Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2007-6500

2. Registrant Information.

Registrant Reference Number: PROSAR Case 1-15178409

Registrant Name (Full Legal Name no abbreviations): Syngenta Crop Protection Canada, Inc.

Address: 140 Research Lane, Research Park

City: Guelph

Prov / State: Ontario

Country: Canada

Postal Code: N1G4Z3

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

Human

Environment

4. Date registrant was first informed of the incident.

03-AUG-07

5. Location of incident.

Country: CANADA

Prov / State: SASKATCHEWAN

6. Date incident was first observed.

01-AUG-07

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)

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PMRA Registration No. 26396      PMRA Submission No.       EPA Registration No.

Product Name: Reglone Desiccant

• Active Ingredient(s)
  • DIQUAT

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7. b) Type of formulation.

Application Information

8. Product was applied?

Yes

9. Application Rate.

Unknown

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

Site: Agricultural-Outdoor/Agricole-extérieur

Préciser le type: Alfalfa

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

Aerial Application, 320 Acres, 25 Mile Per Hour Wind

To be determined by Registrant

12. In your opinion, was the product used according to the label instructions?

Unknown

Subform II: Human Incident Report (A separate form for each person affected)

1. Source of Report.

Data Subject

2. Demographic information of data subject

Sex: Male

Age: >19 <=64 yrs / >19 <=64 ans

3. List all symptoms, using the selections below.

System

• Eye
  • Symptom - Irritated eye

4. How long did the symptoms last?

Unknown / Inconnu

5. Was medical treatment provided? Provide details in question 13.

No

6. a) Was the person hospitalized?

Unknown

6. b) For how long?

7. Exposure scenario

Non-occupational

8. How did exposure occur? (Select all that apply)

Drift from the application site

9. If the exposure occured during application or re-entry, what protective clothing was worn? (select all that apply)

None

10. Route(s) of exposure.

Eye

11. What was the length of exposure?

Unknown / Inconnu

12. Time between exposure and onset of symptoms.

<=30 min / <=30 min

13. Provide any additional details about the incident (eg. description of the frequency and severity of the symptoms, type of medical treatment, results from medical tests, outcome of the incident, amount of pesticide exposed to, etc.)

History: Someone sprayed product across 320 acres of alfalfa with a 25 mile wind yesterday. Will it kill the crop? Caller also states it may have gotten into his eye. ((Applicator) Applicator's Phone #: ) The caller reports that his 320 acre field of alfalfa was accidentally sprayed with Reglone by a crop duster. A portion of the contaminated crop has been bailed, but not yet distributed or sold for livestock feed. A majority of the remaining plant material seems to be "dead." The caller was standing on the property at the time of the exposure. He believes some of the spray may have drifted into his eye. He does not describe any dermal exposure. His eye has remained irritated over the past few days. The caller is threatening legal action against the crop duster. Assessment: - Ocular exposure to the dilute concentration may result in transient eye irritation. Since the irritation has not yet resolved, please seek medical attention at this time. - Provided the Case #. Please contact CS for more crop-related information. Do not sell or distribute this crop without first consulting CS. - Please have your physician contact us with any other questions or concerns.

To be determined by Registrant

14. Severity classification.

Minor

15. Provide supplemental information here.

Subform IV: Environment (includes plants insects and wildlife)

1. Type of organism affected

Herbaceous Plants / Plante herbacée

2. Common name(s)

Alfalfa

3. Scientific name(s)

Unknown

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.).

History: Someone sprayed product across 320 acres of alfalfa with a 25 mile wind yesterday. Will it kill the crop? Caller also states it may have gotten into his eye. ( (Applicator) Applicator's Phone #: ) The caller reports that his 320 acre field of alfalfa was accidentally sprayed with Reglone by a crop duster. A portion of the contaminated crop has been bailed, but not yet distributed or sold for livestock feed. A majority of the remaining plant material seems to be "dead." Assessment: - Provided the Case #. Please contact CS for more crop-related information. Do not sell or distribute this crop without first consulting CS. - Please have your physician contact us with any other questions or concerns. Unknown Amount of Crop that has been aaffected.

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?

01-AUG-07

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?

Unknown

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