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Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2010-5642

2. Registrant Information.

Registrant Reference Number: PROSAR Case #: 1-24200191

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.

5. Location of incident.

Country: CANADA

Prov / State: ONTARIO

6. Date incident was first observed.

Unknown

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. 25878      PMRA Submission No.       EPA Registration No.

Product Name: Bug-B-Gon Max Hornet Wasp Eliminator Spray (Ortho)

• Active Ingredient(s)
  • RESMETHRIN

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: Pub. Area - Indoor/Zone publique - int

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: Unknown

Age: Unknown / Inconnu

3. List all symptoms, using the selections below.

System

• Nervous and Muscular Systems
  • Symptom - Headache

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

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)

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.)

1-24200191- The reporter indicates exposure to an insecticide containing the active ingredient resmethrin. The reporter notified the registrant that the product (a hornet and wasp spray) was used in a workplace setting and ¿¿¿employees are complaining of headaches¿¿¿. The reporter did not clarify details about the application or about the exposure. Nothing further is known.

To be determined by Registrant

14. Severity classification.

Minor

15. Provide supplemental information here.

Response to the exposure via inhalation may yield respiratory irritation, headache and nausea due to the nonspecific irritant effect. No harm beyond this would be expected in healthy individuals.