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Consumer Product Safety

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