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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2016-4912

2. Registrant Information.

Registrant Reference Number: 2016-66

Registrant Name (Full Legal Name no abbreviations): MONSANTO CANADA INC.

Address: 180 KENT STREET, SUITE 810

City: OTTAWA

Prov / State: ON

Country: CANADA

Postal Code: K1P 0B6

3. Select the appropriate subform(s) for the incident.

Packaging Failure

4. Date registrant was first informed of the incident.

15-AUG-16

5. Location of incident.

Country: CANADA

Prov / State: SASKATCHEWAN

6. Date incident was first observed.

15-AUG-16

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. 28198      PMRA Submission No.       EPA Registration No.

Product Name: Roundup Transorb HC Liquid Herbicide

  • Active Ingredient(s)
    • GLYPHOSATE (PRESENT AS POTASSIUM SALT)

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 VI: Packaging Failure

1. What is the type of packaging that failed?

Tank tote / Cuve

2. Did packaging failure occur during?

Other

specify Value was not on tank tote properly.

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.

The valve on the tote wasn't screwed in or attached properly and splashed the customer when he first used it. He was able to closed off the value properly but about 10L of product was spilled. Customer was hosed off and does not appear to have any symptoms the day after the spill. No other information was provided.

For Registrant use only

5. Provide supplemental information here.