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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2015-2209

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.

Packaging Failure

4. Date registrant was first informed of the incident.

5. Location of incident.

Country: CANADA

Prov / State: TO BE DETERMINED

6. Date incident was first observed.

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. 28593      PMRA Submission No.       EPA Registration No.

Product Name: AQUA TROL ABOVE-GROUND POOL AUTOMATION

  • Active Ingredient(s)
    • DEVICE, NO GUARANTEE REQUIRED

7. b) Type of formulation.

Application Information

8. Product was applied?

Unknown

9. Application Rate.

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

Site: Unknown / Inconnu

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

Registrant recently identified a firmware configuration issue on one of our AquatTrol models. The product will not operate and communicates a failure message on start up.

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?

Other / Autre

specify automatic chlorinator

2. Did packaging failure occur during?

Use of Product

specify On start up of chlorinator

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.

Recently purchased a 24' above ground pool with salt system. There have been issues with the automatic chlorinator. Registrant aware that the software used in this device was not working. Registrant stated they were able to use the manifacturing codes to determine which units were affected. 150 - 200 defective units were sold by Canadian retailers. Registrant responding to complaints and are able to fix units at customer locations.

For Registrant use only

5. Provide supplemental information here.