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Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2014-1419

2. Registrant Information.

Registrant Reference Number: DERBI289978

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

Address: Suite 2100, 450 - 1 Street S.W.

City: Calgary

Prov / State: Alberta

Country: Canada

Postal Code: T2P 5H1

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.       PMRA Submission No.       EPA Registration No. Unknown

Product Name: n/a

• Active Ingredient(s)
  • FENBUCONAZOLE

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 GF-267I : Acute Toxicity to Water Fleas, Daphnia magna, Under Static-Renewal Conditions, Following OECD Guideline #202

Date 14-DEC-12

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)

Dow AgroSciences (DAS) has submitted the enclosed study in response to its understanding of the U.S. Environmental Protection Agencys interpretation of FIFRA 6(a)(2). However, DAS has not concluded that this information regards an unreasonable adverse effect on the environment or that it is reportable under FIFRA 6(a)(2).

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