Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2007-4453
2. Registrant Information.
Registrant Reference Number: 2007-12
Registrant Name (Full Legal Name no abbreviations): BASF Canada
Address: 100 Milverton, 5th
City: Mississauga
Prov / State: ON
Country: Canada
Postal Code: L5R4H1
3. Select the appropriate subform(s) for the incident.
Domestic Animal
4. Date registrant was first informed of the incident.
18-JUN-07
5. Location of incident.
Country: UNITED STATES
Prov / State: COLORADO
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.
PMRA Submission No.
EPA Registration No.
Product Name: paramount herbicide
7. b) Type of formulation.
Liquid
Application Information
8. Product was applied?
Yes
9. Application Rate.
5.85
Other Units: oz/pa
10. Site pesticide was applied to (select all that apply).
Site: Agricultural-Outdoor/Agricole-extérieur
Préciser le type: adjoining field to pasture
11. Provide any additional information regarding application (how it was applied, amount applied, the size of the area treated etc).
sprayed 6/12,used spray sheet for product,satellite GPS system,Amm Sulfate at 2.5lb/A ,crop oil conc at 0.24gal/A,20gal water wind at 8mph from sw, drifting to east,sky partly cloudy.
To be determined by Registrant
12. In your opinion, was the product used according to the label instructions?
Yes
Subform III: Domestic Animal Incident Report
1. Source of Report
Animal's Owner
2. Type of animal affected
Cow / Vache
3. Breed
calf
4. Number of animals affected
1
5. Sex
Unknown
6. Age (provide a range if necessary )
Unknown
7. Weight (provide a range if necessary )
400
lbs
8. Route(s) of exposure
Unknown
9. What was the length of exposure?
Unknown / Inconnu
10. Time between exposure and onset of symptoms
>24 hrs <=3 days / >24 h <=3 jours
11. List all symptoms
System
12. How long did the symptoms last?
>24 hrs <=3 days / >24 h <=3 jours
13. Was medical treatment provided? Provide details in question 17.
Unknown
14. a) Was the animal hospitalized?
Unknown
14. b) How long was the animal hospitalized?
15. Outcome of the incident
Died
16. How was the animal exposed?
Spray drift / Dérive de pulvérisation
17. Provide any additional details about the incident
(eg. description of the frequency and severity of the symptoms
Without posting the calf, there is no way to know what caused the death of the calf
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Death
19. Provide supplemental information here
Unknown cause of death, animal herd data would be needed to further assess the case.