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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2013-3612

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

Prov / State: ONTARIO

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: unknown

  • 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: Unknown / Inconnu

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?


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



Salt Water

6. Check all symptoms that apply

Abnormal behavioural effects


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

There were a total of 43 colonies in the bee yard. All 43 colonies were affected.There were between 0 and 500 dead bees per colony observed outside of the hive. It has been too cold for the bees to have been foraging. Adult bee symptoms included shaking/trembling/twitching, crawling, and disoriented. No queen symptoms this year, last year large number of queens got superceded. A lot of winter loss seems to be tied with queen loss, winter kill 47%. Sample of dead bees taken from affected hive in home yard had positive detects for clothianidin.Samples of live bees taken from semi-affected hive in home yard had no detected active ingredients. Composite sample of dead bees taken from affe cted hive in homeyard; had positive detects for clothianidin, thiabendazole and thiamethoxam. The weather at the time of the incident was overcast/cloudy, raining, drizzle cold, wind west at 30km/hr., temp 8C, very humid. Prior to the incident, there were an average of 4 to 5 frames of bees, 2 to 3 frames of brood, and 1] frame of pollen and 5 honey syrup frames. The following pests were present in the affected bee yard in the past year: nosema. After the incident, it was too soon to tell the general health of bee frames, frames of brood lost their foragers; beekeeper expects hives to be stalled out for a bit.Lots of honey/pollen reserves in hives. Additional food sources provided to the bees included sugar syrup, pollen supplement. In 2012, the following treatments were applied to the hives: formic acid. Information on crops located near the beeyards: 75 ac of corn was planted north of beeyard , May 9 to May 10. Information on crops located near the beeyards: 75 ac of corn was adjacent to beeyard , May 9 to May 10. Did not expect to see this kind of damage, conditions were as good as they can get for this happen. Initial call: 5 yards, all affected. Noticed dead bees. Hives came through winter poorly. Split hives, therefore incredibly small. Home yard - planter finished Thurs May 9, 10. Bees haven't been foraging at all.

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