Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2016-7710
2. Registrant Information.
Registrant Reference Number: ProPharma Group case #: 1-45307929
Registrant Name (Full Legal Name no abbreviations): Syngenta Canada Inc.
Address: 140 Research Lane, Research Park
City: Guelph
Prov / State: Ontario
Country: Canada
Postal Code: N1G4Z3
3. Select the appropriate subform(s) for the incident.
Environment
4. Date registrant was first informed of the incident.
19-AUG-16
5. Location of incident.
Country: CANADA
Prov / State: ONTARIO
6. Date incident was first observed.
Unknown
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. 31058
PMRA Submission No.
EPA Registration No.
Product Name: REGLONE ION
7. b) Type of formulation.
Application Information
8. Product was applied?
Yes
9. Application Rate.
Unknown
10. Site pesticide was applied to (select all that apply).
Site: Agricultural-Outdoor/Agricole-extérieur
Préciser le type: unknown
11. Provide any additional information regarding application (how it was applied, amount applied, the size of the area treated etc).
1-45307929 - The product was accidentally applied to the vegetable crops as a result of a mechanical failure of an aircraft applicator. The product was intended to be applied to another crop an unknown amount of miles away.
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
Herbaceous Plants / Plante herbacée
2. Common name(s)
potatoes, tomatoes, cucumber, corn, beets, basil, squash, and carrots
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
Visible injury ( eg. chlorosis, necrosis, bleaching)
7. Describe symptoms and outcome (died, recovered, etc.).
1-45307929 - The reporter indicates use of an herbicide that contains the active ingredient diquat. On the day of initial contact with the registrant, the reporter indicated an unknown amount of the product had been accidentally sprayed at an unknown time on multiple vegetable crops due to a mechanical failure on an applicator aircraft. The affected plants displayed spotting and localized damage to the leaf surfaces. No additional information is available.
8. a) Was the incident a result of (select all that apply)
Other
Accidental application because of mechanical failure
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)
Minor
13. Please provide supplemental information here