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Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2021-3070

2. Registrant Information.

Registrant Reference Number: 2021-24

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.

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. 20898      PMRA Submission No.       EPA Registration No.

Product Name: Bentazon Technical Herbicide

• Active Ingredient(s)
  • BENTAZON (PRESENT AS SODIUM SALT)

PMRA Registration No. 25109      PMRA Submission No.       EPA Registration No.

Product Name: Imazamox Technical Herbicide

• Active Ingredient(s)
  • IMAZAMOX

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 BAS 762 01 H: Toxicity to the Aquatic Plant Myriophyllum spicatum in a Static Growth Inhibition Test with a Prior Rooting Phase

Date 18-JUN-21

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)

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?

Unknown

For Registrant use only

7. Provide supplemental information here