Déclaration d'incident

Sous-formulaire I: Renseignements généraux

1.Type de rapport.

Nouvelle déclaration d'incident

No de la demande: 2013-3624

2. Renseignements concernant le titulaire.

Numéro de référence du titulaire d'homologation: x

Nom du titulaire (nom légal complet, aucune abbréviation): x

Adresse: x

Ville: x

État: x

Pays: x

Code postal /Zip: X

3.Choisir le (les) sous-formulaire(s) correspondant à l'incident.

Environnement

4. Date à laquelle le titulaire d'homologation a été informé pour la première fois de l'incident.

5. Lieu de l'incident.

Pays: CANADA

État: ONTARIO

6. Date de la première observation de l'incident.

06-MAY-13

Description du produit

7. a) Donner le nom de la matière active et, si disponibles, le numéro d'homologation et le nom du produit (incluant tous les mélanges). Si le produit n'est pas homologué, donner le numéro de la demande d'homologation.

Matière(s) active(s)

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ARLA No d'homologation       ARLA No de la demande d'homologation       EPA No d'homologation.

Nom du produit: unknown

• Matière active
  • CLOTHIANIDIN
  • THIAMETHOXAM

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7. b) Type de formulation.

Renseignments sur l'application

8. Est-ce que le produit a été appliqué?

Inconnu

9. Dose d'application.

Inconnu

10. Site d'application (choisir tout ce qui s'applique).

Site: Unknown / Inconnu

11. Donner tout renseignement additionnel concernant l'application (comment le produit a été appliqué, la quantité utilisée, la superficie de la zone traitée, etc.)

In 2012, the following treatments were applied to the hives: formic acid, fluvalinate-tau and antibiotics. In 2013, the following treatments were applied to the hives: formic acid and antibiotics. Information on crops located near the beeyards: 40 ac of corn - Field 1 was unknown distance from the beeyard, and was planted on 2013-05-06, using a conventional method. Pioneer P0118YHR (PPST 250) P9910LR Lot# K3Ch A11146-0 was planted. Other crops in the area included soybean stubble, bush and hay;400 ac of corn - Field 2 was an unknown distance from the beeyard, and was planted on May 3 - May 6 2013 using a White Air Planter - Positive Air as the planting method . Pioneer (Poncho/Vitivo 1250) Variety P0Z16HR Lot# K3PLY11015-0 Batch#1727959 was planted; No seed Lubricant was used; 20 ac of corn - Field 3, and was planted on 2013-05-07, using a John Deere 1780 (vacuum) as planting method. 35F44 Pioneer (Herleulex Roundup) Treated with PPs250, no seed lubricant used was used; 50 ac of corn - Field 4 was unknown distrance from the beeyard, and was planted on May 2 - May 4 2013 , using a John Deere 1780 (vacuum) . Pioneer 35F60 (probably treated with PPS250), Seed Lubricant - John Deere Talc (250ml 6 bags) was used;50 ac of corn - Field 5 was unknown distance from the beeyard, and was planted on 2013-05-07. Dekalb 5262 was used; Corn - Field 6 was unknown distance from the beeyard. Dekalb was used on the crop. Beekeeper reported kill of 300 plus bees.

À être déterminé par le titulaire

12. Selon vous, le produit a-t-il été utilisé en conformité avec le mode d'emploi de L'étiquette?

Inconnu

Sous-formulaire IV : Environnement (y compris les plantes, les insectes et la faune)

1. Type d'organisme touché

Terr. Invrtbrt-Honey Bee/Inv.Ter-Abeille

2. Nom(s) commun(s)

honey bee

3.Nom(s) scientifique(s)

Inconnu

4. Nombre d'organismes touchés

Inconnu

5. Description du lieu où l'incident a été observé:

Eau douce

Terrestre

Eau salée

6. Cocher tous les symptômes qui s'appliquent à:

Anomalies du comportement

Mort

7.Décrire les symptômes et issue (mort, rétablissement, etc.).

There were a total of 25 colonies in the bee yard. There were 5 affected colonies. There were 0 - 500 dead bees per colony observed outside of hive. Bees were actively foraging at the time of the incident.Adult bee symptoms included shaking/ trembling/twitching, vomit, regurgitation, and crawling. No brood symptoms were observed; no queen symptoms were observed; Sample of moist soil from wet area, labelled Sample # 4, had positive detects for clothianidin. Sample of dead bees taken from affected hive labelled`Sample # 2, had positive detects for clothianidin, fuberidazole and thiamethoxam. Sample of live bees taken from affected hive, labelled sample #1, had positive detects for clothianidin and thiamethoxam. Samples of live bees taken from unaffected hive, labelled sample # 3, had no detected active ingredients.The weather at the time of the incident was sunny, dry not that windy, warm, normal spray weather. Prior to the incident, there were an average of approx. 8 frames of bees, approx. 5 frames of brood, and approx. 2 with honey/pollen mix. The adverse effects were still occuring at the time of the report. Additional food sources provided to the bees included sugar syrup.In 2012, the following treatments were applied to the hives: formic acid, fluvalinate-tau and antibiotics.In 2013, the following treatments were applied to the hives: formic acid and antibiotics.Information on crops located near the beeyards: 40 ac of corn - Field 1 was unknown distance from the beeyard, and was planted on 2013-05-06, using a conventional method. Pioneer P0118YHR (PPST 250) P9910LR Lot# K3Ch A11146-0 was planted. Other crops in the area included soybean stubble, bush and hay; 400 ac of corn - Field 2 was an unknown distance from the beeyard, and was planted on May 3 - May 6 2013 using a White Air Planter - Positive Air as the planting method . Pioneer (Poncho/Vitivo 1250) Variety P0Z16HR Lot# K3PLY11015-0 Batch#1727959 was planted; No seed Lubricant was used; 20 ac of corn - Field 3, and was planted on 2013-05-07, using a John Deere 1780 (vacuum) as planting method. 35F44 Pioneer (Herleulex Roundup) Treated with PPs250, no seed lubricant used; 50 ac of corn - Field 4 was unknown distrance from the beeyard, and was planted on May 2 - May 4 2013 , using a John Deere 1780 (vacuum) . Pioneer 35F60 (probably treated with PPS250), Seed Lubricant - John Deere Talc (250ml 6 bags) was used; 50 ac of corn - Field 5 was unknown distance from the beeyard, and was planted on 2013-05-07. Dekalb 5262 was used; Corn - Field 6 was unknown distance from the beeyard. Dekalb was used on the crop. Beekeeper reported kill of 300 plus bees.

8. a) Est-ce que l'incident a été causé par (coucher tout ce qui s'applique) :

Inconnu

8. b) i)Combien de fois le produit a-t-il été appliqué cette année?

Inconnu

8. b) ii)Date de la dernière application

Inconnu

9. Est-ce qu'il a plu

9. a) Pendant l'application?

Inconnu

9. b) Jusqu'à 3 jours après l'application?

Inconnu

10. a)Y avait-il une zone tampon?

Inconnu

10. b) De quel genre?

Aquatique

10. c) Quelle étaite la taille de la zone tampon?

11.Est-ce que des échantillons ont été recueillis dans l'environnement et analysés?

Inconnu

À être déterminé par le titulaire

12.Classification selon la gravité (s'il y a plus d'une catégorie possible, veuillez choisir la plus grave)

13.Donner des renseignements additionnels ici