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Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2019-4531

2. Registrant Information.

Registrant Reference Number: B003/276148

Registrant Name (Full Legal Name no abbreviations): Amvac Chemical Corporation

Address: 4695 MacArther Court Suite 1200

City: Newport Beach

Prov / State: California

Country: USA

Postal Code: 92660

3. Select the appropriate subform(s) for the incident.

Scientific Study

4. Date registrant was first informed of the incident.

5. Location of incident.

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. 19399      PMRA Submission No.       EPA Registration No. 5481-469

Product Name: Vapam Technical

• Active Ingredient(s)
  • METAM-SODIUM

PMRA Registration No. 6453      PMRA Submission No.       EPA Registration No. 5481-466

Product Name: Vapam Liquid Solution Soil Fumigant

• Active Ingredient(s)
  • METAM-SODIUM

PMRA Registration No. 13139      PMRA Submission No.       EPA Registration No. 5481-470

Product Name: Pole-Fume

• Active Ingredient(s)
  • METAM-SODIUM

PMRA Registration No. 29128      PMRA Submission No.       EPA Registration No. 5481-468

Product Name: Vapam HL

• Active Ingredient(s)
  • METAM-SODIUM

PMRA Registration No. 29770      PMRA Submission No.       EPA Registration No.

Product Name: Pole-Fume HL

• Active Ingredient(s)
  • METAM-SODIUM

7. b) Type of formulation.

Application Information

8. Product was applied?

Unknown

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 VII: Scientific Study

1. Study Reference

Title Evaluation of the Mutagenic Activity of Metam Sodium in an in vitro Mammalian Cell Gene Mutation Test with L5178Y Mouse Lymphoma Cells

Date 03-JUN-19

2. a) Is an extension needed to translate the document?

No

3. Type of incident identified in the study

New health or environmental hazard

4. Describe the incident identified in the study (e.g. study demonstrates an increased risk to non-Hodgkin's Lymphoma after exposure to pesticide X)

The letter addresses data from an in vitro mouse lymphoma assay (MLA) (OECD 490) as well as information from an Ames assay (OCED 471) also conducted by Eastman in 2019 for metam sodium and additional data in the context of existing data that the U.S. Environmental Protection Agency (EPA) has reviewed and on which it has based its conclusion that [¿¿¿¿¿¿t]here is no mutagenic concern for metam sodium.¿¿¿¿¿¿

5. a) Was the study discontinued before completion?

No

5. b) Provide the reason for discontinuation

6. If the study is ongoing, what is the expected completion date?

For Registrant use only

7. Provide supplemental information here