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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2013-3673

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 product

  • 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)

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 21 colonies in the bee yard. There were 3 affected colonies. There were between 501 - 1000 (handful) number of dead adult bees per colony. Dead bees were observed outside the hive. Bees were actively foraging at the time of the incident. After the adverse effects there was a noticeable decline in foraging. Adult bee symptoms included crawling, disoriented. Additionally, dead bees in front of hives. Brood symptoms included overall decline in brood production. Additionally, less brood in 4 hives. Queen symptoms included less brood in 4 hives. Additionally, the queen stopped laying in 1 hive.Sample of pollen taken from strong hive, unaffected comb sample, had positive detects for clothianidin and Linuron. Sample of honey taken from unaffected comb sample had positive detects for thiamethoxam. Sample of pollen taken from affected hive, affected comb sample, had positive detects for thiamethoxam. Samples of live bees taken from strong hive, unaffected live bees, had no detected active ingredients. Sample of dead bees taken from affected hive, composite sample of dead bees from 4 hives, had positive detects for clothianidin. The weather at the time of the incident was very dry, overcast cloudy. Prior to the incident, there were an average of 6 to 8 strong frames of bees, 2 to 3 frames of brood, and 1 to 2 frames of pollen and honey. The following pests were present in the affected bee yard in the past year; chalkbrood. The previously noted disease(s) or pest(s) did not get worse after the incident.After the incident, there was no significant change in the average frames of bees, frames of brood and frames of pollen and honey. Additional food sources provided to the bees included pollen supplement.In 2012, the following treatments were applied to the hives: formic acid, amitraz.Information on crops located near the beeyards: 100 ac of 3 corn fields was located east of the hives, and was just planted 3 days ago, using some air seeder. Other crops in the area included corn all around the bee yard, some soybean was also planted. A forest was located near the affected bee yard. Beekeeper reported 1 to 2 hives out of 4 or 5 yards are getting weak and that two hives have lost queens. Beekeeper noted that there are only a few dead bees. Bees were actively foraging at the time of case. Bees were crawling and disoriented and dead bees were found at the front of the hive. Loss of brood noted in 4 hives. Queen did stop laying eggs. Samples were collected. The general health of the affected yard did not change significantly before and after the noted case. No pests or disease was noted in the bees. Bees were fed additional food sources. Treatment for pests/disease did occur in the Fall of 2012, none noted in the Spring of 2013. Corn and soybean are crops that surround this bee yard, along with forest.

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