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Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2011-2590

2. Registrant Information.

Registrant Reference Number: PROSAR Case #: 1-26423600

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.

5. Location of incident.

Country: CANADA

Prov / State: QUEBEC

6. Date incident was first observed.

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.

PMRA Registration No. 25730      PMRA Submission No.       EPA Registration No.

Product Name: Primextra II Magnum

• Active Ingredient(s)
  • ATRAZINE (PLUS RELATED ACTIVE TRIAZINES)
  • S-METOLACHLOR AND R-ENANTIOMER

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?

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.

1-26423600- The reporter, an employee of the registrant, indicates a package failure involving an herbicide containing the active ingredients atrazine (and related triazines), and s-metolachlor. The caller indicates one jug had leaked an undisclosed volume of the product on 18 adjacent jugs while in storage. This was reported to occur just before the call. The caller had indicated the product had been cleaned at the point of the call and no environmental injury or exposure had occurred. The caller did not clarify from where (on the package itself) the leak had occurred. No further information is available.

For Registrant use only

5. Provide supplemental information here.