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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2011-2586

2. Registrant Information.

Registrant Reference Number: PROSAR Case #: 1-26349056

Registrant Name (Full Legal Name no abbreviations): Syngenta Crop Protection Canada, Inc.

Address: 140 Research Lane, Research Park

City: Guelph

Prov / State: Ontario

Country: Canada

Postal Code: N1G4Z3

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

Packaging Failure

4. Date registrant was first informed of the incident.

01-JUN-11

5. Location of incident.

Country: CANADA

Prov / State: MANITOBA

6. Date incident was first observed.

01-JUN-11

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. 19346      PMRA Submission No.       EPA Registration No.

Product Name: Tilt 250E Fungicide

  • Active Ingredient(s)
    • PROPICONAZOLE

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?

Jug-plastic / Cruche-plastique

2. Did packaging failure occur during?

Transportation

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.

1-26349056- The reporter indicates a package failure involving a fungicide containing the active ingredient propiconazole. The reporter, a warehouse customer service employee, indicates an 8 liter jug of the product was being transported by truck the day of initial report. At the point of transfer from the truck to the warehouse where the product was to be stored the jug was reported to have leaked. The reporter was unable to verify the volume leaked or the point of the package which had failed. The product had been effectively contained and cleaned at the time of report. No exposure or environmental injury was noted. No further information is available.

For Registrant use only

5. Provide supplemental information here.