Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2015-3653
2. Registrant Information.
Registrant Reference Number: 2005-07-15
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.
Environment
4. Date registrant was first informed of the incident.
15-JUL-15
5. Location of incident.
Country: CANADA
Prov / State: ONTARIO
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. 24984
PMRA Submission No.
EPA Registration No.
Product Name: Matador 120EC Insecticide
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).
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 IV: Environment (includes plants insects and wildlife)
1. Type of organism affected
Terr. Invrtbrt-Honey Bee/Inv.Ter-Abeille
2. Common name(s)
Honey bee
3. Scientific name(s)
Apis mellifera
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
Death
7. Describe symptoms and outcome (died, recovered, etc.).
No information available.
8. a) Was the incident a result of (select all that apply)
Application
N/A
8. b) i) How many times has the product been applied this year?
Unknown
8. b) ii) What was the date of the last application?
Unknown
9. Did it rain
9. a) During application?
Unknown
9. b) Up to 3 days after application?
Unknown
10. a) Was there a buffer zone?
Unknown
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
The registrant was notified of a potential bee incident involving an unknown number of bees/bee colonies that were possibly affected by an application of the listed product (Matador 120EC Insecticide) to canola. It is our understanding that the application occurred during the late morning while the crop was in bloom. No additional information is available. The Ontario Ministry of the Environment and Climate Change is conducting an investigation of the incident.