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Déclaration d'incident

Sous-formulaire I: Renseignements généraux

1.Type de rapport.

Nouvelle déclaration d'incident

No de la demande: 2013-3656

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.

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.

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

Nom du produit: unknown

• Matière active
  • THIABENDAZOLE

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.)

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

Agricole

Eau salée

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

Mort

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

There were a total of 600 colonies in the bee yard. There were 600 affected colonies. There were between 0 - 500 dead bees per colony observed outside of hive. After the adverse effects there was a noticeable decline in foraging. Adult bee symptoms included shaking/trembling/twitching, crawling, disoriented. Additionally, sitting on flowers, running up and down grass. No brood symptoms. No queen symptoms observed. Samples of water taken from water sample from affected yard. Labelled sample #2 had no detected active ingredients. Sample of water taken from Water sample from affected yard. Labelled Sample #1, had positive detects for Fosthiasate. Samples of water taken from Water sample from puddle in adjacent farm field to affected yard. Labelled Sample #3 had no detected active ingredients. Sample of dead bees taken from affected hive, composite dead bees from affected bowl yard had positive detects for thiabendazole. Samples of dead bees taken from affected hive, composite dead bees from affected bowl yard had no detected active ingredients. Samples of dead bees taken from affected hive, composite dead bees from affected bowl yard had no detected active ingredients. The weather at the time of the incident was sunny. Prior to the incident, there were an average frames of bees was 1, frames of brood was 1, and frames of pollen and honey was 1. After the incident, there were an average of 1 frames of bees, 1 frames of brood, and 1 frames of pollen and honey. Additional food sources provided to the bees included sugar syrup. In 2012, the following treatments were applied to the hives: fluvalinate-tau. Information on crops located near the beeyards: Corn was 1 km from the beeyard. Other crops in the area include an area that was forested. Soybean was 1 km from the beeyard. Other crops in the area included an area that was forested. 3 large fields of oats was 500 - 1000m from the beeyard, and was planted on 2013-09-03. Milled oats, untreated was used on the crop. Other crops in the area include previously planted w/ winter wheat. Area surrounding bee yard is filled with trees, wildflowers (wild and planted), fruit trees (apples). There is limited agriculture (cereals 2013 across the road), lots of pasture and lawns. Yard contains 600 small colonies, 5 full sized colonies and 1 hive swarm. Bee keeper noticed effects in nucs on June 7. He noticed twitching, bees sitting on flowers, running up and down grass around hives. He thinks that the pesticide contamination is somehow associated with drinking water for the bees as the most affected bees are returning with no pollen on their legs. Bee and water samples were collected for analysis. Bees were not visiting water sources on day of sampling therefore difficult to determine if bees were drinking from those sites. BK called to report a bee kill in 1 hive in his home yard. He was seeing around 300 dead bees. This all happened on Sept. 4. He mentioned that on the evening of the 3rd, the farmer was planting oats for plow-down before winter. This field was previously winter wheat and will be corn in 2014. BK reported that the farmer told him that the oats were treated with an insecticide and then changed to say that they were untreated milled oats. During inspection, inspector dug up oat seeds from the planted field and they were untreated plain oats. BK noted that bees were flying heavy on Sept.4, taking in lots of goldenrod pollen. All of BK queens are in this yard (in 260 nucs_. As he sells queens he will join nucs to create colonies (3 nucs = colony). This yard has been reported in 2 prior cases (May and July).

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

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

8. b) ii)Date de la dernière application

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