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Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2021-4053

2. Registrant Information.

Registrant Reference Number: 2021-39

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.

5. Location of incident.

Country: CANADA

Prov / State: PRINCE EDWARD ISLAND

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. 33265      PMRA Submission No.       EPA Registration No.

Product Name: Sefina

• Active Ingredient(s)
  • AFIDOPYROPEN
    • Guarantee/concentration 50 g/L

7. b) Type of formulation.

Application Information

8. Product was applied?

No

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 Jug was missing cap and foil seal.

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.

One jug had no cover or seal and was located in the center of the pallet. This made it undetectable due to the leakage. The other jug in the case with it was totally soaked. The label was not legible and was partially disintegrated. The open jug had no cap or foil seal on it nor in the box.

For Registrant use only

5. Provide supplemental information here.