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Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2021-3942
2. Registrant Information.
Registrant Reference Number: CVTA202108041
Registrant Name (Full Legal Name no abbreviations): Corteva Agriscience Canada Company
Address: Suite 2450, 215 - 2nd Street S.W.
City: Calgary
Prov / State: Alberta
Country: Canada
Postal Code: T2P 1M4
3. Select the appropriate subform(s) for the incident.
Packaging Failure
4. Date registrant was first informed of the incident.
27-JUL-21
5. Location of incident.
Country: CANADA
Prov / State: MANITOBA
6. Date incident was first observed.
27-MAY-21
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. 30914
PMRA Submission No.
EPA Registration No.
Product Name: Curtail M
- Active Ingredient(s)
- CLOPYRALID PRESENT AS ACID, OR AS SALTS
- Guarantee/concentration 50 g/L
- MCPA (PRESENT AS ESTERS)
- Guarantee/concentration 280 g/L
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?
Jug-plastic / Cruche-plastique
2. Did packaging failure occur during?
Other
specify unknown, a leaking jug was identified in the middle of a pallet.
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.
Unknown
For Registrant use only
5. Provide supplemental information here.