Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2013-2561
2. Registrant Information.
Registrant Reference Number: DAS12080900
Registrant Name (Full Legal Name no abbreviations): Dow AgroSciences Canada Inc.
Address: Suite 2100, 450 - 1 Street S.W.
City: Calgary
Prov / State: Alberta
Country: Canada
Postal Code: T2P 5H1
3. Select the appropriate subform(s) for the incident.
Environment
4. Date registrant was first informed of the incident.
09-AUG-12
5. Location of incident.
Country: CANADA
Prov / State: ALBERTA
6. Date incident was first observed.
06-JUL-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. 29751
PMRA Submission No.
EPA Registration No.
Product Name: Reclaim A
- Active Ingredient(s)
- AMINOPYRALID
- METSULFURON-METHYL
PMRA Registration No. 29750
PMRA Submission No.
EPA Registration No.
Product Name: Reclaim B
- Active Ingredient(s)
- 2,4-D (PRESENT AS LOW VOLATILE ESTERS)
7. b) Type of formulation.
Application Information
8. Product was applied?
Yes
9. Application Rate.
Unknown
10. Site pesticide was applied to (select all that apply).
Site: Agricultural-Outdoor/Agricole-extérieur
Préciser le type: Box Elder, Willows, Mountain Ash, oak, a plum tree as well as; raspberries, peas, beans, potatoes, and onions
11. Provide any additional information regarding application (how it was applied, amount applied, the size of the area treated etc).
20 acres/case of the product was applied by helicopter on July 6, 2012. Concerned neighbours adjacent to the treated area contacted the applicator a couple of weeks later to report that some of their trees and garden were showing symptoms of herbicide damage.
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
Herbaceous Plants / Plante herbacée
2. Common name(s)
raspberries, peas, beans, potatoes, and onions
3. Scientific name(s)
Unknown
4. Number of organisms affected
Unknown
5. Description of site where incident was observed
Fresh water
Terrestrial
Residential
Agricultural
Salt Water
6. Check all symptoms that apply
Visible injury ( eg. chlorosis, necrosis, bleaching)
7. Describe symptoms and outcome (died, recovered, etc.).
Trees and vegetables were showing symptoms of herbicide damage i.e. browning and cupping of the leaves.
8. a) Was the incident a result of (select all that apply)
Application
N/A
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)
Minor
13. Please provide supplemental information here
Subform IV: Environment (includes plants insects and wildlife)
1. Type of organism affected
Trees or shrubs / Arbre ou arbuste
2. Common name(s)
Box Elder, Willows, Mountain Ash, Oak, a plum tree as well
3. Scientific name(s)
Unknown
4. Number of organisms affected
Unknown
5. Description of site where incident was observed
Fresh water
Terrestrial
Residential
Agricultural
Salt Water
6. Check all symptoms that apply
Visible injury ( eg. chlorosis, necrosis, bleaching)
7. Describe symptoms and outcome (died, recovered, etc.).
Trees and vegetables were showing symptoms of herbicide damage i.e browning and cupping of the leaves
8. a) Was the incident a result of (select all that apply)
Application
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)
Minor
13. Please provide supplemental information here