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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2018-3998

2. Registrant Information.

Registrant Reference Number: x

Registrant Name (Full Legal Name no abbreviations): x

Address: x

City: x

Prov / State: x

Country: x

Postal Code: X

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


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. 29343      PMRA Submission No.       EPA Registration No.


  • Active Ingredient(s)
      • Guarantee/concentration 18 %

7. b) Type of formulation.


Application Information

8. Product was applied?


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?


Subform VI: Packaging Failure

1. What is the type of packaging that failed?

Bottle-plastic / Bouteille-plastique

2. Did packaging failure occur during?


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.

On August 2, 2018 at approximately 9:00 pm, x was performing a chemical container reconciliation in x of the x when he noticed liquid in the bottom of corrosive cabinet #7 in x (Chemical Storage). The cabinet is vented so there was no immediate smell and a pH test indicated a pH of 3. There were six, four liter containers of Safer's Commercial Topgun Herbicide Concentrate (PCP# 29343) at the bottom of the cabinet. Further inspection found that two of the containers were cracked and leaking herbicide into bottom of the cabinet. The majority of the spill was contained in the spill tray but some liquid did overflow into the cabinet and ground. The acid cabinet next to cabinet #7 also had herbicide on top of it as a result of the containers being placed on top to identify what was issue. The herbicide did not enter the drain that is located in the room. (drain is connected to containment tank and a closed system). A total of approximately 4 liters of herbicide spilled during the incident. The MSDS for the herbicide was looked up in the database and proper spill procedures were followed. Water and absorbent pads were used to soak up the herbicide and all contents were placed in a hazardous waste drum for proper disposal. A mop and water was used to do a secondary clean-up of the area as per the MSDS instructions. Proper protective equipment (Tyvek suit, booties, full face respirator, Organic Vapour cartridges and nitrile gloves were worn by x during the entire cleanup. The doors to the room and overhead door in x were opened up to allow adequate ventilation. The contents of the other 4 remaining Safer's containers (plastic containers were brittle and 4 years old) were transfered to new waste containers and will be disposed of through a licensed disposal company in Sept.

For Registrant use only

5. Provide supplemental information here.

No humans, animals or the environment suffered any harm as a result of the incident.