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Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2024-2373

2. Registrant Information.

Registrant Reference Number: 8532970

Registrant Name (Full Legal Name no abbreviations): ADAMA Agricultural Solutions Canada Ltd.

Address: 300 a 191 Lombard Avenue

City: Winnipeg

Prov / State: Manitoba

Country: Canada

Postal Code: R3B 0X1

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. 29373      PMRA Submission No.       EPA Registration No.

Product Name: ADAMA CLODINAFOP-PROPARGYL TECHNICAL

• Active Ingredient(s)
  • CLODINAFOP-PROPARGYL

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 Clodinafop-propargyl: Bacterial Reverse Mutation Assay

Date 13-MAY-24

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)

In a OECD 471 Guideline and GLP compliant Ames test, positive resultswere obtained in S. typhimurium strains TA98 and TA 1537, atconcentrations of aY=4 mg/plate and aY=1.6 mg/plate respectively, in thepresence of metabolic activation only.

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?

For Registrant use only

7. Provide supplemental information here