Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2018-2949

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: ONTARIO

6. Date incident was first observed.

Unknown

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.

Active(s)

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PMRA Registration No. 29957      PMRA Submission No.       EPA Registration No.

Product Name: PONY XP

• Active Ingredient(s)
  • PERMETHRIN
    • Guarantee/concentration .1 %
  • PIPERONYL BUTOXIDE
    • Guarantee/concentration .5 %
  • PYRETHRINS
    • Guarantee/concentration .05 %

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7. b) Type of formulation.

Other (specify)

Spray

Application Information

8. Product was applied?

Yes

9. Application Rate.

Unknown

10. Site pesticide was applied to (select all that apply).

Site: Animal / Usage sur un animal domestique

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

It was reported that the product was sprayed on horses inside a barn.

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

Bird - Songbird / Oiseau - Chanteur

2. Common name(s)

Barn swallow

3. Scientific name(s)

Hirundo rustica

4. Number of organisms affected

3

5. Description of site where incident was observed

Fresh water

Terrestrial

Other

Salt Water

6. Check all symptoms that apply

Death

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

It was reported that 3-4 dead barn swallows had been found in the stalls of the barn (spring-summer 2018). In one specific incident the reporter brought her horse into the stall, where there were no swallow carcasses. She tacked up the horse, and just before leaving, sprayed the horse heavily with Pony XP. After a ride (approximately 45 minutes later), the reporter returned to the same stall and there was a dead swallow (appeared to be juvenile; definitely able to fly, but still small).

8. a) Was the incident a result of (select all that apply)

Unknown

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?

Unknown

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

It was reported that the barn swallows build nests along the ceiling beams above the stalls in the older style barn, with a low ceiling, used for horses. The reporter was concerned that inside the barns stalls, where ventilation is low, the aerosol from the horse fly spray is at a concentration in the air that can kill the swallows. It was reported that there are cats in the barn sometimes, but these particular carcasses did not appear to be mauled, and no cats were seen in the vicinity when the carcasses were found. The reporter stated that the cats cannot get up to the nests, and the carcasses found were all from birds old enough to fly.