Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2019-0508
2. Registrant Information.
Registrant Reference Number: DASC072318
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.
23-JUL-18
5. Location of incident.
Country: CANADA
Prov / State: ALBERTA
6. Date incident was first observed.
25-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. 28945
PMRA Submission No.
EPA Registration No.
Product Name: Grazon XRT
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: Other / Autre
Préciser le type: Along a retaining wall
11. Provide any additional information regarding application (how it was applied, amount applied, the size of the area treated etc).
Applicator controlling non-desirable shrubs and broad leaf weeds along retaining wall / fenced area reported drift into non-target area.
To be determined by Registrant
12. In your opinion, was the product used according to the label instructions?
No
Subform IV: Environment (includes plants insects and wildlife)
1. Type of organism affected
Trees or shrubs / Arbre ou arbuste
2. Common name(s)
Crab apple trees and shrubs
3. Scientific name(s)
Unknown
4. Number of organisms affected
Unknown
5. Description of site where incident was observed
Fresh water
Terrestrial
Residential
Salt Water
6. Check all symptoms that apply
Abnormal leaf discoloration
Epinasty (leaf wilt)
Visible injury ( eg. chlorosis, necrosis, bleaching)
7. Describe symptoms and outcome (died, recovered, etc.).
Cupping/browning (dessication) of affected, non-target foliage of shrubs. Alleged crab apple trees showed yellowing of leaves.
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