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Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2022-2064

2. Registrant Information.

Registrant Reference Number: Rocky Mountain PC Case#: 6548074

Registrant Name (Full Legal Name no abbreviations): FMC Corporation

Address: 2929 Walnut Street

City: Philadelphia

Prov / State: Pennsylvania

Country: USA

Postal Code: 19104

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: SASKATCHEWAN

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.       PMRA Submission No.       EPA Registration No. 279-3241

Product Name: AIM EC Herbicide

• Active Ingredient(s)
  • CARFENTRAZONE-ETHYL
    • Guarantee/concentration 22.3 %

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?

Storage

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.

Jug leaked in container- No exposure

For Registrant use only

5. Provide supplemental information here.

Note for 4/13/2022[Name], FMC RepresentativeStates [Name] reports 4 containers of AIM 1.2L Lot # W220-2-07-1, Distributor [Distributor]"Seepage from bottles, CS well discovered what looks like to be glue from the labels all over bottles"Action: Will replace with Demo product as neededNote for 4.25.2022[Name], FMC RepresentativeRetail: [Retailer]Product: Aim - Lot # W2105-10-1 - number of cases #1Number of containers 2 - Photos takenDescription:"Leaking seals on jugs, caused product to spill on to jugs.Action: Gave them 2 demo jugs.Note for 5.10.2022[Name], FMC RepresentativeGrower Name: [Name], [Name].Retail SWT - [Name]Product AIM 1.2 L - Unknown Lot # - Number of cases 1Number of containers 8 - Distributor [Distributor] - no photos takenDescription:Sealed case, but at least one jug was leaking and made a mess of the contents.Action:Please ship 1 case of AIM 1.2 L to [Name], Pioneer Co-Op, Swift Current