Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2022-4931

2. Registrant Information.

Registrant Reference Number: CTVA220808

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

Address: Suite 2450, 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.

09-AUG-22

5. Location of incident.

Country: CANADA

Prov / State: ONTARIO

6. Date incident was first observed.

09-AUG-22

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. 29752      PMRA Submission No.       EPA Registration No.

Product Name: Clearview Herbicide

• Active Ingredient(s)
  • AMINOPYRALID (PRESENT AS POTASSIUM SALT)
  • METSULFURON-METHYL

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7. b) Type of formulation.

Application Information

8. Product was applied?

Unknown

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).

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

Herbaceous Plants / Plante herbacée

2. Common name(s)

Corn, Soybean

3. Scientific name(s)

Zea Mays, Glycine Max

4. Number of organisms affected

Unknown

5. Description of site where incident was observed

Fresh water

Terrestrial

Roadside

Salt Water

6. Check all symptoms that apply

Stunted vegetative growth

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

Corn and soybean field exhibited visual symptoms that aligned with Clearview damage. Clearview was sprayed in roadside ditch adjacent to production fields.

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