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Incident Report
Subform I: General Information
1. Report Type.
Update the report
Incident Report Number: 2012-1680
2. Registrant Information.
Registrant Reference Number: x
Registrant Name (Full Legal Name no abbreviations): x
Address: x
City: x
Prov / State: x
Country: x
Postal Code: X
3. Select the appropriate subform(s) for the incident.
Environment
4. Date registrant was first informed of the incident.
5. Location of incident.
Country: CANADA
Prov / State: ONTARIO
6. Date incident was first observed.
17-APR-12Product 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.
Active(s)PMRA Registration No. PMRA Submission No. EPA Registration No.
Product Name: Pioneer seed
- Active Ingredient(s)
- CLOTHIANIDIN
- THIAMETHOXAM
7. b) Type of formulation.
Application Information
8. Product was applied?
Yes
9. Application Rate.
Unknown
10. Site pesticide was applied to (select all that apply).
Site: Agricultural-Outdoor/Agricole-extérieur
Préciser le type: corn seed
11. Provide any additional information regarding application (how it was applied, amount applied, the size of the area treated etc).
Inspected by Health Canada Pest Mgt. Program, ENE, and OMAFRA on April 18.To be determined by Registrant
12. In your opinion, was the product used according to the label instructions?
Unknown
Subform IV: Environment (includes plants insects and wildlife)
1. Type of organism affected
Terr. Invrtbrt-Honey Bee/Inv.Ter-Abeille
2. Common name(s)
Honey Bee
3. Scientific name(s)
4. Number of organisms affected
5. Description of site where incident was observed
Fresh water
Terrestrial
Agricultural
Salt Water
6. Check all symptoms that apply
Death
7. Describe symptoms and outcome (died, recovered, etc.).
Corn planted in large field (1200 acres) adjacent to hives on April 17. 23 hives in bee yard with signs of light bee kill. Corn planted by (name), confederation line. Corn planted with large John Deere Air Seeder. Planted with Pioneer Seed - treated with PPST 250 (thiamethoxam). Talc powder (seed lubricant) is added to seed at approx 1 cup to 15 bags seed. Sample of dead bees obtained by ENE on April 18.
8. a) Was the incident a result of (select all that apply)
Unknown
8. b) i) How many times has the product been applied this year?
Unknown
8. b) ii) What was the date of the last application?
Unknown
9. Did it rain
9. a) During application?
Unknown
9. b) Up to 3 days after application?
Unknown
10. a) Was there a buffer zone?
Unknown
10. b) What type?
10. c) What was the size of the buffer zone?
11. a) Were environmental samples collected and analysed?
Yes
