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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2020-3843

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.


4. Date registrant was first informed of the incident.

5. Location of incident.

Country: CANADA


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: UNKNOWN

  • Active Ingredient(s)
    • 2,4-D (PRESENT AS ACID)

7. b) Type of formulation.


Application Information

8. Product was applied?


9. Application Rate.

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

Site: Agricultural-Outdoor/Agricole-extérieur

Préciser le type: Barley

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

The following was reported: After viewing evidence of damage to our vines, we suspected a herbicide had been applied, most probably from the field of barley, located across x Road, immediately to the East of our site. We made contact with the owner of that property, belonging to Mr. (name), on July 8, 2020. Mr. (name) confirmed that he had utilized the services of a contractor to apply a herbicide for weed control in his barley field. He also indicated that he would then reach out to his contractor, to confirm details. He was able to have the representatives of the contracting firm attend our site, to review the damage, for further evaluation. They confirmed our assessment, linking the damage to the vines to a potential overspray of 2,4-D chemical in June 2020. Our action points are to continue to apply standard vinecare techniques for these vines, regardless of final outcome, to ensure lower stress on the vines. Until the crop is harvested, yield analysis will not be available. However, it is demonstrated that the effects of this overspray are considerable, with expected yields in the range of 10 - 15% of normal/average.

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

Trees or shrubs / Arbre ou arbuste

2. Common name(s)

Siegerrebe, Marechal Foch

3. Scientific name(s)

Vitis vinifera

4. Number of organisms affected


5. Description of site where incident was observed

Fresh water



Salt Water

6. Check all symptoms that apply

Abnormal flower quality or number


Reduction in seed or fruit yield

Stunted vegetative growth

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

The following was reported: Affected area on our property, is approximately 3 acres, adjacent to x Road. 2 grape varietals are grown in this portion of the vineyard, namely Siegerrebe and Marechal Foch. Observations include: - Deformed leaves on Siegerrebe and M. Foch, consistent with damage caused by 2,4-D/Group 4 herbicide. - Stunted shoots on Siegerrebe, and deformed leaves on M. Foch - Siegerrebe flowers dried up (bloom was at time of herbicide application) and very poor, if negligible fruit set - M. Foch veraison is uneven, caused by the 2,4-D overspray

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