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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2013-3652

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


Reproductive impairment

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

There were a total of 32 colonies in the bee yard. There were 4 affected colonies. The average number of dead adult bees per colony were unknown. Dead bees were observed outside the hive and in front of hive. Adult bee symptoms included shaking/trembling/twitching and disorientation. Not a lot of brood sign. Queen symptoms included unusual laying pattern. Additionally, queen not as healthy, new queen placed in cell, 4 out of 32 hives queenless. Sample of pollen comb taken from affected hive, collected from colony 13 at yard, had positive detects for acetachlor, clothianidin and thiamethoxam.Sample of pollen comb taken from less affected hive, collected from colony 6 at yard, had positive detects for thiabendazole, thiacloprid and thiamethoxam.Samples of live bees taken from less affected hive, collected from colony 6 (lesser affected hive) at yard, had no detected active ingredients.Sample of dead bees taken from affected hive, collected from affected colony 13(note queen falling) at yard, had positive detects for carbendazim. The weather at the time of the incident was unknown. The following pests were present in the affected bee yard in the past year; chalkbrood. After the incident, there were an average of 10 to 12 frames of bees, 5 to 6 frames of brood, and 4 to 5 frames of pollen and honey. In 2012, the following treatments were applied to the hives: oxalic acid, formic acid and fluvalinate-tau. In 2013, the following treatments were applied to the hives: formic acid, amitraz. Information on crops located near the beeyards: Corn was located 20 yards from the beeyard. Forest(woods) was surrounds the bee yard from the beeyard.Beekeeper has 57 yards and 52 yards in total were affected. This spring he has a 62% loss of colonies (483 hives). There has been corn planting in his area. Beekeeper has not noticed piles of dead bees but has noticed twitching bees. A number of his colonies are queenless and are disappearing. Southern yards were more affected than northern yards. Yard on 86 not as bad. In general nucs appeared better than full colonies (old food sources in both though). Hive with twitching short circuiting bees and lots of old dead bees. Opened hive and not a lot of bees. Drone layer in hive a sign of queen failing -new queen cell placed in hive yesterday. Initial call (June 6): last year, 1338 colonies, corn planting. This spring 62% loss (483 hives, 57 beeyards). Not the number of dead bees, twitching, number of colonies disappearing. large number of hives queenless. 195 dead hives.

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