Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2015-1603
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.
Domestic Animal
4. Date registrant was first informed of the incident.
5. Location of incident.
Country: CANADA
Prov / State: MANITOBA
6. Date incident was first observed.
02-AUG-14
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. 23705
PMRA Submission No.
EPA Registration No.
Product Name: PYRINEX 480EC FOR FOOD CROPS
PMRA Registration No. 30332
PMRA Submission No.
EPA Registration No.
Product Name: VERTISAN FUNGICIDE
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: Sunflower field
11. Provide any additional information regarding application (how it was applied, amount applied, the size of the area treated etc).
Both products above were tank mixed and applied via Aerial application. Product was applied to a sunflower field during bloom. Restriction on the label of Pyrinex indicates it should not be applied during bloom.
The pond was sprayed via aerial application. Water was tested and showed to have levels of 0.0046ml/litre (4.6ppb) chlorpyrifos. Sample taken three days after spraying (August 5, 2014). Application was drift off field and occured one time.
To be determined by Registrant
12. In your opinion, was the product used according to the label instructions?
Unknown
Subform III: Domestic Animal Incident Report
1. Source of Report
Animal's Owner
2. Type of animal affected
Fish / Poisson
3. Breed
Rainbow Trout
4. Number of animals affected
100
5. Sex
Unknown
6. Age (provide a range if necessary )
Unknown
7. Weight (provide a range if necessary )
Unknown
8. Route(s) of exposure
Skin
Eye
Oral
Respiratory
9. What was the length of exposure?
Unknown / Inconnu
10. Time between exposure and onset of symptoms
Unknown / Inconnu
11. List all symptoms
System
- General
- Symptom - Death
- Symptom - Lethargy
12. How long did the symptoms last?
>3 days <=1 wk / >3 jours <=1 sem
13. Was medical treatment provided? Provide details in question 17.
Unknown
14. a) Was the animal hospitalized?
Unknown
14. b) How long was the animal hospitalized?
15. Outcome of the incident
Died
16. How was the animal exposed?
Spray drift / Dérive de pulvérisation
17. Provide any additional details about the incident
(eg. description of the frequency and severity of the symptoms
Initially found the first few fish floating dead and noticed some swimming lethargically around the shore. As the week progressed more and more fish were found dead. Some of the fish seemed to be diving down under weeds and grasses and seemed to be trying to get away from affected water. Found dead fish along shore and along bottom of the pond. All fish in pond died within a week. Along with fish, also found dead birds, dragonflies, frogs and many other insects in and around the pond.Concern about bees and other insects around the field. There are three yards located close to the sunflower field that was sprayed during blooming. Bees would have been in the field so is concerned with their exposure and potential drift onto the bee yards.
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Not Applicable
19. Provide supplemental information here