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Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2020-6006
2. Registrant Information.
Registrant Reference Number: 2020-41
Registrant Name (Full Legal Name no abbreviations): BASF Canada Inc.
Address: 100 Milverton Drive, 5th Floor
City: Mississauga
Prov / State: Ontario
Country: Canada
Postal Code: L5R 4H1
3. Select the appropriate subform(s) for the incident.
Packaging Failure
4. Date registrant was first informed of the incident.
17-JUN-20
5. Location of incident.
Country: CANADA
Prov / State: ALBERTA
6. Date incident was first observed.
17-JUN-20
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. 28837
PMRA Submission No.
EPA Registration No.
Product Name: LIBERTY 150SN
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 VI: Packaging Failure
1. What is the type of packaging that failed?
Tank tote / Cuve
2. Did packaging failure occur during?
Other
specify Unknown
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.
Retailer found a leaking drum of Liberty in their warehouse. It was leaking from the bottom.
For Registrant use only
5. Provide supplemental information here.