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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2015-2258

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: Crops were planted on 2014-05-17. The area surrounding is heavily cropped with ginseng, vegetable crops, white beans, corn and soy. Heavy ag chemical use in the area because of variety and timing of crops. Soil is sandy. Used to be tobacco producing land in this county. Corn was planted in alternating strips adjacent to hives on sat may 17th, 2014. seed was pink. No seed exposed. Planted using a vacuum planter (air-assist).

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


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

There were a total of 12 colonies in the bee yard. There were 12 affected colonies. Number of frames of bees, brood and honey are on track for this time of year. The following pests were present in the affected bee yard in the past year; varroa mite (high levels august 2013). Additional food sources provided to the bees included Pollen supplement (on hives now) and sugar syrup (only if needed in spring). In fall 2013, Mite wipes and oxalic acid were applied and apivar was applied in the spring of 2014. In Fall the antibotics fumagilin-B and oxytetracycline were applied to the hives, oxytetracycline was also applied in the spring. Bees were actively foraging when original mortality was observed, actively foraging when questionnaire being filled out, and lack of foragers returning to hive. too soon to tell if after the adverse effects there was a notieable decline in foraging. There were ~300 visible, more were likely scavenged by insects dead bees observed outside of each hive. dead bees had tongues out, no pollen on legs, quite fresh, fuzzy. Have not been rained on (would have dies within 24hrs of inspection). Adult bee symptoms included shaking/trembling/twitching, crawling, disoriented, vomit/regurgitation. Additionally, tongues out (dead), some crawling, clinging to grass, twitching on back. Brood symptoms included spotty brood production (in one hive) and very minor amount of chalkbrood being dumped out of hive. Queen symptoms included unusual laying pattern (hive 5 observed) - pollen & nectar mixed in with capped brood, odd. other than that no queen symptoms observed. The weather at the time of the incident was sunny, temperature was between 10-20 C. Rained on and off all week. Beekeeper believes In general, had very high over winter losses and the hives are having trouble building up- pesticides are playing a role. there was heavy frost the last 2 nights, so eaves/blossoms don't like healthy but majority were already pollinated - apples will survive. -Bumble bees and other pollinators have been working flowers, but honey bees not as much. 12 hives arrived last week (Tues - wed), and will stay until approx. May 25. no insecticides have been sprayed yet -flowers are in various stages of bloom (good for bees and apples). Sample of dead bees taken had positive detects for clothianidin and myclobutanil. Sample of pollen comb taken had positive detects for clothianidin and acetamiprid. General Notes from Discussion with [name] (BKer) - In 2013 spring @ Home Yard, there were 600 hives and 5 barrels of sugar syrup. No bees were foraging. At other yards, the bees were thick in the air. 2014: - first- pass of over-winter loss checks had 50% loss, second pass showed 85-90% winter loss. - High levels of mites in the Fall 2013. Hives were all treated (see section 6) -no mite found during this inspection

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