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Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2015-2267
2. Registrant Information.
Registrant Reference Number: xx
Registrant Name (Full Legal Name no abbreviations): x
Address: x
City: x
Country: 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.
02-JUL-14
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.
PMRA Submission No.
EPA Registration No.
Product Name: x
- 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).
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
Reproductive impairment
7. Describe symptoms and outcome (died, recovered, etc.).
There were a total of 16 colonies in the bee yard.There were 16 affected colonies. The following pests were present in the affected bee yard in the past year; Nosema. Additional food sources provided to the bees included sugar syrup, and pollen supplement. In fall and spring, Mite Wipes was applied to the hives to treat varroa. In fall and spring the antibotics Oxysol, and Fumagillan-B was applied to the hives; Fum-B mixed with sugar syrup in spring, to treat ABF. There were some but not many (0-500) dead bees observed outside of each hive. Brood symptoms included spotty brood production. Queen symptoms included unusual laying pattern. Queens laying eggs that are not in centre of the cell. Effects were gradual over a long period of time. Beekeeper believes that bees brought in pollen that was contaminated with neonics + Fed on it all winter caused the incident. Samples of dead bees and comb pollen taken had positive detects for thiamethoaxam and clothianidin.
8. a) Was the incident a result of (select all that apply)
Drift
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?
10. c) What was the size of the buffer zone?
11. a) Were environmental samples collected and analysed?
Yes
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