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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2015-2256

2. Registrant Information.

Registrant Reference Number: x

Registrant Name (Full Legal Name no abbreviations): x

Address: x

City: xx

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: 20ac, and 20ac of corn was 25m and 50m West and east from the beeyard, and was planted on April 13 and 14 2014. Early plant of two 20 acres east and west farm fields - beekeeper request to use traditional planting and not air planting equipment - farmer complied with the request. Last good crop of honey obtained from bee hives was in 2011 approx. 184kg. Subsequently to 2011 product progressively lower each year. Soy in spring 2013, 100m south of bee yard in 200ac.

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 3 colonies (2-double brood box & 1 single) in the bee yard and two dead colonies (feb/march 2014). There were 3 affected colonies. The following pests were present in the affected bee yard in the past year; American foulbrood (spring 2013). Other: suspected pesticides effect over winter caused weak hives and led to loss of two. Additional food sources provided to the bees included sugar syrup (oct-13). Formic acid (65%) and oxalic acid were applied to the hives to treat varroa. (formic acid pads: april 19, 2014 for 21 days; fall 2013 - Sept 18 to Oct 28, oxalic acid: Nov 2013). In 2013 (Oct 10, Oct 14, Oct 20); and 2014 (Apr 22, May 2 & 7) the antibotic oxytetracycline was applied to the hives at oxysol 62-5, to treat ABF. Bees were actively foraging at time of intial mortality; actively foraging when questionnaire being filled out; dead bees had pollen on their legs; lack of foragers returning to hive; other: a drop in bee population and population remained low in numbers - unable to rebuild up to a satisfactory level. There were 0-500 dead bees observed inside, outside and between the lid and inside cover of each hive. bee population not building up - same as 2013 - bees foraging with pollen bundles walking around but not accessing the inside of the hives. brood not building up. no queen symptoms observed. The weather at the time of the incident was sunny, temperature and humidity were 10-15 C and moderate. Bekeeper believes Pesticides residue in the enviroment (soil and water) results in contamination of native vegetation that lead to bees obtaining the pesticides during foraging; exessive removal of fence lines that provide native vegetation and habitat for the native bees and other native species is becoming more of a problem was the cause of the incident. Samples taken from dead bees and vegetation taken had positive detects for clothianidin. Samples of water and pollen comb taken had positive detects for thiamethoxam, and clothianidin, the water additionally hadmetalax and the pollen additionally had imidacloprid.

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