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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2012-4382

2. Registrant Information.

Registrant Reference Number: x

Registrant Name (Full Legal Name no abbreviations): x

Address: x

City: x

Prov / State: x

Country: x

Postal Code: X

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

Environment

4. Date registrant was first informed of the incident.

5. Location of incident.

Country: CANADA

Prov / State: SASKATCHEWAN

6. Date incident was first observed.

22-AUG-12

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. 14879      PMRA Submission No.       EPA Registration No.

Product Name: Lorsban 4E Insecticide

  • Active Ingredient(s)
    • CHLORPYRIFOS

7. b) Type of formulation.

Application Information

8. Product was applied?

Yes

9. Application Rate.

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

Site: Agricultural-Indoor / Agricole-intérieur

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

aerial application

To be determined by Registrant

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

Unknown

Subform IV: Environment (includes plants insects and wildlife)

1. Type of organism affected

Terr. Invrtbrt-Honey Bee/Inv.Ter-Abeille

2. Common name(s)

Unknown

3. Scientific name(s)

Unknown

4. Number of organisms affected

Unknown

5. Description of site where incident was observed

Fresh water

Terrestrial

Agricultural

Salt Water

6. Check all symptoms that apply

Death

7. Describe symptoms and outcome (died, recovered, etc.).

No information at this time regarding scope of incident(s) in terms of number bee yards/colonies or of total bees lost etc.:however, likely affected majority or all of adult foraging bees at the affected bee yard(s). Average bee yard in SK IS 24-48 COLONIES. At 50000 bees per colony and at 40 losses, a reasonable estimate might be 0.5 - 1.0 million bees lost per affected bee yard.Hives were healthy prior, no nozema, afb. Fall mite counts were low. beekeeper does spring treatments with Apivar for mite control. Topography: less than a mile to the west there was blooming canola, in between was canola that had finished blooming. The spraying was throughout the half-section of canola that had mostly completed blooming. The spraying was witnessed by others that recounted it to the beekeeper later. Spraying started - water sources - would be sloughs within 400ft of the yards. Weather on day of application was beautiful and sunny.

8. a) Was the incident a result of (select all that apply)

Unknown

8. b) i) How many times has the product been applied this year?

Unknown

8. b) ii) What was the date of the last application?

Unknown

9. Did it rain

9. a) During application?

Unknown

9. b) Up to 3 days after application?

Unknown

10. a) Was there a buffer zone?

Unknown

10. b) What type?

10. c) What was the size of the buffer zone?

11. a) Were environmental samples collected and analysed?

No

To be determined by Registrant

12. Severity classification (if there is more than one possible classification, select the most severe)

13. Please provide supplemental information here