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Incident Report

Subform I: General Information

1. Report Type.

Update the report

Incident Report Number: 2013-2907

2. Registrant Information.

Registrant Reference Number: 23283.01

Registrant Name (Full Legal Name no abbreviations): U.S. BORAX INC.

Address: P.O. Box 6609

City: Englewood

Prov / State: CO

Country: USA

Postal Code: 80155

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. 23283      PMRA Submission No.       EPA Registration No. 1624-120

Product Name: BOROGARD ZB CORROSION INHIBITOR, BIOCIDE AND FIRE RETARDANT

• Active Ingredient(s)
  • ZINC BORATE

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 VII: Scientific Study

1. Study Reference

Title A 28-Day Oral (Gavage Dose Range Finding Toxicity Study of Zinc Borate 2335 in Sprague Dawley Rats - Seven Day Inhalation Toxicity Study of Zinc Borate 2335 in Rats

Date 24-MAY-13

2. a) Is an extension needed to translate the document?

No

3. Type of incident identified in the study

New health or environmental hazard

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)

Oral Study demonstrated that the low dose of 125 mg/kg/day was determined to be the No Observed Adverse Effect Level (NOAEL); Inhalation Study showed that administration of zinc borate 2335 by nose only inhalation at an exposure concentration of 500 and 750 mg/m3 for 6 hours per day for 5 days resulted in the early death of 4 and 3 animals, respectively. No mortality was onserved in the 250 mg/m3 exposure group.

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?

Unknown

For Registrant use only

7. Provide supplemental information here

Status update: Full report being attached