APPLICATION FOR LAND USE BYLAW OR OFFICIAL COMMUNITY PLAN AMENDMENT

Transcription

1 SCHEDULE A1 APPLICATION NO. APPLICATION FOR LAND USE BYLAW OR OFFICIAL COMMUNITY PLAN AMENDMENT I/We hereby make application for (check where applicable) an amendment to the Official Community Plan Bylaw an amendment to the text of Land Use Bylaw the rezoning of the property described as (legal description) Legal Description of Property: and located at (street address or general location) from zone, to zone. Required application fee and the completed Information forms are attached. (DATE) (APPLICANT'S SIGNATURE) THIS APPLICATION IS MADE WITH MY FULL KNOWLEDGE AND CONSENT REGISTERED OWNER S NAME (PLEASE PRINT) (DATE) REGISTERED OWNER'S SIGNATURE Where the Applicant is NOT the REGISTERED OWNER the Application MUST be signed by the REGISTERED OWNER FOR OFFICE USE ONLY APPLICATION FEE OF $ RECEIVED Receipt No. (DATE) (Signature of Official)

2 Page 2 NOTICE OF COLLECTION OF PERSONAL INFORMATION Personal information collected on this form is collected for the purpose of processing this application and for administration and enforcement. The personal information is collected under the authority of the Local Government Act and the City s bylaws and pursuant to Section 26 of the Freedom of Information and Protection of Privacy Act. If you have any questions about this collection, contact the Director of Planning, City of Colwood, 3300 Wishart Road, Colwood, B C., V9C 1R1, Tel: APPLICANT AND REGISTERED OWNER a) Applicant's Name Address Postal Code Telephone: Business Home FAX b) Registered Owner's Name Address Postal Code Telephone: Business Home FAX A copy of a State of Title Certificate dated no more than 30 days prior to submission of the application must accompany the application as a proof of ownership. Also include copies of any restrictive covenants or easements. 2. APPLICATION FEE An Application Fee as set out in Schedule "B" shall be made payable to the City of Colwood and shall accompany the application. 3. TEXT AMENDMENT TO EITHER THE LAND USE BYLAW OR COMMUNITY PLAN Describe the Proposed Text Amendment 4. SUBJECT PROPERTY AND DEVELOPMENT a) Legal Description in full b) Location (street address of property, general description or map):

3 Page 3 c) Size of Property (area and number of parcels) d) Present Zoning e) Proposed Zoning f) Present OCP Designation g) Proposed OCP Designation h) Description of the Existing Use/Development i) Description of the Proposed Use/Development Attachments 5. One digital set and two full-sized printed sets of the following attachments are required for this Application. The Director of Planning may require additional information. a) A dimensioned Sketch Plan showing the parcel(s) or part of the parcel(s) and the location of existing buildings, structures and uses. b) A dimensioned Site Development Plan showing the proposed use, buildings and structures, highway access, parking, landscaping, and open spaces. c) A Contour Map with a maximum 2 metre contour interval. d) A dimensioned Sketch Plan drawn to a scale of 1 to 1,000 of the proposed subdivision, where subdivision is contemplated. e) One digital and one printed set of legible reduced plans no larger than 28 cm x 43 cm (11 x 17 ).

4 Page 4 SCHEDULE B APPLICATION FEES Application Type Land Use Zone Type/Density Proposed Application Fees Amendment to the Official Community Plan (OCP) or the Land Use Bylaw (Rezoning) All Zones $3,400 +$0.20/m 2 Lot Area <5,000 m 2 +$0.10/m 2 Lot Area >5,000 m 2 Text Amendment All Zones $2,000 Joint OCP-Rezoning Amendment All Zones Temporary Use Permit All Zones $2,000 Public Hearing Fee All Zones $2,200 Development Permit (DP) Form & Character (F&C) Development Permit (DP) Environmental Protection (EP) Minor Exterior Renovations* $ m 2 Building Floor Area All Zones >100m 2 Building Floor Area All Zones 0 150m 2 Land Alteration Area (Non-riparian) OCP Amendment Fee + $2,000 $1,000 $2,800 + $0.50/m 2 Building Floor Area $200 Up to 1000m 2 Land Alteration Area $1, m m 2 Land Alteration Area 4501m 2 25,000m 2 Land Alteration Area $3,500 $5,500 >25,000m 2 Land Alteration Area $7,500 DP+Add Per Variance Req d All Zones $250 DP+ (Joint F&C EP) All Zones DP F&C Fee + 0.5(DP-EP Fee) Development Variance Permit (DVP) All Zones $1,500 + $250/ Additional Variance Required Strata Conversion All Zones $500/strata lot Notice Sign Fee For Rezoning, DP-F&C, DP-EP, DVP Deleted Maximum Fee Cap (Excluding rezoning or amendments to the OCP) All Zones $35,000 *Minor exterior renovations of existing intensive residential (including duplex) and multi-family residential buildings that change the form and character of a building or buildings over $10,000 construction value, to a cap of $30,000.

5 Page 5 SCHEDULE C DEVELOPMENT APPLICATION SIGNS It is Council policy that the following procedures be adhered to with respect to applications for rezoning, development permit and development variance permit: 1. Where an applicant is required to post notification signs on land that is subject to a proposed development, the signs will be prepared and posted in accordance with the sign specifications prescribed by the Director of Planning and verify to the Director of Planning that the signs have been erected. 2. The notification signs should include but not be limited to the following information: a. Location of the application b. Purpose of the application c. Applicant contact information d. Location map indicating the subject property 3. The signs shall be posted prior to the City sending out notification to nearby land owners/occupiers to notify them when your application will be considered by the Planning and Land Use Committee, Committee of the Whole, or Council, as the case may be. The Planner assigned to your file will confirm your posting date 4. The signs shall remain posted until: a. in the case of a rezoning application, after the Public Hearing; b. in the case of a development permit application; and c. in the case of a development variance permit application, after consideration by Council. 5. A notification sign is not required for a Form & Character Development Permit for Minor Exterior Renovations where there are no variances and Environmental Protection m2 Land Alteration Area (Non-riparian) 6. Signs are to be posted no higher than 2 metres (6.6 ft.) above the grade of the road and no further back from the road right-of-way than 3 metres (10 ft.)

6 Page 6 REQUIREMENTS FOR POSTING NOTICES ON PROPERTY SUBJECT TO DEVELOPMENT APPLICATION It is the applicant s responsibility to prepare and post a notice sign facing each street frontage prior to the City sending out notification for the meeting of the Planning and Land Use Committee. The planner assigned to your file will confirm your posting date. Sign Production: The City of Colwood Planning Department requires the sign(s) be produced according to the specifications shown on the template below. Sign Maintenance: The applicant is required to maintain and/or replace the sign(s) as necessary. Confirmation of posting: Following placement of the sign(s) on the property, please provide photographs confirming sign posting (including the date the sign was posted) to the Planning Department at planning@colwood.ca. 48 wide (corrugated plastic sign) 36 high

7 City of Colwood 3300 Wishart Road Colwood, B.C. V9C 1R1 Telephone: Fax: Personal Information on this form is collected pursuant to Section 26 of the Freedom of Information and Protection of Privacy Act. If you have any questions about this collection, contact the Director of Planning, City of Colwood, 3300 Wishart Road, Colwood, B C., V9C 1R1, Tel: File No /12048 WASTE MANAGEMENT ACT SITE PROFILES The Waste Management Amendment Act, 1993, came into effect on April 1, The Act creates a system for screening properties for possible contamination. It uses site profiles that require information about the past and present uses of the site, as well as basic land descriptions. Please indicate what type of application you are making: Zoning Development Permit Development Variance Permit Temporary Commercial Permit Temporary Industrial Permit Master Development Permit The attached Site Profile Form is provided for your information and use. If you will not be submitting a Site Profile Form, please sign below to indicate you are aware of the regulations and that you do not consider them applicable to your application. For further information, please contact: Ministry of Environment Vancouver Island Regional Office A Labieux Road Nanaimo, BC V9T 6J9 Telephone: (250) Fax: (250) Signature of Applicant

8 Regional Offices Vancouver Island Region 2080 Labieux Road Nanaimo, B.C. V9T 6J9 Lower Mainland Region 2nd Floor, nd Street Surrey, B.C. V3R 0Y3 Thompson Region 1259 Dalhousie Drive Kamloops, B.C. V2C 5Z5 Kootenay Region 205 Industrial Road G. Cranbrook, B.C. V1C 7G Victoria Street Nelson, B.C. V1L 4K3 Phone: Fax: Cariboo Region Borland Street Williams Lake, B.C. V2G 4T1 Skeena Region PO Box # Alfred Avenue Smithers, B.C. V0J 2N0 Omineca Region th Avenue Prince George, B.C. V2N 1B3 Okanagan Region 102 Industrial Place Penticton, B.C. V2A 7C8 Peace Region Avenue Fort St. John, B.C. V1J 6M2

9 Version 1.1 SITE PROFILE Applicant's Questions (excluding Mines Act and Petroleum and Natural Gas Act Requirements) Do I Need to Complete a Site Profile? Page 2 How Do I Complete a Site Profile? Page 3 To Who & When Do I Submit a Site Profile? Page 4 What Happens Then? Page 5 How Do I Get More Information? Page 6 This document does not replace the requirements of the Waste Management Act or related regulations. This document is written from the perspective of the general public and does not list ALL the provisions which exist with respect to site profiles submitted by Municipalities as land owners and other provisions. If there are differences or omissions in this guide, the act and regulations apply.

10 Version Do I Need to Complete a Site Profile? In general. Site profiles are not required until April 1st, 1997 when the Waste Management Amendment Act (Act) becomes law. There must be a reason stated in the Act for a site profile to be completed and submitted. Site profile forms submitted as a complaint are not considered site profiles under the Act and are not subject to the site profile processing requirements. There is NO requirement to complete and submit a site profile on April 1, 1997 when the Act becomes law just because you own a site with a particular activity on it. You must be doing the things described below to require a site profile. Specifically. 1) Have any of the activities listed in Schedule 2 of the Contaminated Sites Regulation occurred on your site? (see page 7 of this guide) => If "NO", then you don't have to complete a site profile UNLESS the municipality asks you to complete parts of a site profile for their records, (end of process) => If "YES", then you MAY have to complete a site profile, (carry on) 2) Are you making an application for: subdivision, zoning, development or development variance permits, soil removal, or demolition? 3) Are you decommissioning a site? 4) Are you taking over a property as a trustee, receiver or liquidator? 5) Are you selling property which has or had a schedule 2 activity on it? => If any of the above are 'YES', then you WILL have to complete a site profile UNLESS one of the following statements exempts you. Site Profile Exemptions These exemptions DO NOT APPLY if you are taking possession or control of a schedule 2 activity property as a trustee, receiver or liquidator. A site profile is always required in this situation. A). The site has a site profile on the Site Registry which is reflects your current knowledge of the site. B) Your development or variance permit application does not require soil excavation. C) The demolition permit application is not associated with decommissioning the site. D) The demolition permit application relates to temporary petroleum, natural gas, mineral or geothermal exploration or development facilities. E) The site is already under an official order from BC Environment. F) The site already has an Approval In Principle, a Certificate of Compliance or a Conditional Certificate of Compliance from BC Environment. G) If the site was cleaned up prior to April 1, 1997, it has a BC Environment letter saying so and the clean up is still consistent with the proposed land or water use. H) The site JS already been officially determined to be a contaminated site by BC Environment on the Site Registry. I) The site is part of an official "wide area remediation plan" AND the site profile would be required due to the contamination that the wide area remediation plan addresses. J) For property sales: if the purchaser says in writing that they do not require a site profile.

11 Version i.l at the time of sale, the property is used for residential purposes, OR has always been zoned as residential. => If one of these statements applies to your site, you will not be required to complete a site profile. Be prepared to provide proof. => The Site Registry provides information concerning the site assessment and clean up process. Access to the Site Registry is generally done through B C OnLine. How Do I Complete a Site Profile? In general. 1) There is normally a site profile form attached to this guide. If not, get a site profile form from either your local municipality or BC Environment Office (BC Environment office addresses: page 9). 2) You must complete Section I, II and IE, answer ALL questions in sections IV through IX, and sign section XI for the site profile to be considered satisfactorily completed. 3) The person completing this site profile is responsible for the accuracy of the answers. Questions are to be answered to the best of your knowledge. 4) If the site profile is not satisfactorily completed it may result in delays in getting an approval. 5) A municipality may ask you to complete Section I, II, III and XI at the time of an application for their own records. These site profiles will not normally be sent to the BC Environment manager. If such a site profile is forwarded, the municipality will notify you with their reasons before they send the site profile to the BC Environment manager. Specifically. Section I Contact Identification 1) 'Name of Site Owner' means the person(s) or organization(s) who owns the property. 2) 'Person Completing Site Profile' can be the same as the site owner, or someone submitting the site profile on the owner's behalf and their authorization. 3) 'Person to Contact Regarding the site profile' can be the same as the site owner or the person completing the site profile. However, the Person to Contact... must be responsible for communicating the results of the site profile submission to the site owner. Section II Site Identification: 1) One (1) site profile may be completed for a site comprized of more than one titled or untitled parcel, but individual parcels must be identified. 2) For urban sites: In general, most urban sites are legally surveyed, titled and registered and will have PIDs (Parcel IDentifiers). You can obtain PIDs for your site from your local Land Titles office. All PIDs must be provided for each parcel contained by the site as well as the each parcel's legal description. 3) For remote sites: If the site is untitled Crown land (i.e. no PID number), then the appropriate PIN numbers (Parcel Identification Numbers) for each parcel with the appropriate land description should be supplied if available. Contact your local Crown Lands office to get this number. If there is a PIN available, but it is for a large area (e.g. > than a 1 km 2 ), please provide the associated PIN, and also the information required below for very remote sites. For very remote sites, sometimes a PID or PIN number is not available. In this case, please provide the following: => a latitude and longitude using the 1983 North American Datum accurate to 0.5 of a second of the centre of the site is required. => an accurate map, containing latitude, longitude and datum references, which shows the boundaries of the site. Please use the largest scale map available.

12 Version 1.1 If available, the Crown Land File Number for the site should also be supplied. Section III Commercial and Industrial Purposes or Activities 1) Review the Commercial and Industrial Purposes or Activities list (Contaminated Sites Regulation, Schedule 2) provided on page 8 of this guide. 2) Using the best of your knowledge, identify if any of the activities listed on page 7 of this guide have occurred on your site either now or in the past. 3) Enter the identifies activities' reference numbers (e.g. Al, E 7 etc.) AND the related written description (e.g. adhesives manufacturing or wholesale bulk storage, road salt storage facilities etc.) in the space provided. 4) If you CAN'T identify any listed activities, reread "Do I Need to Complete a Site Profile" because its likely that you don't. Sections IV, V, VI, VII, VIII and IX 1) All questions must be answered to the best of your knowledge. 2) Each question must be have an 'X' in either the YES or NO column to indicate your answer. Section X Additional Comments and Explanation This section allows further opportunity to provide information to the municipality or the BC Environment Manager concerning the site and to the put any 'YES' answers in context. And finally. Section XI Signatures The 'Person Completing the Site Profile', in addition to answering all the above questions, must also sign and date this section for the submission to considered complete. Section XII Official Use This section does not require any information from you. This section is for the local governments and BC Environment to complete. To Who and When Do T Submit a Site Profile? Generally. Many of the applications to the municipality or the approving officer need discussion and clarification before proceeding. The site profile is considered 'received' at the time the application is finalized and officially received. If you have determined that you must complete a site profile, and have completed a site profile, the site profile should be submitted to the following: 1) to an approving officer with a subdivision application. 2) to a municipality with an application for zoning, development or variance permits, soil removal and demolition permits. 3) For decommissioning a site: to a municipality with a demolition permit if required, OR to a manager 10 days prior to dismantling 4) to a purchaser from the vendor 30 days prior to the transfer of actual ownership or at least provided before the agreement date. There is NO requirement to submit this site profile to a manager. 5) to a manager from a trustee, receiver or liquidator within 10 days of taking control of a Schedule 2 activity (page 8) site - always. Normal site profile exemptions do not apply for this requirement. 6) to a manager on ordering a site profile be prepared.

13 Version 1.1 Municipalities which have 'opted out' A municipality and/or an approving officer can choose not to receive site profiles. This means the following: Site profiles which would normally go to a municipality or approving officer with an application are not required by the municipality or approving officer. Site profiles received by other means related to an application are not under the same requirement and will be processed as time permits. What Happens Then? Once a satisfactorily completed site profile has been received by a municipality or approving officer, they have 15festetantsdays to do the following: Timing Considerations In summary, the time requirements are as follows: Once a satisfactorily completed site profile is officially received by a municipality or approving officer, they must act within 15 MBfa days. Once the BC Environment manager receives the site profile from the municipality or approving officer, the manager must act within 15 to 30-teems days. Time impacts on the various application's approval will differ depending upon the decisions at both levels of government. Also, site profiles will normally be sent by mail and this will add to the processing time. 1) Forward any site profiles to the BC Environment manager if there are any 'YES' answers in sections IV to IX. Otherwise, the site profile is sent to the Site Registrar and the application approval process proceeds. 2) Notify the applicant whether or not the site profile has been forwarded to the BC Environment manager. Once a BC Environment manager receives the site profile from the municipality or approving officer, the manager has 15 Sesllgs days to do the following: 1) Determine if a site investigation is needed, and 2) Notify the related municipality or approving officer and the applicant of the decision. The BC Environment manager can extend the time necessary to reach a decision by an extra 15 m days by notifying the applicant.

14 Version 1,1 How Do I Get More Information More information is available from BC Environment's Regional and Victoria offices (addresses attached). A copy of the Waste Management Amendment Act and Contaminated Sites Regulations can be obtained at cost at the following address: Crown Publications Inc. 521 Fort Street Victoria, BC V8W 1E7 Telephone: (250) Facsimile: (250) Orders generally are mailed out the next business day. Additional information concerning the Act and regulations may also be found on the internet: Waste Management Amendment Act, statutes/sdocs/bill26.html Contaminated Sites Regulation (Effective April ) elp/r375_96c.htm Contaminated Sites Fees Regulation (Repealed as of March 31, 1997) ml Contaminated Sites Program Infonnation iwhc/cshome.html

15 contaminated Sites Regulation: Schedule 2 Industrial and Commercial Purposes and Activities A 6 C 6. welding or machine shops (repair or fabrication) D Mining, milling or related industries and activities 6. nonferrous metal mining or milling 1-: Miscellaneous industries, operations or activities F COLUMN II Purpose or Activity Chemical industries and activities 1 adhesives manufacturing or wholesale bulk storage 2. chemical manufacturing or wholesale bulk storage 3. explosives or ammunition manufacturing or wholesale bulk storage 4. fire reiardant manufacturing or wholesale bulk storage 5. fertilizer manufacturing or wholesale bulk storage 6. ink or dye manufactunng or wholesale bulk storage 7. leather or hides tanning 8. paint, lacquer or varnish manufacturing, formulation, recycling or wholesale bulk storage 9. pharmaceutical products manufacturing 10. plastic products (foam or expanded plastic products) manufacturing 11. textile dying 12. pesticide manufacturing, formulation or wholesale bulk storage 13, resin or plastic monomer manufacturing, formulation or wholesale bulk storage Electrical equipment industries and activities 1. battery (lead acid or other) manufacturing or wholesale bulk storage 2. communications stations using or storing equipment that contains PCBs 3. electrical equipment manufacturing, refurbishing or wholesale bulk storage 4. electrical transmission or distribution substations 5. electronic equipment manufacturing 6. transformer oil manufacture, processine or wholesale bulk storage Metal smelting, processing or finishing industries and activities 1. foundries or scrap metal smelting 2. galvanizing 3. metal plating or finishing 4. metal salvage operations 5, nonlerrous metal smelting or refining 1. asbestos mining, milling, wholesale bulk storage or shipping 2. coal coke manufacture, wholesale bulk storage or shipping 3. coal or lignite mining, milling, wholesale bulk storage or shipping 4, milling reagent manufacture, wholesale bulk storage or shipping 5. nonferrous metal concentrate wholesale bulk storage or shipping 1. appliance, equipment or engine repair, reconditioning, cleaning or salvage 2. ash deposit from boilers, incinerators, or other thermal facilities 3. asphalt tar roofing manufacture, wholesale storage and distribution 4. coal gasification (manufactured gas production) 5. medical, chemical, radiological or biological laboratories 6. rifle or pistol firing ranges 7. road salt storage facilities 8. measuring instruments (containing mercury) manufacture, repair or wholesale bulk storage Petroleum and natural gas drilling, production, processing, retailing and distribution 1. petroleum or natural gas drilling 2. petroleum or natural gas production facilities 3. natural gas processing 4. petroleum coke manufacture, wholesale bulk storage or shipping 5. petroleum product dispensing facilities, including service stations and cardlots 6, petroleum, natural gas or sulphur pipeline rights of way excluding rights of way for pipelines used to distribute natural gas to consumers in a community 7. petroleum or natural gas product or produced water storage in above II ground or underground tanks 3. petroleum product wholesale bulk storage or distribution 9. petroleum refining wholesale bulk storage or shipping 10. solvent manufacturing or wholesale bulk storage 11. sulphur handling, processing or wholesale bulk storage and distribution Transportation industries, operations and related activities 1. aircraft maintenance, cleaning or salvage 2. automotive, truck, bus, subway or other motor vehicle repair, salvage or wrecking 3. bulk commodity storage or shipping (e.g. coal) 4. dry docks, ship building or boat repair 5. marine equipment salvage 6. rail car or locomotive maintenance, cleaning, salvage or related uses, including railyards 7. truck, rail or marine bulk freight handling Waste disposal and recycling operations and activities 1. antifreeze bulk storage or recycling 2. barrel, drum or tank reconditioning or salvage 3. battery (lead acid or other) recycling 4. biomedical waste disposal 5 bulk manure stockpiling and high rate land application or disposal (nonfarm applications only) 6. construction demolition material landfilling 7. contaminated soil storage, treatment or disposal 5. dredged waste disposal 9. drycleaning waste disposal 10. electrical equipment recycling 11. industrial waste lagoons or impoundments 12. industrial waste storage, recycling or landfilling i 3. industrial woodwaste (log yard waste, hogfuel) disposal 14. mine tailings waste disposal 15. municipal waste storage, recycling, composting or landfilling 16. organic or petroleum material landspreading (land/arming) 17. sandblasting waste disposal 18. septic tank pumpage storage or disposal 19. sewage lagoons or impoundments 20. special (hazardous) waste storage, treatment or disposal 21. sludge drying or composting 22. street or yard snow removal dumping 23. waste oil reprocessing, recycling or bulk storage 24. wire reclaiming operations Wood, pulp and paper products and related industries and activities 1. panicle board manufactunng 2. pulp mill operations 3. pulp and paper manufacturing 4. treated wood storage at the site of treatment 5. veneer or plywood manufacturing 6. wafer board manufacturing 7. wood treatment (antisapstain or preservation) 8. wood treatment chemical manufacturing, wholesale bulk storage

16 Introduction SCHEDULE 1 Site Profile Version 4.0 Under section 40 of the Environmental Management Act, a person who knows or reasonably should know that a site has been used or is used for industrial or commercial purposes or activities must in certain circumstances provide a site profile. Schedule 2 ofthe Contaminated Sites Regulation sets out the types ofindustrial or commercial purposes or activities to which site profile requirements apply. Ifsection 40 ofthe Environmental ManagementAct applies toyou andyou know or reasonably should know that the site has been used or is usedfor one ofthe purposes or activities found in Schedule 2 ofthe ContaminatedSites Regulation, you may be requiredto completethe attached site profile. Notes/Instructions: Persons preparing a site profile must complete Section I, II and III, answer all questions in sections IV through IX, and sign section XI. If the site profile is not satisfactorily completed, it will not be processed under the Environmental Management Act and the Contaminated Sites Regulation. Failure to complete the site profile satisfactorily may result in delays in approval of relevant applications and in the postponement ofdecisions respecting the property. The person completing this site profile is responsible for the accuracy of the answers. Questions must be answered to the best of your knowledge. Section 27 (1) of the Freedom of Information and Protection of Privacy Act requires that provision of personal information concerning an individual must be authorized by that individual. Persons completing the site profile on behalfof the site owner must be authorized by the site owner. One(1) site profile may be completed for a site comprised of morethanone titledor untitled parcel, but individual parcels must be identified. The latitude and longitude (accurateto 0.5 of a second using North American Datum established in 1983)of the centre of the site must be provided. Also, please attach an accurate map, containing latitude, longitude and datum references, which shows the boundaries of the site in question. Please use the largest scale map available. If the property is legally surveyed, titled and registered, then all PID numbers (Parcel.IDentifiers - Land Title Registry system) must be provided for each parcel as well as the appropriate legal description. If the property is untitled Crown land (no PID number), then the appropriate PIN numbers (Parcel Identification Numbers - Crown Land registry system)for each parcel with the appropriate land description should be supplied. If available, the Crown Land File Number for the site should also be supplied. Anything submitted in relation to thissiteprofile will become part of the public record and may be made available to the public through the Site Registry as established under the Environmental Management Act. Undersection 43 of the Environmental Management Act, corporate and personal information contained in the site profile may be made available to the public through the'site Registry. If you have questions concerning the collection of this information, contact the Site Registrar, at site(a>gov.bc.ca. For questions on site profiles, please send a message to siteprofilesf^gov.bc.ca.

17 I CONTACT IDENTIFICATION A. Name ofsite Owner: Last First Middle Initial(s) (and/or, ifapplicable) Company. Owner's Civic Address. City Province/State Country, Postal Code/ZIP B. Person Completing Site Profile (Leave blank ifsame as above): Last First Middle Initial(s). Company. (and/or, if applicable) C. Person to Contact Regarding the Site Profile: Last First.Middle Initial(s). (and/or, ifapplicable) Company. Mailing Address. City Province/State Country. Postal Code/ZIP. Telephone ( ) Fax ( ) _ II SITE IDENTIFICATION Please attach a site location map All Property Coordinates (usingthe North American Datum 1983 convention) for the centreof the site: Latitude: Degrees Minutes Seconds Longitude: Degrees Minutes Seconds Please attach a map of appropriate scale showing the boundariesof the site. For Legally Titled, Registered Property Site Street Address (if applicable) City Postal Code -2-

18 PID numbers andassociated legal descriptions. Attach anadditional sheet ifnecessary. PIP Legal Description Total number oftitled parcels represented by this site profile is: For Untitled Crown Land PIN numbers and associated Land Description. Attach an additionalsheet ifnecessary. PIN Land Description Total number of untitled crown land parcels represented by this site profile is:. (and, if available) Crown land file numbers. Attach an additional sheet ifnecessary. Ill COMMERCIAL AND INDUSTRIAL PURPOSES OR ACTIVITIES Please indicate below, in the format of the example provided, which of the industrial and commercial purposes and activities from Schedule 2 have occurred or are occurring on this site. EXAMPLE Schedule 2 Reference El F10 Pleaseprintlegibly. Schedule 2 Reference Description appliance, equipment or engine repair, reconditioning, cleaning or salvage solvent manufacturing or wholesale bulk storage Attach an additional sheet ifnecessary Description -3-

19 IV AREAS OF POTENTIAL CONCERN Is there currently or to the best ofyour knowledge has there previously been on the site any (please mark the appropriate column opposite the question): A. Petroleum, solvent or other polluting substance spills to the environment greater than 100 litres? B. Residue left after removal ofpiled materials such as chemicals, coal, ore, smelter slag, air quality control system baghouse dust? C. Discarded barrels, drums or tanks? YES NO D. Contamination resulting from migration ofsubstances from other properties? V FILL MATERIALS Is there currently or to the best ofyour knowledge has there previously been on the site any deposit of (please mark the appropriate column opposite the question): A. Fill dirt, soil, gravel, sand or like materials from a contaminatedsite or from a source used for any ofthe activities listed under Schedule 2? B. Discarded or waste granular materials such as sand blasting grit, asphalt paving or roofing material, spent foundry casting sands, mine ore, waste rock or float? C. Dredgedsediments, or sedimentsand debris materials originating from locationsadjacent to foreshore industrial activities, or municipal sanitary or stormwater discharges? YES NO VI WASTE DISPOSAL Is there currently or to the best ofyour knowledge has there previously been on the site any landfilling, deposit,spillageor dumping of the following materials (please mark the appropriate column opposite the question): A. Materialssuch as household garbage, mixedmunicipal refuse,or demolition debris? YES NO B. Waste or byproducts such astank bottoms, residues, sludge, or flocculation precipitates from industrial processes or wastewater treatment? C. Waste products from smelting or mining activities, such assmelter slag, mine tailings, or cull materials from coal processing? D. Waste products from natural gasand oil well drilling activities, such as drilling fluids and muds? E. Waste products from photographic developing or finishing laboratories; asphalt tar manufacturing; boilers, incinerators or otherthermal facilities (e.g. ash); appliance, small equipment or engine repair or salvage; drycleaning operations (e.g. solvents); or from thecleaning or repair of parts of boats, ships, barges, automobiles or trucks, including sandblasting gritor paint scrapings?

20 VII TANKS OR CONTAINERS USED OR STORED, OTHER THAN TANKS USED FOR RESIDENTIAL HEATING FUEL Are there currently or to the best ofyour knowledge have there been previously on the site any (please mark the appropriate column opposite the question): A. Underground fuel or chemical storage tanks other than storage tanks for compressed gases? B. Above ground fuel or chemical storage tanks other than storage tanks for compressed gases? YES NO VIII HAZARDOUS WASTES OR HAZARDOUS SUBSTANCES Are there currently or to the best ofyour knowledge have there been previously on the site any (please mark the appropriate column opposite the question): A. PCB-containing electrical transformers or capacitors either at grade, attached above ground to poles, located within buildings, or stored? B. Waste asbestos or asbestos containing materials such as pipe wrapping, blown-in insulation or panelling buried? C. Paints, solvents, mineral spirits or waste pest control products or pest control product containers stored in volumes greater than 205 litres? YES NO IX LEGAL OR REGULATORY ACTIONS OR CONSTRAINTS To the best ofyour knowledge are there currently any of the following pertaining to the site (please mark the appropriate column opposite the question): A. Governmentorders or other notifications pertainingto environmental conditions or quality of soil, water, groundwater or other environmental media? B. Liens to recover costs, restrictive covenants on land use, or other charges or encumbrances, stemming from contaminants or wastes remaining onsite or from other environmental conditions? C. Government notifications relating to past or recurring environmental violations at the site or any facility located on the site? YES NO X ADDITIONAL COMMENTS AND EXPLANATIONS (Note 1: Please listanypastor present government orders, permits, approvals, certificates and notifications pertaining to the environmental condition, use or quality of soil, surface water, groundwater or biota at the site. Note 2: If completed bya consultant, receiver or trustee, please indicate thetypeanddegree of access to information used to completethis site profile. Attach extra pages, if necessary): -5-

21 XI SIGNATURES The person completing the site profile states that the above information is true based on the person's current knowledge as ofthe date completed. Signature of person completing site profile Date completed: (YY-MM-DD) XII OFFICIAL USE Local Government Authority Reason for submission (Pleasecheck one or more of thefollowing) Soil removal Q Subdivision application Zoning application Development permit Q Variance permit Q Demolition permit Date received: Local Government contact Name Date submitted to Site Registrar: Date forwarded to Director ofwaste Management: Agency. Address Telephone Fax Director ofwaste Management Reason for submission (Please check one or more ofthefollowing) Under Order Q Site decommissioning Foreclosure Date received: Assessed by: Name Investigation Required? Decision date: Region. YES NO Telephone Fax Ifsite profile entered, SITE ID #_ Site Registrar Date received: Entered onto Site Registry by: SITE ID #: Entry date: -6-