Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2017-5199
2. Registrant Information.
Registrant Reference Number: 2017-18
Registrant Name (Full Legal Name no abbreviations): BASF Canada
Address: 100 Milverton, 5th floor
City: Mississauag
Prov / State: ON
Country: Canada
Postal Code: L5R4H1
3. Select the appropriate subform(s) for the incident.
Environment
4. Date registrant was first informed of the incident.
18-AUG-17
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. 32220
PMRA Submission No.
EPA Registration No.
Product Name: Engenia
- Active Ingredient(s)
- DICAMBA (PRESENT AS N,N-BIS-(3-AMINOPROPYL)METHYLAMINE SALT)
7. b) Type of formulation.
Application Information
8. Product was applied?
Yes
9. Application Rate.
300
Other Units: ml/a
10. Site pesticide was applied to (select all that apply).
Site: Agricultural-Outdoor/Agricole-extérieur
Préciser le type: soy
11. Provide any additional information regarding application (how it was applied, amount applied, the size of the area treated etc).
applied at 300ml/a to dt soy boom width 100ft,nozzle space 20in;wind speed 7.5-9.1,temperature 22-23C
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)
soy
3. Scientific name(s)
glycine max
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 flower quality or number
Stunted vegetative growth
Visible injury ( eg. chlorosis, necrosis, bleaching)
7. Describe symptoms and outcome (died, recovered, etc.).
buffer zone 10ft, appeared to affect 30a
8. a) Was the incident a result of (select all that apply)
N/A
Unknown
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