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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2020-1014

2. Registrant Information.

Registrant Reference Number: N/A

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

Address: 4695 MacArthur Court, Suite 1200

City: Newport Beach

Prov / State: California

Country: USA

Postal Code: 92660

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: ALBERTA

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. 29000      PMRA Submission No.       EPA Registration No.

Product Name: Thimet 20G

  • 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?

Box-plastic / Bote-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.

It appears that the container was punctured by a forklift when loading into truck.

For Registrant use only

5. Provide supplemental information here.

Spilled material was swept up and placed in a sealed drum for disposal. No exposures or adverse effects were reported.