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Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2025-5956

2. Registrant Information.

Registrant Reference Number: 2025-71

Registrant Name (Full Legal Name no abbreviations): BASF Agricultural Solutions Canada Inc.

Address: 510 - 28 Quarry Park Blvd. SE

City: Calgary

Prov / State: Alberta

Country: Canada

Postal Code: L4W 0B6

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. 27598      PMRA Submission No.       EPA Registration No.

Product Name: CENTURION EMULSIFIABLE CONCENTRATE

• Active Ingredient(s)
  • CLETHODIM
  • POLYOXYALKYLATED ALKYL PHOSPHATE ESTER

PMRA Registration No. 22644      PMRA Submission No.       EPA Registration No.

Product Name: AMIGO ADJUVANT

• Active Ingredient(s)

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

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.

This product is a Co-pack of Centurion and Amigo products, and it's unclear which product was leaking.

For Registrant use only

5. Provide supplemental information here.