED BY THE PRIVACY ACT OP 1974, PL 98—579, DECEMBER 81 1974, 6 USC. EBbZa(e)(8), .A ND THE PAPERWORK REDUCTION ACT OF 1980, PL OG—B6il, DECEMBER 11, 1980, 44 USC. Gso7. FCC Form 442 — Page 5 March 1996


Document Created: 2002-03-28 11:18:02
Document Modified: 2002-03-28 11:18:02
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