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Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2014-3513
2. Registrant Information.
Registrant Reference Number: PROSAR case #: 1-37698918
Registrant Name (Full Legal Name no abbreviations): Scotts Canada Ltd.
Address: 2000 Argentia Road, Plaza 2, Suite 300
City: Mississauga
Prov / State: Ontario
Country: Canada
Postal Code: L5N1V8
3. Select the appropriate subform(s) for the incident.
Environment
4. Date registrant was first informed of the incident.
03-JUL-145. Location of incident.
Country: CANADA
Prov / State: ONTARIO
6. Date incident was first observed.
Unknown
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. 2009025 PMRA Submission No. EPA Registration No.
Product Name: Turf Builder Lawn Fertilizer 10-0-0 with Weed Prevent
- Active Ingredient(s)
- CORN GLUTEN MEAL
7. b) Type of formulation.
Application Information
8. Product was applied?
No
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 IV: Environment (includes plants insects and wildlife)
1. Type of organism affected
Mammal-Small/Mammifère-De petite taille
2. Common name(s)
Mouse
3. Scientific name(s)
Unknown
4. Number of organisms affected
Unknown
5. Description of site where incident was observed
Fresh water
Terrestrial
Residential
Salt Water
6. Check all symptoms that apply
Death
7. Describe symptoms and outcome (died, recovered, etc.).
1-37698918 - The reporter, a home owner, indicated that some wild mice were exposed to a weed preventer containing the active ingredient corn gluten meal. The reporter contacted the registrant by email indicating that he had stored the product in his shed over the winter. This spring he found the bag with holes chewed in it and an unspecified number of mice were found dead in the shed. The reporter thought that the death of the mice might be related to ingestion of this product. The reporter could not be reached on follow-up. No further information is available.
8. a) Was the incident a result of (select all that apply)
Other
The mice chewed holes into the product bag
8. b) i) How many times has the product been applied this year?
8. b) ii) What was the date of the last application?
9. Did it rain
9. a) During application?
No
9. b) Up to 3 days after application?
No
10. a) Was there a buffer zone?
No
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
