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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2015-2248

2. Registrant Information.

Registrant Reference Number: x

Registrant Name (Full Legal Name no abbreviations): x

Address: x

City: x

Country: 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: x

  • 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).

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

Information on crops located near the beeyards: 7.8ha North, 5ha North West and 3.8ha west of corn was 90m, 250m, and 265m (respectively) from the beeyard, and was planted on 2014-05-26 and 2014-05-24. There were a lot of hay/pasture fields in the area as well as a few fields close by that were planted to corn (corn was at the coleoptile stage at time of inspection). Hay pasture to the E (3.8ha) and W (4.2ha) of field. First observed bee kill May 26th but only collected dead bees by May 28th. Trees and flowers in yard are flowering; dandelions & buttercup in hay field is flowering. A small ornamental pond in Bk's yard at the south end.

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


Reproductive impairment

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

There were a total of 1 colony in the bee yard. There was 1 affected colony. There were an average of 10 frames of bees. The following pests were present in the affected bee yard in the past year; AFB (american foul brood) and likely varroa mite. Additional food sources provided to the bees included sugar syrup (Spring 2014). On May 1st for one month, Thymovar was applied 2 waffers per colony to treat varroa mite. May 1-31st 2014 the antibotic ocytetracycline was applied to the hives at 1 heaping tbsp on top of frames, to treat AFB. Bee were actively foraging when incident occurred; actively foraging when questionnaire being filled out; and dead bees had pollen on their legs. There were 0-500 dead bees observed outside of each hive. Adult bee symptoms included shaking/trembling/twitching, crawling, disoriented and tongues out. Brood to bee ratio is off, could be due to a population lost. The weather at the time of the incident was sunny. the beekeeper believes that neonic pesticide was th cause of the incident. Bker is new to beekeeping - first started in 2014 -she started with 2 hives - one lost last fall due to foul brood - the second hive overwintered and this hive was the hive that she noticed the pesticide poisoning symptoms in. - she did not see a big kill; while the effect were first observed on May 26, she did not collect any dead/ affected bees until May 28. she collected Bees over a number of days - the majority were collected between May 28 and May 30. At the time of our inspection no adverse effects were observed with the affected hive; the bees were actively foraging, bringing pollen back to the hive. There were alot of hay/ pasture fileds in the area as well as a few fields close by that were planted to corn (corn was at the coleoptile stage on the date of my visit). Sample of dead bees taken had positive detects for clothianidin and carbaryl. Sample of comb pollen taken was positive detects for thiamethoxam, clothianidin and inidacloprid.

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