Search Results | Clear Search | Previous (in doc) | Next (in doc) | Prev Doc | Next Doc
B.C. Reg. 375/96
O.C. 1480/96
Deposited December 16, 1996
effective April 1, 1997
This consolidation is current to October 31, 2017.
See “Amendments Not in Force” for amendments
effective after October 31, 2017.
Link to Point in Time

Environmental Management Act

Contaminated Sites Regulation

[includes amendments up to B.C. Reg. 184/2016, July 19, 2016]

Schedule 1

[am. B.C. Regs. 17/2002, ss. 15 to 19; 343/2008, s. 10.]

Site Profile

All Information Must be Provided and All Questions Answered

I. CONTACT IDENTIFICATION

A. Name of Site Owner:

Last .................................................... First ....................................... Middle Initial(s) ................... (and / or, if applicable)

Company ........................................................................................................................................................................

Owner's Civic Address .....................................................................................................................................................

City ...................................................................... Province/State ................................................................

Country ................................................................ Postal Code/ZIP ..............................................................

B. Person Completing Site ProfileLeave blank if same as above:

Last .................................................... First....................................... Middle Initial(s) ................... (and / or, if applicable)

Company .......................................................................................................................................................................

C. Person to Contact Regarding the Site Profile:

Last .................................................... First....................................... Middle Initial(s) ................... (and / or, if applicable)

Company ........................................................................................................................................................................

Mailing Address ...............................................................................................................................................................

City ...................................................................... Province/State ...............................................................

Country ................................................................ Postal Code/ZIP .............................................................

Telephone (...........) ................. -................................ Fax (...........) ................ -..........................................

II. SITE IDENTIFICATION

Please attach a site location map

All Property:

Coordinates (using the North American Datum 1983 convention) for the centre of the site:

Latitude: Degrees ............................ Minutes .......................... Seconds ................................

Longitude: Degrees ............................ Minutes .......................... Seconds ................................

Please attach a map of appropriate scale showing the boundaries of the site.

For Legally Titled, Registered Property

Site Street Address
 ....................................................................................................................................................................

City ..................................................................... Postal Code .....................................................................

PID numbers and associated legal descriptions. Attach an additional sheet if necessary.

PIDLegal Description
..............................................................................................................................................................................
..............................................................................................................................................................................
..............................................................................................................................................................................
..............................................................................................................................................................................
..............................................................................................................................................................................

Total number of titled parcels represented by this site profile is: ..............................

For Untitled Crown Land

PIN numbers and associated land description. Attach an additional sheet if necessary.

PINLand 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 if necessary.

III. 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 2Description
Reference
E1appliance, equipment or engine repair, reconditioning, cleaning or salvage
F10solvent manufacturing or wholesale bulk storage
...................................................................................................................................................................................
Please print legibly. Attach an additional sheet if necessary
Schedule 2Description
Reference
.................................................................................................................................................................................
.................................................................................................................................................................................
.................................................................................................................................................................................
.................................................................................................................................................................................
.................................................................................................................................................................................
IV. AREAS OF POTENTIAL CONCERN
 Is there currently or to the best of your knowledge has there previously been on the site any(please mark the appropriate column opposite the question):YESNO
APetroleum, solvent or other polluting substance spills to the environment greater than 100 litres?  
BResidue left after removal of piled materials such as chemicals, coal, ore, smelter slag, air quality control system baghouse dust?  
CDiscarded barrels, drums or tanks?  
DContamination resulting from migration of substances from other properties?  
V. FILL MATERIALS
 Is there currently or to the best of your knowledge has there previously been on the site any deposit of(please mark the appropriate column opposite the question):YESNO
AFill dirt, soil, gravel, sand or like materials from a contaminated site or from a source used for any of the activities listed under Schedule 2?  
BDiscarded or waste granular materials such as sand blasting grit, asphalt paving or roofing material, spent foundry casting sands, mine ore, waste rock or float?  
CDredged sediments, or sediments and debris materials originating from locations adjacent to foreshore industrial activities, or municipal sanitary or stormwater discharges?  
VI. WASTE DISPOSAL
Is there currently or to the best of your knowledge has there previously been on the site any landfilling, deposit, spillage or dumping of the following materials (please mark the appropriate column opposite the question):YESNO
AMaterials such as household garbage, mixed municipal refuse, or demolition debris?  
BWaste or byproducts such as tank bottoms, residues, sludge, or flocculation precipitates from industrial processes or wastewater treatment?  
CWaste products from smelting or mining activities, such as smelter slag, mine tailings, or cull materials from coal processing?  
DWaste products from natural gas and oil well drilling activities, such as drilling fluids and muds?  
EWaste products from photographic developing or finishing laboratories; asphalt tar manufacturing; boilers, incinerators or other thermal facilities (e.g. ash); appliance, small equipment or engine repair or salvage; dry cleaning operations (e.g. solvents); or from the cleaning or repair of parts of boats, ships, barges, automobiles or trucks, including sandblasting grit or paint scrapings?  
VII. TANKS OR CONTAINERS USED OR STORED, OTHER THAN TANKS USED FOR
RESIDENTIAL HEATING FUEL
 Are there currently or to the best of your knowledge have there been previously on the site any(please mark the appropriate column opposite the question):YESNO
AUnderground fuel or chemical storage tanks other than storage tanks for compressed gases?  
BAbove ground fuel or chemical storage tanks other than storage tanks for compressed gases?  
VIII. HAZARDOUS WASTES OR HAZARDOUS SUBSTANCES
 Are there currently or to the best of your knowledge have there been previously on the site any(please mark the appropriate column opposite the question):YESNO
APCB-containing electrical transformers or capacitors either at grade, attached above ground to poles, located within buildings, or stored?  
BWaste asbestos or asbestos containing materials such as pipe wrapping, blown-in insulation or panelling buried?  
CPaints, solvents, mineral spirits or waste pest control products or pest control product containers stored in volumes greater than 205 litres?  
IX. LEGAL OR REGULATORY ACTIONS OR CONSTRAINTS
 To the best of your knowledge are there currently any of the following pertaining to the site(please mark the appropriate column opposite the question):YESNO
AGovernment orders or other notifications pertaining to environmental conditions or quality of soil, water, groundwater or other environmental media?  
BLiens 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?  
CGovernment notifications relating to past or recurring environmental violations at the site or any facility located on the site?  

X. ADDITIONAL COMMENTS AND EXPLANATIONS

(Note 1: Please list any past or 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 by a consultant, receiver or trustee, please indicate the type and degree of access to information used to complete this site profile):

XI. SIGNATURES

The person completing the site profile states that the above information is true, based on the person's current knowledge as of the date completed.

....................................................................................................................................................
Signature of person completing site profileDate completed: (YY-MM-DD)

Contents | Parts 1 to 18 | Schedule 1 | Schedule 1.1 | Schedule 2 | Schedule 3 | Schedule 4 | Schedule 5 | Schedule 6 | Schedule 7 | Schedule 8 | Schedule 9 | Schedule 10 | Schedule 11