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Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2008-4121

2. Registrant Information.

Registrant Name (Full Legal Name no abbreviations): Dow Chemical Canada Inc.

Address: 1425 Vidal Street South, B114

City: Sarnia

Prov / State: ON

Country: Canada

Postal Code: N7T 8C6

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

Scientific Study

4. Date registrant was first informed of the incident.

5. Location of incident.

6. Date incident was first observed.

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.

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

Product Name: Experimental Blend

• Active Ingredient(s)
  • 2,2-DIBROMO-3-NITRILOPROPIONAMIDE
  • BRONOPOL

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 VII: Scientific Study

1. Study Reference

Title BIOBAN¿¿¿ QK-PRO: LOCAL LYMPH NODE ASSAY IN CBA/J MICE

Date 13-AUG-08

2. a) Is an extension needed to translate the document?

No

3. Type of incident identified in the study

Increased health or environmental risk

4. Describe the incident identified in the study (e.g. study demonstrates an increased risk to non-Hodgkin's Lymphoma after exposure to pesticide X)

The blend of the two active ingredients within the screening study test of the Local Lymph Node Assay (LLNA) resulted in complete deterioration of both ear pinnas in the top two dose levels. Within the final LLNA study the blended product was concluded to be consistent with moderate dermal sensitization potential.

5. a) Was the study discontinued before completion?

No

5. b) Provide the reason for discontinuation

6. If the study is ongoing, what is the expected completion date?

For Registrant use only

7. Provide supplemental information here

As this is a new blended product not yet registered we are asking that the information be treated as confidential and only used for the purpose of adverse effects tracking. Please contact the submitter if you have any questions or concerns.