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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2012-4377

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.


4. Date registrant was first informed of the incident.

5. Location of incident.

Country: CANADA


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.       PMRA Submission No.       EPA Registration No.

Product Name:

  • Active Ingredient(s)

7. b) Type of formulation.

Application Information

8. Product was applied?


9. Application Rate.


10. Site pesticide was applied to (select all that apply).

Site: Agricultural-Outdoor/Agricole-extérieur

11. Provide any additional information regarding application (how it was applied, amount applied, the size of the area treated etc).

Statement from bookeeper:'I am unsure what particular chemical caused the damage or what the bees were foraging on but am certain it was pesticide damage'. Anecdotally, products being used in the area at the time included chlorpyrifos and dimethoate. Statement from beekeeper: "The main floral source in the area at the time would have been wild mustard, volunteer canola and/or dandelion growing in the crop land and bush within 2 miles of the bee yards. Bees commonly travel up to 2 miles for forage sources - this encompasses approximately 50 quarters of farmland around each apiary location.

To be determined by Registrant

12. In your opinion, was the product used according to the label instructions?


Subform IV: Environment (includes plants insects and wildlife)

1. Type of organism affected

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

2. Common name(s)


3. Scientific name(s)


4. Number of organisms affected


5. Description of site where incident was observed

Fresh water



Salt Water

6. Check all symptoms that apply


7. Describe symptoms and outcome (died, recovered, etc.).

" Adult foraging bees - total number of affected hives bees unknown. death; dead bees on ground outside affected hives live worker bees clearing out dead and or dying foraging bees. Death of majority of foraging population of affected hives; reduced viablility of the hive due to loss of adult foraging (nectar/pollen collecting bees); reduced honey yield Photos of dead bees on the ground surrounding the hives (according to the Provincial Specialist in Apiculture, this pattern is associated with a pesticide-related incident). Additional statements from the Beekeeper: (included with Incident Report What is often overlooked is the potential for bees to be foraging for water in nearby non forage crop land and the fact that spray planes kill bees flying across non forage crops to access forage crops. Continued allowance by regulatory bodies of insecticides with multi day residual is a detriment to the managed and wild bee populations and well as other wildlife and the environment.Beekeeper has seen spray planes and high clearance sprayers spraying insecticides during forage hours, including mid day. (Off) label use is not uncommon. An average apiary site is SK is from 24 - 48 colonies. SK beekeepers operate approximately 120,000 colonies.

8. a) Was the incident a result of (select all that apply)


8. b) i) How many times has the product been applied this year?


8. b) ii) What was the date of the last application?


9. Did it rain

9. a) During application?


9. b) Up to 3 days after application?


10. a) Was there a buffer zone?


10. b) What type?

10. c) What was the size of the buffer zone?

11. a) Were environmental samples collected and analysed?


To be determined by Registrant

12. Severity classification (if there is more than one possible classification, select the most severe)

13. Please provide supplemental information here