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Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2015-3967

2. Registrant Information.

Registrant Reference Number: 20150122

Registrant Name (Full Legal Name no abbreviations): Bayer CropScienc Inc

Address: Suite 200, 160 Quarry Park Blvd SE

City: Calgary

Prov / State: AB

Country: Canada

Postal Code: T2C 3G3

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. 19705      PMRA Submission No.       EPA Registration No.

Product Name: BROMOXYNIL OCTANOATE TECHNICAL

• Active Ingredient(s)
  • BROMOXYNIL

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 Toxicity of Bromoxynil-octanoate Technical During an Acute Oral LD50 with the Canary (Serinus canaria)

Date 02-JAN-15

2. a) Is an extension needed to translate the document?

No

3. Type of incident identified in the study

Increased health or environmental risk

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)

BCS is submitting to the Agency new information related to the toxicity of Bromoxynil Technical. BCS has performed an avian acute oral toxicity test (OCSPP 850.2100) with the passerine species Serinus canaria (canary) and this new information is being submitted for the agencys own review and evaluation.

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?

For Registrant use only

7. Provide supplemental information here