Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2014-1947

2. Registrant Information.

Registrant Reference Number: DAS130724-00

Registrant Name (Full Legal Name no abbreviations): Dow AgroSciences Canada Inc.

Address: Suite 2100, 450-1st Street S.W.

City: Alberta

Prov / State: Calgary

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.

24-JUL-13

5. Location of incident.

Country: CANADA

Prov / State: SASKATCHEWAN

6. Date incident was first observed.

24-JUN-13

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)

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PMRA Registration No. 27634      PMRA Submission No.       EPA Registration No.

Product Name: Grazon Herbicide

• Active Ingredient(s)
  • 2,4-D (PRESENT AS AMINE SALTS : DIMETHYLAMINE SALT, DIETHANOLAMINE SALT, OR OTHER AMINE SALTS)
  • PICLORAM (PRESENT AS AMINE SALTS)

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7. b) Type of formulation.

Application Information

8. Product was applied?

Yes

9. Application Rate.

2.8

Other Units: L/ac

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

Site: Agricultural-Outdoor/Agricole-extérieur

Préciser le type: alfalfa/grass hay field

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

A fixed wing aerial applicator was hired to apply Grazon at 2.8 L/ac onto a pasture. The neighbouring land owner is alleging drift of Grazon onto his adjacent mixed alfalfa/grass hay field. Approximately 86ac have been affected. It is unknown if the product was used according to the label instructions.

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)

Alfalfa and grass hay field

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

Abnormal leaf discoloration

Epinasty (leaf wilt)

Visible injury ( eg. chlorosis, necrosis, bleaching)

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

An agrologist inspected the field and the alfalfa is brown and bending over.

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

Drift

N/A

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

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

9. Did it rain

9. a) During application?

No

9. b) Up to 3 days after application?

No

10. a) Was there a buffer zone?

No

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