Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2021-1777

2. Registrant Information.

Registrant Reference Number: CACC200616

Registrant Name (Full Legal Name no abbreviations): Corteva Agriscience

Address: Suite 2400, 215 - 2nd Street S.W.

City: Calgary

Prov / State: Alberta

Country: Canada

Postal Code: T2P 1M4

3. Select the appropriate subform(s) for the incident.

Environment

4. Date registrant was first informed of the incident.

31-MAR-21

5. Location of incident.

Country: CANADA

Prov / State: BRITISH COLUMBIA

6. Date incident was first observed.

11-JUN-20

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. 30077      PMRA Submission No.       EPA Registration No.

Product Name: OcTTain XL

• Active Ingredient(s)
  • FLUROXYPYR 1-METHYLHEPTYL ESTER
    • Guarantee/concentration 90 g/L

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7. b) Type of formulation.

Application Information

8. Product was applied?

Yes

9. Application Rate.

1.1

Units: L/ha

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

Site: Other / Autre

Préciser le type: grass land around a race track

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

Applied via boom sprayer, low to ground, environmental spray conditions were good, applied to area around race track where kochia was growing. closest vineyard was 50 meter away, generally vines 150 meters away form area sprayed. Damage was reported in the corner of the vineyard closest to the one section where the application took place. Application occured around May 13th 2020.

To be determined by Registrant

12. In your opinion, was the product used according to the label instructions?

Yes

Subform IV: Environment (includes plants insects and wildlife)

1. Type of organism affected

Trees or shrubs / Arbre ou arbuste

2. Common name(s)

Vines

3. Scientific name(s)

Unknown

4. Number of organisms affected

Unknown

5. Description of site where incident was observed

Fresh water

Terrestrial

Agricultural

Salt Water

6. Check all symptoms that apply

Visible injury ( eg. chlorosis, necrosis, bleaching)

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

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

Application

N/A

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?

No

To be determined by Registrant

12. Severity classification (if there is more than one possible classification, select the most severe)

Minor

13. Please provide supplemental information here