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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2009-5223

2. Registrant Information.

Registrant Reference Number: 2009-05

Registrant Name (Full Legal Name no abbreviations): Interprovincial Cooperative Limited (IPCO)

Address: 945 Marion Street

City: Winnipeg

Prov / State: Manitoba

Country: Canada

Postal Code: R2J 0K7

3. Select the appropriate subform(s) for the incident.

Packaging Failure

4. Date registrant was first informed of the incident.

30-NOV-09

5. Location of incident.

Country: CANADA

Prov / State: MANITOBA

6. Date incident was first observed.

30-NOV-09

Product Description

7. a) Provide the active ingredient and, if available, the registration number and product name (include all tank mixes). If the product is not registered provide a submission number.

Active(s)

PMRA Registration No. 27988      PMRA Submission No.       EPA Registration No.

Product Name: IPCO Factor 540 Liquid Herbicide

  • Active Ingredient(s)
    • GLYPHOSATE (PRESENT AS POTASSIUM SALT)

7. b) Type of formulation.

Application Information

8. Product was applied?

Unknown

9. Application Rate.

10. Site pesticide was applied to (select all that apply).

11. Provide any additional information regarding application (how it was applied, amount applied, the size of the area treated etc).

To be determined by Registrant

12. In your opinion, was the product used according to the label instructions?

Unknown

Subform VI: Packaging Failure

1. What is the type of packaging that failed?

Tank tote / Cuve

2. Did packaging failure occur during?

Storage

3. Did packaging failure result in?

potential exposure

4. Describe how the packaging failed and the surrounding circumstances, including a description of the potential injury or exposure.

A Factor 540, 450 litre plastic tote was found to be leaking in a distribution warehouse. The warehouse operator noticed a small amount of liquid (less than 1 litre) had leaked from the bottom of the tote.

For Registrant use only

5. Provide supplemental information here.

No exposure reported. The defect in the tote was not repairable and the tote was disposed of in an appropriate manner.