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Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2019-2224
2. Registrant Information.
Registrant Reference Number: Rocky Mountain PC Case#: 6066635
Registrant Name (Full Legal Name no abbreviations): FMC Corporation
Address: 2929 Walnut Street
City: Philadelphia
Prov / State: Pennsylvania
Country: USA
Postal Code: 19104
3. Select the appropriate subform(s) for the incident.
Packaging Failure
4. Date registrant was first informed of the incident.
17-MAY-19
5. Location of incident.
Country: CANADA
Prov / State: UNKNOWN
6. Date incident was first observed.
15-MAY-19
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. 29468
PMRA Submission No.
EPA Registration No.
Product Name:
7. b) Type of formulation.
Application Information
8. Product was applied?
No
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?
Unknown
Subform VI: Packaging Failure
1. What is the type of packaging that failed?
Unknown / Inconnu
2. Did packaging failure occur during?
Storage
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.
3 cases of the product have the active ingredient for Nuance in them, but were mislabeled with a Nimble label. The 3 cases have been isolated.
For Registrant use only
5. Provide supplemental information here.