Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2016-2341
2. Registrant Information.
Registrant Reference Number: DASC150619-00
Registrant Name (Full Legal Name no abbreviations): Dow AgroSciences Canada Inc.
Address: 2400, 215-2nd Street S.W.
City: Alberta
Prov / State: Calgary
Country: Canada
Postal Code: T2P 1M4
3. Select the appropriate subform(s) for the incident.
Environment
4. Date registrant was first informed of the incident.
14-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. 29752
PMRA Submission No.
EPA Registration No.
Product Name: Clearview
- Active Ingredient(s)
- AMINOPYRALID
- METSULFURON-METHYL
7. b) Type of formulation.
Application Information
8. Product was applied?
Yes
9. Application Rate.
230
Units: g/ha
10. Site pesticide was applied to (select all that apply).
Site: Pub. Area - Outdoor/Zone publique - ext
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
Herbaceous Plants / Plante herbacée
2. Common name(s)
soybeans
3. Scientific name(s)
Unknown
4. Number of organisms affected
Unknown
5. Description of site where incident was observed
Fresh water
Terrestrial
Roadside
Salt Water
6. Check all symptoms that apply
Death
Stunted vegetative growth
Visible injury ( eg. chlorosis, necrosis, bleaching)
7. Describe symptoms and outcome (died, recovered, etc.).
An (name) custom applicator was contracted to treat roadsides with Clearview Herbicide. They applied the product at the label rate of 230 g/ha. Shortly after application there was a 3" rain. The area treated was elevated above the field and treated plant material was washed into the field. Damage was detected a couple of weeks later and seems to be only on soybeans along the first few rows of the field (no other crops affected).
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?
Yes
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