Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2009-2061

2. Registrant Information.

Registrant Reference Number: Prosar 1-18372291

Registrant Name (Full Legal Name no abbreviations): Scotts Canada Ltd.

Address: 2000 Argentia Road, Plaza 5, Suite 101

City: Mississauga

Prov / State: Ontario

Country: Canada

Postal Code: L5N2R7

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

Human

4. Date registrant was first informed of the incident.

07-MAY-09

5. Location of incident.

Country: CANADA

Prov / State: ONTARIO

6. Date incident was first observed.

07-MAY-09

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. 28179      PMRA Submission No.       EPA Registration No.

Product Name: Ecosense Weed Control Spray with Pull N Spray Applicator (Scotts)

• Active Ingredient(s)
  • ACETIC ACID

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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 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

• General
  • Symptom - Flu-like symptoms
  • Specify - "Cold symptoms"

4. How long did the symptoms last?

Unknown / Inconnu

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

Unknown

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)

Other

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

Unknown

10. Route(s) of exposure.

Unknown

11. What was the length of exposure?

Unknown / Inconnu

12. Time between exposure and onset of symptoms.

Unknown / Inconnu

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.)

1-18372291: A reporter called on 05/07/2009 to report his possible exposure to an herbicide containing the active ingredient Acetic Acid. According to the reporter, the product bottle was empty and he added bleach to the bottle. The reporter mentioned that he had been having cold symptoms, but the time frame of exposure and the route of exposure is unknown. The reporter was planning to see a health care provider for evaluation of his symptoms. The reporter wanted to know if there could be a possible reaction between the product residue and bleach. The reporter was advised that there is no reactivity data with regard to mixing the product and bleach. A recommendation was made to discard the bottle. No further information was obtained.

To be determined by Registrant

14. Severity classification.

Minor

15. Provide supplemental information here.