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Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2016-1571

2. Registrant Information.

Registrant Reference Number: 2005-4106

Registrant Name (Full Legal Name no abbreviations): MCPA Task Force Three on behalf of Nufarm Inc.

Address: 101 Northway Ct

City: Raleigh

Prov / State: North Carolina

Country: United States

Postal Code: 27615

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. 2005-4106      EPA Registration No.

Product Name:

• Active Ingredient(s)
  • MCPA (PRESENT AS AMINE SALTS: DIETHANOLAMINE, DIMETHYLAMINE, OR MIXED AMINES)

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 MCPA DMA 500 g/L: Growth Inhibition of Myriophyllum spicatum in a Water / Sediment System

Date 22-APR-14

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)

Study provides new data on the acute toxicity of the compound to a non-typical non-target aquatic plant species.

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