Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2015-4102

2. Registrant Information.

Registrant Reference Number: 2015-22

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

Address: 900 One Research Road

City: Winnipeg

Prov / State: Manitoba

Country: CANADA

Postal Code: R3T 6E3

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

Environment

4. Date registrant was first informed of the incident.

04-AUG-15

5. Location of incident.

Country: CANADA

Prov / State: ONTARIO

6. Date incident was first observed.

22-JUN-15

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. 27487      PMRA Submission No.       EPA Registration No.

Product Name: Roundup WeatherMax with Transorb 2 Technology Liquid Herbicide

• Active Ingredient(s)
  • GLYPHOSATE (PRESENT AS POTASSIUM SALT)

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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).

Site: Unknown / Inconnu

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

Fish-Non-schooling/Poisson-Autre poisson

2. Common name(s)

Pike, Catfish, Chub, minnow

3. Scientific name(s)

Esox lucius, Siluriformes, Leuciscus cephalus

4. Number of organisms affected

100

5. Description of site where incident was observed

Fresh water

Stream

Terrestrial

Agricultural

Salt Water

6. Check all symptoms that apply

Death

7. Describe symptoms and outcome (died, recovered, etc.).

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

Spill

N/A

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)

Major

13. Please provide supplemental information here

There is a possibility that some species at risk may be present in the area and therefore Monsanto is erring on the side of caution and submitting as a major environmental incident with a reporting time frame of 15 days.