Application for Research Permit

Privacy Notice Statement

Health Canada
Collection and use of personal information in this application is in accordance with the federal Privacy Act.

The personal information you provide is collected under the authority of section 48 of the Pest Control Product Regulations for the purpose of contacting the applicant in regards to the application and to communicate any decisions and outcomes of the application.

The Privacy Act gives you the rights of access to, correction of and protection of your personal information. For further information about this Privacy statement please contact Health Canada’s Access to Information and Privacy Coordinator by email at atip-aiprp@hc-sc.gc.ca.

Instructions

For exemptions from research permit requirements see Regulatory Directive Dir98-05.

The purpose of the Research Permit is to allow testing of an unregistered product or testing of unregistered uses of a control product. There must be reportable results of testing of all work carried out under the Research Permit.

Sale of Treated Food - A copy of this application together with the relevant data (toxicology, residue, analytical methodology, etc.) must be submitted to the PMRA if treatment of a food crop or livestock is involved. The applicant will be contacted directly by officials of the PMRA as required.

Instructions for completing sections on form

1

If the product does not yet have a brand name, give the experimental name or identification number used by the manufacturer.

Return to instruction 1 referrer

2

Give the CSA common or proposed common name for the active ingredient. If no common name has been proposed, give the chemical name according to IUPAC or Chemical Abstracts.

Return to instruction 2 referrer

3

Self explanatory

Return to instruction 3 referrer

4

Self explanatory

Return to instruction 4 referrer

5

Self explanatory

Return to instruction 5 referrer

6a

Only a sufficient quantity of product (i.e., to treat test area at desired rate) is to be imported.

Return to instruction 6a referrer

6b

If the product is being imported, give the points of entry and provide copies of declarations of importation.

Return to instruction 6b referrer

7

Information should resemble that which would appear on an experimental label as required. Application rates should be expressed as volume of active ingredient.

Return to instruction 7 referrer

8

Preharvest interval stated in days.

Return to instruction 8 referrer

9

Indicate purpose of research (i.e., to generate residue, efficacy, environmental or other data).

Return to instruction 9 referrer

10

Indicate exact location, size and number of test sites, including township, county and province, proximity to human habitation and potable water, and provide maps whenever possible.

Return to instruction 10 referrer

11

If new source, provide details.

Return to instruction 11 referrer

12

  1. If the end-use product is new, submit a Product Specification Form (HC6003) as well as Material Safety Data Sheets and other pertinent information on formulation components.
  2. An Experimental label is required for all research conducted with pest control products. Refer to Dir98-05 for details.
  3. Material Safety Data Sheets refer to active ingredients or formulation components as indicated in a) above.
  4. If location of test sites cannot be precisely located by an address, then legible maps may be required, These should be accompanied by information on distance to human habitation, public places, bodies of water or areas sensitive to environmental impact. These maps, when required, must be submitted 2 weeks prior to application of the control product.
  5. Maintain a list of all cooperators and program participants. Indicate the number of individuals involved and their occupations/positions. When research is completed, the company/research establishment must submit a final list of cooperators and program participants.
  6. Indicate whether experimental protocols or references to published protocols have been provided.
  7. Indicate what supporting data (if any) has been submitted to support the request. All data must be organized according to directive PRO98-02. Previously submitted data may be referenced only if it has been submitted in accordance with PRO98-02.

Return to instruction 12 referrer

Form

Instruction 1
Instruction 2
3. Applicant Information Instruction 3

Contact
4. Research Coordinator Information Instruction 4
5. Supplier Information Instruction 5
Instruction 6a
Instruction 6b
Instruction 7
Instruction 8
9. Purpose (required) Instruction 9



Instruction 10
11. Type of research (required) Instruction 11





12. Indicate if the following have been submitted (required) Instruction 12

 

 







13. I hereby specify that the above information is correct in all respects. I understand that the grant of a permit does not create any liability on the Crown and the applicant remains totally liable for such things as damage to treated crops or properties on the crops or property of others and for such matters as occupational health and safety and environmental impact as a result of this research being performed.

Pursuant to the application and attachments and subject to amendments (if any) made therein, authorization is granted to proceed with research involving the specified pest control product. This issuance of this federal permit does not imply provincial approval. It is the applicant’s responsibility to obtain provincial approval of pesticides research trials where this may be required. Crops harvested from treated plots must not be sold for food purposes unless written authorization is obtained from the PMRA.
Please refer to accompanying letter and experimental label for conditions pertaining to this research authorization.

Privacy Notice Statement