Print | Need Larger Text?

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2011-4282

2. Registrant Information.

Registrant Reference Number: 2011-30

Registrant Name (Full Legal Name no abbreviations): BASF Canada

Address: 100 Milverton, 5th floor

City: Mississauaga

Prov / State: ON

Country: Canada

Postal Code: L5R4H1

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

Packaging Failure

4. Date registrant was first informed of the incident.

5. Location of incident.

Country: CANADA

Prov / State: ONTARIO

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. 29542      PMRA Submission No.       EPA Registration No.

Product Name: PROWL H2O

• Active Ingredient(s)
  • PENDIMETHALIN

7. b) Type of formulation.

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 VI: Packaging Failure

1. What is the type of packaging that failed?

Tank tote / Cuve

2. Did packaging failure occur during?

Use of Product

3. Did packaging failure result in?

potential exposure

4. Describe how the packaging failed and the surrounding circumstances, including a description of the potential injury or exposure.

Silicone plugs that were placed in the new pumps for for the new PROWL H2O totes were not removed before they were shipped to the customer. The customer engaged the pump, placing PROWL under pressure behind the plug. When the plug was removed by the the grower and his hired man, the PROWL under pressure erupted out of the pump, coating both people and coating the shop floor.

For Registrant use only

5. Provide supplemental information here.