Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2013-4917

2. Registrant Information.

Registrant Reference Number: 1-34753595

Registrant Name (Full Legal Name no abbreviations): Syngenta Canada Inc.

Address: 140 Research Lane, Research Park

City: Guelph

Prov / State: Ontario

Country: Canada

Postal Code: N1G4Z3

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

Environment

4. Date registrant was first informed of the incident.

26-AUG-13

5. Location of incident.

Country: CANADA

Prov / State: ONTARIO

6. Date incident was first observed.

20-AUG-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)

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PMRA Registration No. 30404      PMRA Submission No.       EPA Registration No.

Product Name: Endigo Insecticide

• Active Ingredient(s)
  • LAMBDA-CYHALOTHRIN
  • THIAMETHOXAM

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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: Agricultural-Outdoor/Agricole-extérieur

Préciser le type: Soybean Field

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.).

1-34753595 - The reporter, a pesticide applicator, indicated that honeybees at two separate locations near (city), Ontario were exposed to an insecticide with the active ingredients thiamethoxam and lambda-cyhalothrin. The reporter and one of the farmers whose soybean crop was treated with the product indicated that the product was applied seven days prior to initial contact with the registrant. The product was applied during the evening at (name) Farms (# acres) where an apiary operated by (name) Honey is located. It was also reported that the same product was again applied the following day, during the daytime, at (name) Farms (#acres) and (name) Farms (# acres) both of which are close to (name), Ontario. (name) Honey had a second apiary located between these two farms. The beekeeper with (name) honey reported increased mortality in an unknown number of bee hives located adjacent to the applied fields six days, and then again five days prior to initial contact with the registrant. No further information is available.

8. a) Was the incident a result of (select all that apply)

Application

N/A

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?

20-AUG-13

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?

10. c) What was the size of the buffer zone?

11. a) Were environmental samples collected and analysed?

No

To be determined by Registrant

12. Severity classification (if there is more than one possible classification, select the most severe)

Minor

13. Please provide supplemental information here