Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2010-0966

2. Registrant Information.

Registrant Reference Number: 2010-IR-01

Registrant Name (Full Legal Name no abbreviations): Nalco Canada Company

Address: 1055 Truman Street, PO Box 5002

City: Burlington

Prov / State: Ontario

Country: Canada

Postal Code: L7R 3Y9

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

Human

4. Date registrant was first informed of the incident.

17-FEB-10

5. Location of incident.

Country: CANADA

Prov / State: ALBERTA

6. Date incident was first observed.

10-FEB-10

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. 17574      PMRA Submission No.       EPA Registration No.

Product Name: Nalco 7320

• Active Ingredient(s)
  • 2,2-DIBROMO-3-NITRILOPROPIONAMIDE

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7. b) Type of formulation.

Application Information

8. Product was applied?

Yes

9. Application Rate.

20

Units: L

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

Site: Industrial / Industriel

Préciser le type: Cooling tower

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

20 Liters of Nalco 7320 was slug fed into the cooling tower basin (volume 272 cu. meters). Therefore the feed rate was 73.5 ml/ 1000 L.

To be determined by Registrant

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

Yes

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

• Eye
  • Symptom - Burning eye

• Respiratory System
  • Symptom - Other
  • Specify - Chemical smell

4. How long did the symptoms last?

<=30 min / <=30 min

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

No

6. a) Was the person hospitalized?

No

6. b) For how long?

7. Exposure scenario

Occupational

8. How did exposure occur? (Select all that apply)

Application

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

Chemical resistant gloves

Coveralls (non-chemical resistant)

10. Route(s) of exposure.

Eye

11. What was the length of exposure?

<=15 min / <=15 min

12. Time between exposure and onset of symptoms.

<=30 min / <=30 min

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.)

When the subject person noticed the fumes he exited the area. The exposure was not serious but the incident was put in for record for future knowledge. He was wearing safety glasses at the time of incident.

To be determined by Registrant

14. Severity classification.

Minor

15. Provide supplemental information here.

20 liters of Nalco 7320 was slug fed into the cooling tower basin (volume 272 cu.meters). When adding NALCO 7320 chemical to SA 2 cooling tower, experienced burning sensation to eyes and had strong chemical smell. Although I removed myself from the area immediately, the chemical smell lasted about 30 minutes before I stopped smelling it. I did not require or seek medical attention and passed the information on to other operator to ensure they would take appropriate precautions when adding chemicals to SA 1 cooling tower. Had transported the chemical in cab of pond truck and there was no odour to the concentrated chemical. MSDS sheet Section 9 stated that odour was "mild, disinfectant". Section 8 stated that "Where concentrations may exceed limits given in this section, the use of a full face filter mask or air supplied breathing apparatus is recommended." As the cooling tower is a large space, did not anticipate that any limits would be exceeded. Section 10 of the MSDS -Materials To Avoid - includes "chlorites". As HTH, a powdered additive containing chlorine, is frequently added to cooling water, suspect that the biocide chemical reacted with the HTH producing a toxic mixture. Follow up investigation has been recommended.