Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2009-2662

2. Registrant Information.

Registrant Reference Number: Prosar 1-18828038

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.

Domestic Animal

4. Date registrant was first informed of the incident.

15-JUN-09

5. Location of incident.

Country: UNITED STATES

Prov / State: GEORGIA

6. Date incident was first observed.

06-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.       PMRA Submission No.       EPA Registration No. 100-1091

Product Name: Reward Landscape And Aquatic Herbicide

• Active Ingredient(s)
  • DIQUAT
    • Guarantee/concentration 37.3 %

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7. b) Type of formulation.

Liquid

Application Information

8. Product was applied?

Yes

9. Application Rate.

1

Other Units: quart per 1/8 acre pond

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

Site: Res. - Out Home / Rés - à l'ext.maison

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

The product (1 quart) was applied to a 1/8th acre pond on 04/24/2009.

To be determined by Registrant

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

Unknown

Subform III: Domestic Animal Incident Report

1. Source of Report

Animal's Owner

2. Type of animal affected

Fish / Poisson

3. Breed

Catfish

4. Number of animals affected

24

5. Sex

Unknown

6. Age (provide a range if necessary )

Unknown

7. Weight (provide a range if necessary )

Unknown

8. Route(s) of exposure

Skin

Eye

Oral

Respiratory

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

Unknown / Inconnu

11. List all symptoms

System

• General
  • Symptom - Death

12. How long did the symptoms last?

Persisted until death

13. Was medical treatment provided? Provide details in question 17.

No

14. a) Was the animal hospitalized?

No

14. b) How long was the animal hospitalized?

15. Outcome of the incident

Died

16. How was the animal exposed?

Contact treat.area/Contact surf. traitée

17. Provide any additional details about the incident

(eg. description of the frequency and severity of the symptoms

1-18828038: A reporter (fish owner) called on 06/15/2009 to report the exposure of 100 catfish to an aquatic herbicide containing the active ingredient Diquat. According to the reporter, 1 quart of product was applied to a 1/8th acre pond (registered labeled rate) on 04/24/2009. On 05/06/2009, 100 baby catfish were introduced to the pond. Two dozen catfish (1st Subform III) died shortly after being introduced to the pond. The reporter suspects the fish deaths were due to a sudden transition from cold water to the warmer pond water. The remaining fish were asymptomatic. Product information indicates no restrictions for fish with the typical application of 2 gallons of product per surface acre of water. No further information was obtained.

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To be determined by Registrant

18. Severity classification (if there is more than 1 possible classification

Death

19. Provide supplemental information here