Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2013-2568
2. Registrant Information.
Registrant Reference Number: DAS12071100
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.
11-JUL-12
5. Location of incident.
Country: CANADA
Prov / State: ALBERTA
6. Date incident was first observed.
Unknown
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. 28517
PMRA Submission No.
EPA Registration No.
Product Name: Milestone Herbicide
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: Res. - Out Home / Rés - à l'ext.maison
11. Provide any additional information regarding application (how it was applied, amount applied, the size of the area treated etc).
Five acres were treated and 7-8 trees affected. Applicator stayed outside of dripline but application rate was too high - new machinery and calibration was off. Issue has been fixed by applicator. Root uptake of poplar trees is thought to be the issue.
To be determined by Registrant
12. In your opinion, was the product used according to the label instructions?
No
Subform IV: Environment (includes plants insects and wildlife)
1. Type of organism affected
Trees or shrubs / Arbre ou arbuste
2. Common name(s)
Poplar
3. Scientific name(s)
Unknown
4. Number of organisms affected
8
5. Description of site where incident was observed
Fresh water
Terrestrial
Residential
Salt Water
6. Check all symptoms that apply
Visible injury ( eg. chlorosis, necrosis, bleaching)
7. Describe symptoms and outcome (died, recovered, etc.).
These are 40ft trees and possibly 5-8 trees will need to be replaced. 15 trees are showing partial effects. Will wait until next year to determine exact number of trees that need to be replaced.
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?
Unknown
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