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Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2013-3647
2. Registrant Information.
Registrant Reference Number: x
Registrant Name (Full Legal Name no abbreviations): x
Address: x
City: x
Prov / State: x
Country: x
Postal Code: X
3. Select the appropriate subform(s) for the incident.
Environment
4. Date registrant was first informed of the incident.
5. Location of incident.
Country: CANADA
Prov / State: ONTARIO
6. Date incident was first observed.
08-MAY-13Product 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)PMRA Registration No. PMRA Submission No. EPA Registration No.
Product Name: unknown
- Active Ingredient(s)
- CLOTHIANIDIN
- THIAMETHOXAM
7. b) Type of formulation.
Application Information
8. Product was applied?
Unknown
9. Application Rate.
Unknown
10. Site pesticide was applied to (select all that apply).
Site: Unknown / Inconnu
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 IV: Environment (includes plants insects and wildlife)
1. Type of organism affected
Terr. Invrtbrt-Honey Bee/Inv.Ter-Abeille
2. Common name(s)
honey bee
3. Scientific name(s)
Unknown
4. Number of organisms affected
Unknown
5. Description of site where incident was observed
Fresh water
Terrestrial
Agricultural
Salt Water
6. Check all symptoms that apply
Death
7. Describe symptoms and outcome (died, recovered, etc.).
The location of dead adult bees outside of hive. Bees were actively foraging at the time of the incident. Dead bees had pollen on their legs. Adult bee symptoms included disoriented. Brood symptoms included spotty brood pattern.Samples of dead bees taken from affected hive, dead bees collected by bk from home yard in 2012 and frozen taken from had no detected active ingredients. Samples of dead bees taken from affected hive, dead bees collected by bk from home yard in 2012 and frozen had no detected active ingredients. Samples of honey taken from affected hive, comb sample from a dead out hive from home yard had no detected active ingredients. Sample of pollen taken from affected hive, comb sample from a dead out hive from home yard had positive detects for clothianidin and thiamethoxam. Samples of honey taken from strong hive, comb from a strong hive, hive#2, home yard had no detected active ingredients. Sample of pollen taken from strong hive, comb from a strong hive, hive#2, home yard had positive detects for clothianidin and thiamethoxam. Samples of dead bees taken from affected hive, composite dead bee sample, home yard had no detected active ingredients. Sample of dead bees taken from affected hive, composite dead bee sample, home yard had positive detects for clothianidin. The weather at the time of the incident was unknown. Additional food sources provided to the bees included sugar syrup in the fall and spring. In 2012, the following treatments were applied to the hives: formic acid, fluvalinate-tau and antibiotics. In 2013, the following treatments were applied to the hives: antibiotics. Other crops in the area include corn and soy, not planted. BK noted only 1 yard as reporting effects, she was unable to confirm the size of the yard or number of hives affected. Hives were checked Friday, May 10 and they were strong. Planting of corn happened in the area and when hives checked on May 9th, weak bees with pesticide exposure symtoms were observed. Questionnarie was then completed for 1 yard . This yard overall was weak, a heavy winter loss was experienced a this location. However, beekeeper also ntoed that many additional yards were potentially affected. info.
8. a) Was the incident a result of (select all that apply)
Unknown
8. b) i) How many times has the product been applied this year?
Unknown
8. b) ii) What was the date of the last application?
Unknown
9. Did it rain
9. a) During application?
Unknown
9. b) Up to 3 days after application?
Unknown
10. a) Was there a buffer zone?
Unknown
10. b) What type?
Aquatic
10. c) What was the size of the buffer zone?
11. a) Were environmental samples collected and analysed?
Unknown
