Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2009-4055

2. Registrant Information.

Registrant Reference Number: DAS090529A

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

Address: Suite 2100, 450 - 1st Street S.W.

City: Calgary

Prov / State: Alberta

Country: Canada

Postal Code: T2P 5H1

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

Environment

4. Date registrant was first informed of the incident.

31-AUG-09

5. Location of incident.

Country: CANADA

Prov / State: ALBERTA

6. Date incident was first observed.

29-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. 28787      PMRA Submission No.       EPA Registration No.

Product Name: Benchmark A

• Active Ingredient(s)
  • FLORASULAM

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PMRA Registration No. 28876      PMRA Submission No.       EPA Registration No.

Product Name: Benchmark B

• Active Ingredient(s)
  • BROMOXYNIL

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7. b) Type of formulation.

Application Information

8. Product was applied?

Yes

9. Application Rate.

Unknown

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

Site: Agricultural-Outdoor/Agricole-extérieur

Préciser le type: Fall Wheat

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

Farmers state the application rates were done according to the label.

To be determined by Registrant

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

Unknown

Subform IV: Environment (includes plants insects and wildlife)

1. Type of organism affected

Herbaceous Plants / Plante herbacée

2. Common name(s)

begonia, potato plants, raspberry bushes, birch, ornamental flowers, apple tries, willow trees, poplars.

3. Scientific name(s)

Unknown

4. Number of organisms affected

Unknown

5. Description of site where incident was observed

Fresh water

Terrestrial

Residential

Agricultural

Salt Water

6. Check all symptoms that apply

Abnormal plant stance

Death

Epinasty (leaf wilt)

Reduced emergence

Reduction in seed or fruit yield

Terminal bud death

Visible injury ( eg. chlorosis, necrosis, bleaching)

7. Describe symptoms and outcome (died, recovered, etc.).

unknown.

8. a) Was the incident a result of (select all that apply)

Application

N/A

8. b) i) How many times has the product been applied this year?

Unknown

8. b) ii) What was the date of the last application?

28-MAY-09

9. Did it rain

9. a) During application?

Unknown

9. b) Up to 3 days after application?

Unknown

10. a) Was there a buffer zone?

No

10. b) What type?

10. c) What was the size of the buffer zone?

11. a) Were environmental samples collected and analysed?

No

To be determined by Registrant

12. Severity classification (if there is more than one possible classification, select the most severe)

Moderate

13. Please provide supplemental information here

A farmer applied the product on May 28/09 to fall wheat via ground application with a (spray air) boomed unit. The damaged was noted beside the sprayed area up to three hundred metres. The wind speed and direction was 6 km/hr SSE. No buffer zone was used as the farmer related that Pioneer told him he could apply as close as three feet. Farmer states that the rate and application was according to the label. The next day (May 29/09) complaints were received during a public meeting by 15 home owners. The number of trees/shrubs/herbaceous plants that were damaged in each complaint is unknown.