Form | Consent to Access Property for Residential Soil Assessment Please complete the form below to proceed with the Soil Assessment Process. Your Name* First Last Your Email* Enter Email Confirm Email Daytime Phone*Best way to reach you: Phone call Text Email (NOTE: Please check your "Junkmail" folder as we have experienced emails not reaching people) We call to schedule testing primarily during office hours, Mon-Fri from 8-4. Please use the "Comments" section below for specific requirements or instructions. Address of Property to be Tested* Street Address Area: Trail, Warfield, Oasis, Rivervale, Casino, Waneta, Montrose AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code I am the:* Owner Tenant Property Manager Mailing Address of Property Owner Same as above Results will be sent here Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Are there children on the property?* Yes No Please indicate the date of birth of the youngest child. MM slash DD slash YYYY If unknown (ie. for a tenant) please indicate a contact method for the resident in the "Comments" section below so we may connect with them. Alternatively, have them fill out a "First Contact Questionnaire" which is available on the website as well. How many days a week do children LIVE at the property?Please enter a number from 1 to 7.(16-24hr periods at this address)How many days a week do children VISIT the property?Please enter a number from 1 to 7.(Less than 16 hours, including after school care, daytime babysitting, regular visits, etc) Feel free to leave clarification in the "Comments" section below. What is your relationship to the child? (ie. Mother, Father, Uncle, Aunt, Friend) Are you expecting? Yes No Please indicate the due date MM slash DD slash YYYY Are there dogs, fences or other safety/access concerns on your property?* Yes No If Yes, please check all that apply: Dogs will be in the yard Fences are locked and require homeowner for access Stairs or structures on the property are in poor condition and may pose a safety risk Other (please explain in Comments section) We will follow-up with you for discussion. Details or further clarification can be noted in the "Comments" section belowAre there tenants on the property?* Yes No Consent to inform tenants I consent to release the results to my current tenant(s)Tenants Name First Last Tenants Phone Number*Would you like to be home while soil testing is carried out?*Soil testing is done outside, with physical distancing measures in place and does not require household presence. For scheduling purposes, please indicate if you want to be home when the Home & Garden (H&G) representative does soil testing. We will call you before coming to the property either way. Yes, I would like to be home when the H&G representative does soil testing. No, I do not need to be home when the H&G representative does soil testing. Are you interested in learning how to make your home FireSmart with the help of the RDKB and BC Wildfire Service?Would you like to be contacted to book a FREE Home Ignition Assessment. Yes please sign me up for this free assessment No thank you Consent to Access Property I consent to officers, employees, and parties authorized by Teck Metals Ltd. (Teck) for the Trail Area Health and Environment Program, Home and Garden Program1 entering and having access to my property at the above address for the following purposes: Performing a property inspection including a property inspection and owner interview; Collecting soil samples from across the yard (lawn areas) and from vegetable and/or flower gardens (if applicable) to a depth of approximately 15 cm below ground surface, and Obtaining photographs and drawings to record soil assessment activities and ground cover. I realize these actions are taken in order to assess the presence of historical smelter-related metals in surface soils, and that a factual report presenting the results of the assessment for the property will be provided to me when completed. I understand and agree that results of this soil testing may be shared with the BC Ministry of Environment and/or Interior Health. This written permission is given by me voluntarily with knowledge of my right to refuse and without threats or promises of any kind. This agreement is only for the purposes described above and for no other work. 1. Delivered by SNC-Lavalin Environment and Water, Division of SNC Lavalin Inc. on behalf of Teck Agreement* I grant access to my property and hereby warrant that I have the authority to make this agreementCOVID-19 Resident Interaction Acknowledgement In response to the COVID-19 pandemic, the Home & Garden (H&G) Team has developed safety protocols to adapt interactions with property owners, residents, and members of the community (referred to as residents) during the 2020 field season. The intention of this document is to align our work with the direction provided from the Ministry of Health (www.gov.bc.ca) in order to work safely within the COVID-19 crisis. The H&G team provides a range of services and may include the following activities: obtaining access consent, on-site planning, delivery of supplies, soil testing, soil excavation, landscaping, and lawn care treatment. H&G staff and our contractors will be abiding by the following safety protocols to minimize the risks of COVID-19 transmission: Property access consents will be submitted online at www.thep.ca or emailed to email@example.com. H&G staff and contractors will NOT enter residences. Residents will be contacted to determine the preferred way to interact (eg. text, video call, phone). Documents that require review or approval will be sent electronically. When H&G staff and contractors are on the property to complete field activities (i.e. ground-cover evaluation, property walk-throughs, excavation monitoring, soil testing, etc. they will take the following precautions: Text or call the resident to note their arrival (instead of knocking on the door). Avoid physical contact such as handshakes when greeting people. Maintain a distance of 2 metres (m) apart from residents while on site. Wear clean nitrile gloves when delivering supplies to be left for the resident (e.g. garden kits or hoses). Reduce in-person meetings to virtual meetings and hold site meetings outside while maintaining physical distancing requirements. Provide a scheduled daily phone or email check-in with the resident at active sites. H&G staff and contractors always follow rigorous health and safety protocols and have adapted work practices to include COVID-19 hygiene best practices including daily personal health monitoring, frequent hand washing, and disinfecting high touch surfaces Note that because of this situation, delays in providing services may be experienced. Please help us by abiding by the following guidelines to help keep our community safe. Without these measures, we will not be able to provide yard and garden programs. COVID-19 Acknowledgement* I acknowledge having the read the above stated precautions and am comfortable to proceed.CommentsAny other information you would like to share with us? Signature*Please note that all information collected is confidential and will not be sharedPhoneThis field is for validation purposes and should be left unchanged.