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Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2015-1882
2. Registrant Information.
Registrant Reference Number: 2015-23-04
Registrant Name (Full Legal Name no abbreviations): Syngenta Canada Inc.
Address: 140 Research Lane, Research Park
City: Guelph
Prov / State: Ontario
Country: Canada
Postal Code: N1G 4Z3
3. Select the appropriate subform(s) for the incident.
Packaging Failure
4. Date registrant was first informed of the incident.
22-APR-15
5. Location of incident.
Country: CANADA
Prov / State: MANITOBA
6. Date incident was first observed.
22-APR-15
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. 28354
PMRA Submission No.
EPA Registration No.
Product Name: Daconil Ultrex
7. b) Type of formulation.
Application Information
8. Product was applied?
No
9. Application Rate.
10. Site pesticide was applied to (select all that apply).
11. Provide any additional information regarding application (how it was applied, amount applied, the size of the area treated etc).
To be determined by Registrant
12. In your opinion, was the product used according to the label instructions?
Unknown
Subform VI: Packaging Failure
1. What is the type of packaging that failed?
Bag-paper / Sac-papier
2. Did packaging failure occur during?
Storage
3. Did packaging failure result in?
potential exposure
4. Describe how the packaging failed and the surrounding circumstances, including a description of the potential injury or exposure.
Customer was taking the pallet of Daconil Ultrex apart to receive and put it into their chemical room and discovered hidden damage to one of the cases in the middle of the pallet. It was crushed enough that one of the inner bags was compromised; that spill has been contained and cleaned up. There are other cases that are crushed, but there doesnt appear to be any further leakage from the inner bags.
For Registrant use only
5. Provide supplemental information here.