Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2017-2258
2. Registrant Information.
Registrant Reference Number: DASC061516
Registrant Name (Full Legal Name no abbreviations): Dow AgroSciences Canada Inc.
Address: 2400, 215-2nd Street S.W.
City: Alberta
Prov / State: Calgary
Country: Canada
Postal Code: T2P 1M4
3. Select the appropriate subform(s) for the incident.
Environment
4. Date registrant was first informed of the incident.
15-JUN-16
5. Location of incident.
Country: CANADA
Prov / State: ALBERTA
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. 29752
PMRA Submission No.
EPA Registration No.
Product Name: ClearView
- Active Ingredient(s)
- AMINOPYRALID
- METSULFURON-METHYL
PMRA Registration No. 30409
PMRA Submission No.
EPA Registration No.
Product Name: Sightline A Herbicide
- Active Ingredient(s)
- AMINOPYRALID
- FLUROXYPYR (PRESENT AS 1-METHYLHEPTYL ESTER)
- METSULFURON-METHYL
PMRA Registration No. 29994
PMRA Submission No.
EPA Registration No.
Product Name: Vantage XRT
- Active Ingredient(s)
- GLYPHOSATE (PRESENT AS DIMETHYLAMINE SALT)
PMRA Registration No. 30795
PMRA Submission No.
EPA Registration No.
Product Name: Sightline B Herbicide
- Active Ingredient(s)
- FLUROXYPYR 1-METHYLHEPTYL ESTER
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: Industrial / Industriel
Préciser le type: Oil Lease Sites
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
Herbaceous Plants / Plante herbacée
2. Common name(s)
Pea crop
3. Scientific name(s)
Canola crop
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
Abnormal leaf discoloration
Reduced emergence
Visible injury ( eg. chlorosis, necrosis, bleaching)
7. Describe symptoms and outcome (died, recovered, etc.).
Caller reported alleged damage to pea and canola crops (yellowing / stunted plants) adjacent to oil lease sites that were sprayed with ClearView or Sightline A + Sightline B in combination with Vantage XRT in 2015.
8. a) Was the incident a result of (select all that apply)
Run-off
N/A
8. b) i) How many times has the product been applied this year?
Unknown
8. b) ii) What was the date of the last application?
Unknown
9. Did it rain
9. a) During application?
Unknown
9. b) Up to 3 days after application?
Unknown
10. a) Was there a buffer zone?
Unknown
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