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Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2009-1507

2. Registrant Information.

Registrant Reference Number: Prosar 1-17907317

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.

Packaging Failure

4. Date registrant was first informed of the incident.

5. Location of incident.

Country: CANADA

Prov / State: SASKATCHEWAN

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. 28642      PMRA Submission No.       EPA Registration No.

Product Name: AXIAL 100EC Herbicide

• Active Ingredient(s)
  • PINOXADEN

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?

Other / Autre

specify Bottle, unknown material

2. Did packaging failure occur during?

Transportation

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.

1-17907317: A reporter called on 03/24/2009 to report the packaging failure of an herbicide containing the active ingredient Pinoxaden. According to the reporter, an unknown amount of product arrived at a warehouse on the day of the report. One bottle of product had a pinhole in it and was leaking. Less than 10 liters of product had spilled. There was no exposure and no injury as a result of the spill. There was no potential for the product entering a water way or ground water. Warehouse personnel had cleaned up the spill and no further assistance was requested.

For Registrant use only

5. Provide supplemental information here.

There was no exposure and no injury as a result of the packaging failure/spill. The product registrant followed up to report the packaging failure to the supplier to ensure this will not happen again.