Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2015-1691
2. Registrant Information.
Registrant Reference Number: DASC140703-00
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.
03-JUL-14
5. Location of incident.
Country: CANADA
Prov / State: SASKATCHEWAN
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. 29985
PMRA Submission No.
EPA Registration No.
Product Name: Tandem A Herbicide
PMRA Registration No. 29965
PMRA Submission No.
EPA Registration No.
Product Name: Tandem B Herbicide
- Active Ingredient(s)
- FLUROXYPYR 1-METHYLHEPTYL ESTER
PMRA Registration No.
PMRA Submission No.
EPA Registration No. Unknown
Product Name: Liberty 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: Agricultural-Outdoor/Agricole-extérieur
Préciser le type: unknown
11. Provide any additional information regarding application (how it was applied, amount applied, the size of the area treated etc).
Caller explained that his neighbour allegedly drifted Tandem Herbicide onto 150 acres of his peas. The caller also alleges that his neighbour had drifted Liberty herbicide onto his wheat in the same field, the year previous. Trees on his property were also alleged to be affected.
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)
field peas
3. Scientific name(s)
n/a
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
Stunted vegetative growth
Visible injury ( eg. chlorosis, necrosis, bleaching)
7. Describe symptoms and outcome (died, recovered, etc.).
Yellowing and stunting of field peas
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
n/a
Subform IV: Environment (includes plants insects and wildlife)
1. Type of organism affected
Trees or shrubs / Arbre ou arbuste
2. Common name(s)
Unknown
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
Visible injury ( eg. chlorosis, necrosis, bleaching)
7. Describe symptoms and outcome (died, recovered, etc.).
Trees on property were affected by the drift.
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
n/a