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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2020-0933

2. Registrant Information.

Registrant Reference Number: Rocky Mountain PC Case# 6197861

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.


5. Location of incident.

Country: CANADA

Prov / State: UNKNOWN

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. 28285      PMRA Submission No.       EPA Registration No.

Product Name: Refine M Herbicide Copack

  • Active Ingredient(s)

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.

While unloading they noticed 10 cases that were wet due to a apparent leak in a case. Upon further inspection it was found that a corner on one of the jugs had been pushed in causing a crack in the jug causing it to leak. There was no evidence of outside case damage. This may have been a bad jug that made it through the line and was undetected prior to filling and final packaging. The product had spilled inside the case and was absorbed by the cardboard on the other cases on the skid. No product escaped from the pallet and the ten cases are being contained in salvage drums for return

For Registrant use only

5. Provide supplemental information here.