Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2009-1800
2. Registrant Information.
Registrant Reference Number: 2009-3
Registrant Name (Full Legal Name no abbreviations): BASF Canada
Address: 100 Milverton Drive, 5th fl
City: Mississauga
Prov / State: ON
Country: Canada
Postal Code: L5R4H1
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.
Active(s)
PMRA Registration No.
PMRA Submission No.
EPA Registration No.
Product Name:
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 Effect of BAS XXX on the immobility of Daphnia magna
Date 19-MAY-09
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)
Study of coformulation resulted in a lower EC50 in test organism.
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
Coformulation is not relevant to Canada, information should be treated as confidential.