Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2021-3828
2. Registrant Information.
Registrant Reference Number: 2021-32
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.
Active(s)
PMRA Registration No. 30561
PMRA Submission No.
EPA Registration No.
Product Name: XEMIUM TECHNICAL FUNGICIDE
PMRA Registration No.
PMRA Submission No.
EPA Registration No. Unknown
Product Name: Mefentrifluconazol
PMRA Registration No. 27321
PMRA Submission No.
EPA Registration No.
Product Name: PYRACLOSTROBIN TECHNICAL FUNGICIDE
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 Acute toxicity of a tank mix formulation out of BAS 752 09 F and BAS 500 06 F to Daphnia magna STRAUS in a 48 hour static test
Date 28-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