Ontario Ministry of the Environment - Record of Site Condition #

Ontario Ministry of the Environment - Record of Site Condition # 214588 Record of Site Condition Under Part XV.1 of the Environment Protection Act Summary Record of Site Condition Number 214588 Date Filed to Environmental Site Registry 2014/09/04 Certification Date 2014/01/31 Current Property Use Commercial Intended Property Use Residential Certificate of Property Use Number No CPU Applicable Site Condition Standards** ESA Phase 1 Property Municipal Address 130 JOHN STREET, ATWOOD, ON, N0G 1B0 Notice to Readers Concerning Due Diligence This record of site condition has been filed in the Environmental Site Registry to which the public has access and which contains a notice advising users of the Environmental Site Registry who have dealings with any property to consider conducting their own due diligence with respect to the environmental condition of the property, in addition to reviewing information in the Environmental Site Registry. Contents of this Record of Site Condition This record of site condition consists (RSC) of this document which is available to be printed directly from the Environmental Site Registry as well as all supporting documentation indicated in this RSC to have been submitted in electronic format to the Ministry of the Environment. Filed Record of Site Condition # 214588 on 2014/09/04 1 of 10

PART 1: PROPERTY OWNERSHIP, PROPERTY INFORMATION AND OWNER'S CERTIFICATIONS Information about the owner who is submitting or authorizing the submission of the RSC Owner Name Mailing Address Postal Code JOHN DUTURA DA SILVA 555 WALLACE AVENUE SOUTH, LISTOWEL ONTARIO, CANADA N4W 1Y7 Phone (519) 291-1051 Fax Email Address Filed Record of Site Condition # 214588 on 2014/09/04 2 of 10

RSC Property Location Information Municipal Address(es) Municipality Legal Description Assessment Roll Number(s) Property Identifier Number(s) 130 JOHN STREET, ATWOOD, ON N0G 1B0 North Perth See Attached Lawyer s Letter 31-40-360-008-13200-0000 53042-0111 (LT) RSC Property Geographical References Coordinate System UTM Datum NAD 83 Zone 17 Easting 498,429.00 Northing 4,835,085.00 RSC Property Use Information The following types of property uses are defined by the Regulation: Agricultural or other use, Commercial use, Community use, Industrial use, Institutional use, Parkland use, and Residential use. Current Property Use Intended Property Use Certificate of Property Use has been issued under section 168.6 of the EPA Commercial Residential No Filed Record of Site Condition # 214588 on 2014/09/04 3 of 10

Please See the Signed Statements of Property Owner, or Agent, or Receiver at the End of this RSC The rest of this page has been left intentionally blank Filed Record of Site Condition # 214588 on 2014/09/04 4 of 10

PART 2: LIST OF REPORTS, SUMMARY OF SITE CONDITIONS AND QUALIFIED PERSON S STATEMENTS AND CERTIFICATIONS Qualified Person's Information Name Type of Licence Under Professional Engineers Act IAN MENDES Licence Licence Number 90240714 QP Employer Name Mailing Address GOLDER ASSOCIATES LTD 100, 6925 CENTURY AVENUE, MISSISSAUGA ONTARIO, L5N 7K2 CANADA Phone (519) 404-5348 Fax (905) 567-6561 Email Address ianmendes@primus.ca Municipal Information Local or Single-Tier Municipality Upper-Tier Municipality North Perth Perth Ministry of the Environment District Office District Office District Office Address London District Office 733 Exeter Road, London ON N6E 1L3 Filed Record of Site Condition # 214588 on 2014/09/04 5 of 10

Phase One Environmental Site Assessment Report Document used as the phase one environmental site assessment report and updates in submitting the RSC for filing The date the last work on all of the records review, interviews and site reconnaissance components of the phase one environmental site assessment was done (refer to clause 28(1)(a) of O. Reg. 153/04) (YYYY/MM/DD) 2014/01/28 Type of Report Report Title Date of Report (YYYY/MM/DD) Author of Report Name of Consulting Company P1 ESA Phase One Environmental Site Assessment, 130 John Street, Atwood, Ontario 2014/01/31 Valentina Ulloa, Ian Mendes GOLDER ASSOCIATES LTD. Reports and Other Documents Related to the Phase One Environmental Site Assessment Reports and other documents relied upon in certifying the information set out in section 10 of Schedule A or otherwise used in conducting the phase one environmental site assessment Report Title Date of Report (YYYY/MM/DD) Author of Report Name of Consulting Company N/A Filed Record of Site Condition # 214588 on 2014/09/04 6 of 10

Site Condition Information Certification date (YYYY/MM/DD) 2014/01/31 Total area of RSC property (in hectares) 0.16000 Number of any previously filed RSC that applies to any part of the RSC property Number of any previously filed Transition Notice that applies to any part of the RSC property Soil brought from another property to this RSC property to remain there following the filing of the RSC? No Filed Record of Site Condition # 214588 on 2014/09/04 7 of 10

Qualified Person s Statements and Certifications As the qualified person, I certify that: A phase one environmental site assessment of the RSC property, which includes the evaluation of the information gathered from a records review, site reconnaissance, interviews, a report and any updates required, has been conducted in accordance with the regulation by or under the supervision of a qualified person as required by the regulation. As of 2014/01/31, no phase two environmental site assessment is required by the regulation for the RSC property and based on the phase one environmental site assessment for the RSC property, in my opinion, it is not necessary for any other reason to conduct a phase two environmental site assessment for the RSC property. As of 2014/01/31, in my opinion, based on the phase one environmental site assessment, there is no evidence of any contaminants in the soil, ground water or sediment on, in or under the RSC property that, if the RSC property were put to any of the types of property uses listed in subsection 1 (2) of the regulation, are likely to interfere with any of those types of property uses. I am a qualified person and have the qualifications required by section 5 of the regulation. I have in place an insurance policy that satisfies the requirements of section 7 of the regulation. I acknowledge that the RSC will be submitted for filing in the Environmental Site Registry, that records of site condition that are filed in the Registry are available for examination by the public and that the Registry contains a notice advising users of the Registry who have dealings with any property to consider conducting their own due diligence with respect to the environmental condition of the property, in addition to reviewing information in the Registry. The opinions expressed in this RSC are engineering or scientific opinions made in accordance with generally accepted principles and practices as recognized by members of the environmental engineering or science profession or discipline practising at the same time and in the same or similar location. I do not hold and have not held and my employer GOLDER ASSOCIATES LTD does not hold and has not held a direct or indirect interest in the RSC property or any property which includes the RSC property and was the subject of a phase one or two environmental site assessment or risk assessment upon which this record of site condition is based To the best of my knowledge, the certifications and statements in this part of the RSC are true as of 2014/01/31. By signing this RSC, I make no express or implied warranties or guarantees. By checking the boxes above, and entering my membership/licence number in this submission, I, IAN MENDES, a qualified person as defined in section 5 of O. Reg. 153/04 am, on 2014/08/14: a) signing this record of site condition submission as a qualified person; and b) making all certifications required as a qualified person for this record of site condition. I Agree Filed Record of Site Condition # 214588 on 2014/09/04 8 of 10

Additional Documentation Provided by Property Owner or Agent The following documents have been submitted to the Ministry of the Environment as part of the record of site condition Lawyer s letter consisting of a legal description of the property Copy of any deed(s), transfer(s) or other document(s) by which the RSC property was acquired A Current plan of Survey Table of Current and Past Uses of the Phase One Property Phase 1 Conceptual Site Model Owner or agent certification statements v 4.1.1 Filed Record of Site Condition # 214588 on 2014/09/04 9 of 10

As an owner of the RSC property: 1. I acknowledge that the RSC will be submitted for filing in the Environmental Site Registry, that records of site condition that are filed in the Registry are available for examination by the public and that the Registry contains a notice advising users of the Registry who have dealings with any property to consider conducting their own due diligence with respect to the environmental condition of the property, in addition to reviewing information in the Registry. 2. I have conducted reasonable inquiries to obtain all information relevant to this RSC, including information from the other current owners of the RSC property named in this part of the RSC and I have obtained all information relevant to this RSC of which I am aware. 3. I have disclosed all information referred to in paragraph 2 to any qualified person named in this RSC. 4. To my knowledge, the statements made in this part of the RSC are true as of August 25, 2014. 5. I have ensured that access to the entire property, including the phase one property, any phase two property and the RSC property, has been afforded to the qualified person and to persons supervised by the qualified person, for purposes of conducting the site reconnaissance. Name of Owner - John Da Silva Signature Date Lj Filed Record of Site Condition # 214588 on 2014/09/04 10 of 10

G:\Projects\2013\13-1152-0166\GIS\MXDs\Reporting\SurveyPlan.mxd Phase One Property and RSC Property

August 2014 Table of Current and Past Uses of the Phase One Property 13-1152-0166 Year Name of Owner Description of Property Use Property Use December 21, 1896 to February 12, 1911 February 12, 1911 to March 7, 1937 March 7, 1937 to July 7, 1954 July 7, 1954 to June 30, 1959 June 30, 1959 to February 18, 1969 February 18, 1969 to March 4, 1983 March 4, 1983 to May 16, 2011 Mrs. Elizabeth Forrest Mr. Hugh Anderson Mr. Jessi Hermiston Anderson Mr. Vallance Inglis Mr. Emke Hiemstra and Mrs. Grietje Hiemstra Hiemstra Nursing Home Limited Trillium Mutual Insurance Company (previously named Elma Mutual Fire Insurance Co.) Developed with one main building (house). At some point (circa. 1904), the Site also had a couple of barns. The Phase One Property operated as a nursing home (Hiemstra Nursing Home Limited). The Phase One Property was also used as a residence by Mr. Hiemstra. The Phase One Property was used by Elma Mutual Fire Insurance as offices. Residential Commercial / Residential Commercial Other Observations from Aerial Photographs, Fire Insurance Plans, Etc. The Phase One Property is bounded by King Street to the north and by James Street on the west in the 1904 FIP. Adjacent properties to the east were noted to be residential dwellings and adjacent properties to the south were noted to be a mix of residential and commercial. The Site Representative reported that during the time the Phase One Property operated as a nursing home, the Phase One Property house was modified by enclosing the front porch and turning this area into rooms. The Site Representative reported that, in the early 1990s, an addition was made to the back (north portion) of the Phase One Property house in order to accommodate a boardroom and extra office space. At this time, an asphalt driveway was constructed on the north portion of the Phase One Property to accommodate for parking spaces. May 16, 2011 to Present Mr. John Dutura Da Silva The Phase One Property was reportedly empty for a period of time (until April 2013). At the time of the Site visit, the property was being occupied by a private individual. Commercial The Site Representative indicated that in the early 2000s, the City s sanitary sewer was installed in the area and as such, the Phase One Property s septic system was removed. Golder Associates Ltd. Page 1 of 1

August 2014 13-1152-0166 PHASE ONE CONCEPTUAL SITE MODEL Past Uses of the Phase One Property The Phase One Property appears to have been first developed for residential use in around the late 1800s (circa 1896) and was used as a residence from construction time until approximately 1959. From 1959 to 1969, the Phase One Property was used as a nursing home (Hiemstra Nursing Home Limited). For a period of time, dating from approximately 1969 to early 1983, the Phase One Property was again used as a residence. From 1983 to 2011, the Phase One Property was used as an office by an insurance company (Trillium Mutual Insurance Company, previous named Elma Mutual Fire Insurance Co.). In May 16, 2011 the Phase One Property was purchased by Mr. John Dutura Da Silva and was reportedly unused/empty until April 2013. Current Uses of the Phase One Property Since April 2013, the Phase One Property has been occupied by a private individual. Potentially Contaminating Activity Based on the information obtained as part of this Phase One ESA Report no potentially contaminating activities were identified for the Phase One Property. Areas of Potential Environmental Concern Based on the information obtained as part of this Phase One ESA Report no areas of potential environmental concern were identified for the Phase One Property. Conceptual Site Model With respect to the Phase One ESA Conceptual Site Model ( CSM ), the following key Site features (as required by O. Reg. 153/04) are present in Figures 1, 2 and 3, where applicable: Existing buildings and structures; Drinking water wells on the Phase One Property; Roads (including names) within the Phase One Property; and Uses of properties adjacent to the Phase One Property. There are no water bodies or areas of natural significance (ANSIs) located in whole or in part of the Phase One study area. The nearest open water body identified were waterways, which appear to be branches of the Middle Maitland River and are located approximately 700 m southeast and east, and 820 m north of the Phase One Property, respectively. The Phase One ESA did not identify any potentially contaminating activities ( PCAs ) or areas of potential environmental concern ( APECs ) within/on the Phase One Property. A railway line is located approximately 210 m south of the Phase One Property; based on distance and inferred trans to downgradient location, it is not anticipated to represent and area of potential environmental concern for the Phase One Property. 1/2

August 2014 13-1152-0166 Topography and Drainage The Phase One Property has a relatively flat topography and is at grade with surrounding properties. Surface water drains via either by infiltrating into the grassed areas and/or overland flow towards the neighbouring streets (i.e., John Street and Main Street). Subsurface Utilities The Phase One Property and surrounding area are serviced with sanitary services. Storm sewers do not service the Phase One Property. A natural gas line was reported to connect via the east portion of the Phase One Property; however, it was not confirmed if the natural gas line connects to the Phase One Property house from Main Street or John Street. A telephone line connection box is located on the southeast corner of the Site and on the northeast perimeter of the Phase One Property. No evidence of existing or potential contamination was identified and as such the underground utilities are not considered to be a concern for contaminant distribution or transport. Geological Conditions Encountered On-site Based on a review of the EcoLog ERIS Water Well Information System, subsurface soils in the vicinity of the Phase One Property consist of a layer of top soil overlying overlying clay or a mixture of clay, gravel, sand and/or silt followed by bedrock between 16.45 to 68 m bgs (54 to 223 ft bgs). In some wells, a layer of hardpan was also recorded between the clay layer and bedrock. Groundwater is inferred to flow southeast-east towards a branch of the Middle Maitland River, located approximately 700 metres southeast and east of the Phase One Property. The reported static water level reported for the water wells ranged from approximately 1.5 to 7 m bgs (5 to 23 ft bgs). Uncertainty and Absence of Information There were no material deviations to the Phase One ESA requirements set out in O.Reg. 153/04, including Schedule D that would cause uncertainty or absence of information that would affect the validity of the findings of this assessment. \\golder.gds\gal\mississauga\active\2013\1152\13-1152-0166 john 'silva landscaping and paving\rsc attachments\3rd rsc submission aug\5-phase one conceptual model\d'silva phase one property description_aug.docx 2/2

4838000 496000 498000 78 LINE 500000 ³ 4838000 75 LINE HIGHWAY 23 77 LINE 166 ROAD MONUMENT ROAD! QUEEN STREET MAIN STREET Atwood PHASE ONE PROPERTY Elma 75 LINE 4834000 4834000 4836000 4836000 Newry PERTH 72 LINE 158 ROAD HIGHWAY 23 G:\Projects\2013\13-1152-0166\GIS\MXDs\Reporting\Figure1_SiteLocationPlan.mxd 4832000 496000 69 LINE LEGEND! Phase One Property Location Roads Railways Watercourse Waterbody Wooded Areas REFERENCE Base Data - MNR LIO, obtained 2009 Produced by Golder Associates Ltd under licence from Ontario Ministry of Natural Resources, Queens Printer 2012 Projection: Transverse Mercator Datum: NAD 83 Coordinate System: UTM Zone 17 498000 Lake Huron! Goderich!! Georgian Bay Owen Sound Barrie Site Location %! Kitchener! INDEX MAP PROJECT TITLE 500000 500 250 0 500 1,000 1,500 SCALE 1:30,000 PHASE ONE ENVIRONMENTAL SITE ASSESSMENT 130 JOHN STREET, ATWOOD, ONTARIO SITE LOCATION PLAN PROJECT NO. 13-1152-0166 DESIGN ME 5 Sep. 2013 GIS ME 5 Sep. 2013 CHECK VU 5 Sep. 2013 Mississauga, Ontario REVIEW METRES SCALE AS SHOWN 4832000 REV. 0.0 FIGURE: 1

498200 498400 498600 498800 LEGEND 4835400 ³ 4835400 Railway Inferred Groundwater Flow Phase One Property Site Buffer (250m from Property Boundary) 1 182-196 Main Street: Mix of Commercial & Residential 2 200-222 Main Street: Mainly Commercial 3 131 John Street: Atwood United Church 4 141 John Street: Funeral Home G:\Projects\2013\13-1152-0166\GIS\MXDs\Reporting\Figure2_SiteAndSurroundLandUsePlan.mxd 4834800 4835000 4835000 4835200 4835200 498200 498400 498600 498800 4834800 REFERENCE Base Data - MNR LIO, obtained 2009 Produced by Golder Associates Ltd under licence from Ontario Ministry of Natural Resources, Queens Printer 2012 Imagery: Bing Maps 2014 Microsoft Corporation and its data suppliers Projection: Transverse Mercator Datum: NAD 83 Coordinate System: UTM Zone 17 PROJECT TITLE 50 25 0 50 100 150 SCALE 1:4,000 METRES PHASE ONE ENVIRONMENTAL SITE ASSESSMENT 130 JOHN STREET, ATWOOD, ONTARIO SITE AND SURROUNDING LAND USE PROJECT NO. 13-1152-0166 SCALE AS SHOWN DESIGN ME 13 Sep. 2013 GIS ME 21 Apr. 2014 CHECK VU 21 Apr. 2014 Mississauga, Ontario REVIEW REV. 0.0 FIGURE: 2

³ LEGEND!A Water Well (Approximate Location) Phase One Property!A G:\Projects\2013\13-1152-0166\GIS\MXDs\Reporting\Figure3_SiteLayout.mxd REFERENCE Projection: Transverse Mercator Datum: NAD 83 Coordinate System: UTM Zone 17 PROJECT TITLE 5 2.5 0 5 10 15 SCALE 1:500 PHASE ONE ENVIRONMENTAL SITE ASSESSMENT 130 JOHN STREET, ATWOOD, ONTARIO SITE LAYOUT METRES PROJECT NO. 13-1152-0166 SCALE AS SHOWN DESIGN ME 13 Sep. 2013 GIS ME 21 Apr. 2014 CHECK VU 21 Apr. 2014 Mississauga, Ontario REVIEW REV. 0.0 FIGURE: 3