Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2018-5220
2. Registrant Information.
Registrant Reference Number: 2018-135
Registrant Name (Full Legal Name no abbreviations): MONSANTO CANADA ULC
Address: 180 KENT STREET, SUITE 810
City: OTTAWA
Prov / State: ONTARIO
Country: CANADA
Postal Code: K1P 0B6
3. Select the appropriate subform(s) for the incident.
Environment
4. Date registrant was first informed of the incident.
16-JUL-18
5. Location of incident.
Country: CANADA
Prov / State: MANITOBA
6. Date incident was first observed.
27-JUN-18
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. 31896
PMRA Submission No.
EPA Registration No.
Product Name: XtendiMax with VaporGrip Technology
- Active Ingredient(s)
- DICAMBA (PRESENT AS ACID, AMINE SALT, ESTER, POTASSIUM SALT, OR SODIUM SALT)
PMRA Registration No. 27487
PMRA Submission No.
EPA Registration No.
Product Name: Roundup WeatherMax
7. b) Type of formulation.
Application Information
8. Product was applied?
Yes
9. Application Rate.
.5
Other Units: L/ac
10. Site pesticide was applied to (select all that apply).
Site: Agricultural-Outdoor/Agricole-extérieur
Préciser le type: soybeans
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?
Yes
Subform IV: Environment (includes plants insects and wildlife)
1. Type of organism affected
Herbaceous Plants / Plante herbacée
2. Common name(s)
soybeans
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
Deformities
Stunted vegetative growth
Visible injury ( eg. chlorosis, necrosis, bleaching)
7. Describe symptoms and outcome (died, recovered, etc.).
leaf cupping and leaf crinkling
8. a) Was the incident a result of (select all that apply)
Drift
N/A
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
20 acres out of a total of 43 acres