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Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2010-0901

2. Registrant Information.

Registrant Name (Full Legal Name no abbreviations): S.C. Johnson and Son, Limited

Address: 1 Webster Street

City: Brantford

Prov / State: ON

Country: Canada

Postal Code: N3T 5R1

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.

PMRA Registration No. 21843      PMRA Submission No.       EPA Registration No.

Product Name: OFF Insect Repellent Pressurized Spray -Spring Fresh Scent

• Active Ingredient(s)
  • DEET (N,N-DIETHYL-M-TOLUAMIDE) PLUS RELATED ACTIVE TOLUAMIDES (ORTHO + PARA ISOMERS)

PMRA Registration No. 22708      PMRA Submission No.       EPA Registration No.

Product Name: OFF! Active Insect Repellent 1

• Active Ingredient(s)
  • DEET (N,N-DIETHYL-M-TOLUAMIDE) PLUS RELATED ACTIVE TOLUAMIDES (ORTHO + PARA ISOMERS)

PMRA Registration No. 23232      PMRA Submission No.       EPA Registration No.

Product Name: OFF! Insect Repellent Pressurized Spray - Fresh Outdoor Scent

• Active Ingredient(s)
  • DEET (N,N-DIETHYL-M-TOLUAMIDE) PLUS RELATED ACTIVE TOLUAMIDES (ORTHO + PARA ISOMERS)

PMRA Registration No. 27474      PMRA Submission No.       EPA Registration No.

Product Name: OFF! Active Insect Repellent

• Active Ingredient(s)
  • DEET (N,N-DIETHYL-M-TOLUAMIDE) PLUS RELATED ACTIVE TOLUAMIDES (ORTHO + PARA ISOMERS)

7. b) Type of formulation.

Liquid

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 Primary Eye Irritation Study In Rabbits with Unscented OFF! Insect Repellent - Aerosol Dosing Method - (SCJ Notebook No. 7935D49-3)

Date 30-SEP-85

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 demonstrates a new toxicological endpoint for our existing deet 15% aerosol products.

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

Confidential breakout of formula sent separately.