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Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2016-3350

2. Registrant Information.

Registrant Reference Number: 2016-0001

Registrant Name (Full Legal Name no abbreviations): Interprovincial Cooperative Limited

Address: 945 Marion Street

City: Winnipeg

Prov / State: Manitoba

Country: Canada

Postal Code: R2J 0K7

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

Packaging Failure

4. Date registrant was first informed of the incident.

5. Location of incident.

Country: CANADA

Prov / State: ONTARIO

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. 27819      PMRA Submission No.       EPA Registration No.

Product Name: IPCO 2,4-DESTER 700 HERBICIDE

• Active Ingredient(s)
  • 2,4-D (PRESENT AS LOW VOLATILE ESTERS)

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 VI: Packaging Failure

1. What is the type of packaging that failed?

Jug-plastic / Cruche-plastique

2. Did packaging failure occur during?

Storage

3. Did packaging failure result in?

potential exposure

4. Describe how the packaging failed and the surrounding circumstances, including a description of the potential injury or exposure.

A warehouse worker lifted a case of 2 x 10 L product which leaked on to his arm. The arm was flushed with copious amounts of water and the worker is fine. Upon opening the case, the caps on both jugs were very loose.

For Registrant use only

5. Provide supplemental information here.

The caps must not have been sealed properly. Packaging of this product is performed on an automatic line. The capping machine may not have applied the correct amount of torque to the caps and/or the sonic sealing apparatus did not operate properly.