Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2013-3716
2. Registrant Information.
Registrant Reference Number: 2013-15
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.
Domestic Animal
4. Date registrant was first informed of the incident.
16-JUL-13
5. Location of incident.
Country: CANADA
Prov / State: ALBERTA
6. Date incident was first observed.
10-JUL-13
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)
PMRA Registration No. 23713
PMRA Submission No.
EPA Registration No.
Product Name: ARSENAL
7. b) Type of formulation.
Application Information
8. Product was applied?
Yes
9. Application Rate.
.23
Units: L/ha
10. Site pesticide was applied to (select all that apply).
Site: Industrial / Industriel
Préciser le type: oil and gas site in pasture
11. Provide any additional information regarding application (how it was applied, amount applied, the size of the area treated etc).
Applied as tank-mix with Roundup to oil and gas site in pasture-pasture held 40 calves with free access to treated area.
To be determined by Registrant
12. In your opinion, was the product used according to the label instructions?
Unknown
Subform III: Domestic Animal Incident Report
1. Source of Report
Animal's Owner
2. Type of animal affected
Cow / Vache
3. Breed
calves, unknown
4. Number of animals affected
40
5. Sex
Unknown
6. Age (provide a range if necessary )
Unknown
7. Weight (provide a range if necessary )
Unknown
8. Route(s) of exposure
Unknown
9. What was the length of exposure?
>1 wk <=1 mo / > 1 sem < = 1 mois
10. Time between exposure and onset of symptoms
>3 days <=1 wk / >3 jours <=1 sem
11. List all symptoms
System
12. How long did the symptoms last?
>1 wk <=1 mo / > 1 sem < = 1 mois
13. Was medical treatment provided? Provide details in question 17.
Yes
14. a) Was the animal hospitalized?
No
14. b) How long was the animal hospitalized?
15. Outcome of the incident
Died
16. How was the animal exposed?
Contact treat.area/Contact surf. traitée
17. Provide any additional details about the incident
(eg. description of the frequency and severity of the symptoms
Medical tests-scours,antibiotics
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Death
19. Provide supplemental information here
Symptoms reported are inconsistent with the known toxicity profile of Imazapyr