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Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2017-4567
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.
Environment
4. Date registrant was first informed of the incident.
5. Location of incident.
Country: CANADA
Prov / State: MANITOBA
6. Date incident was first observed.
06-AUG-17Product 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.
Active(s)PMRA Registration No. 28982 PMRA Submission No. EPA Registration No.
Product Name: DUPONT CORAGEN INSECTICIDE
- Active Ingredient(s)
- CHLORANTRANILIPROLE
7. b) Type of formulation.
Application Information
8. Product was applied?
Yes
9. Application Rate.
Unknown
10. Site pesticide was applied to (select all that apply).
Site: Agricultural-Outdoor/Agricole-extérieur
Préciser le type: canola field
11. Provide any additional information regarding application (how it was applied, amount applied, the size of the area treated etc).
On August 29 2017, the Manitoba Sustainable Development received a phone call from a landowner on (location), stating that on August 6 2017, it was noticed that several thousand crayfish washed on shore. On August 6 an aerial spray plane was noticed spraying the canola field south of his property on the east side of (location). The landowner also indicated that there was a different spraying event a week later on the opposite side of the lake, but is unaware of the any further die off. On August 30 2017, an officer of the Manitoba Sustainable Development went to (location) Lake and spoke to 2 different land owners on opposite ends of the lake, who confirmed seeing crayfish crawling up on the shore as if to get out of the water and several more dead ones washed up on shore. One of the two landowners confirmed ordering the spray and said the product used was Coragen.To be determined by Registrant
12. In your opinion, was the product used according to the label instructions?
Unknown
Subform IV: Environment (includes plants insects and wildlife)
1. Type of organism affected
Aquatic Invertebrate/Invertébré aquat.
2. Common name(s)
Crayfish
3. Scientific name(s)
Unknown
4. Number of organisms affected
Unknown
5. Description of site where incident was observed
Fresh water
Lake
Terrestrial
Salt Water
6. Check all symptoms that apply
Abnormal behavioural effects
Death
7. Describe symptoms and outcome (died, recovered, etc.).
On August 30 2017, an officer of the Manitoba Sustainable Development went to (location) Lake and spoke to 2 different land owners on opposite ends of the lake, who confirmed seeing crayfish crawling up on the shore as if to get out of the water and several more dead ones washed up on shore.
8. a) Was the incident a result of (select all that apply)
Application
8. b) i) How many times has the product been applied this year?
Unknown
8. b) ii) What was the date of the last application?
Unknown
9. Did it rain
9. a) During application?
Unknown
9. b) Up to 3 days after application?
Unknown
10. a) Was there a buffer zone?
Unknown
10. b) What type?
10. c) What was the size of the buffer zone?
11. a) Were environmental samples collected and analysed?
Yes
