Initial to indicate certification as to information on this page

(full text of certification is on page one).

Date

INSTRUCTIONS: Please type or print in ink. Please read carefully the attached instructions and supply the information requested on this form. 

Use additional sheet(s) if necessary.

2. Case # and Name 3. Date and Type of DCI and Number

4. EPA Product 

Registration

5. I wish to cancel 

this product 

registration 

voluntarily

6. Generic Data 7. Product Specific Data

6a. I am claiming a Generic Data 

Exemption because I obtain the 

active ingredient from the source 

EPA registration number listed 

below.

6b. I agree to satisfy Generic Data

Requirements as indicated on the 

attached form entitled 

"Requirements Status and 

Registrant's Response."

7a. My product is an MUP and I 

agree to satisfy the MUP 

requirement on the attached form

entitled "Requirements Status and

Registrant's Response."

7b. My product is an EUP and I 

agree to satisfy the EUP 

requirement on the attached form 

entitled "Requirements Status and 

Registrant's Response."

OMB Approval 2070-0174

1. Company Name and Address

 

4031 - 2-(2-Ethoxyethoxy)ethyl 2-benzimidazole carbamate

Chemical # and Name: 115001

2-(2-Ethoxyethoxy)ethyl 2-benzimidazole carbamate

16-Jul-2010

GENERIC

ID # GDCI-115001-921

United States Environmental Protection Agency

Washington, D.C. 20460

DATA CALL-IN RESPONSE

Page of 1 1

8. Certification: I certify that the statements made on this form and all attachments are true, accurate, and complete. I acknowledge that any

knowingly false or misleading statement may be punishable by fine, imprisonment or both under applicable law.

Signature and Title of Company's Authorized Representative ______________________________________________________

10. Name of Company

N/A

N/A

N/A

N/A

N/A

N/A

9. Date

11. Phone Number 
Initial to indicate certification as to information on this page (full text of certification is on page one) Date

13. Phone Number

10. Certification: I certify that the statements made on this form and all attachments are true, accurate, and complete. I acknowledge that any 

knowingly false or misleading statement may be punishable by fine, imprisonment or both under applicable law.

12. Name of Company

11. Date

OMB Approval 2070-0174

United States Environmental Protection Agency 

Washington, D.C. 20460

REQUIREMENTS STATUS AND REGISTRANT'S RESPONSE

INSTRUCTIONS: Please type or print in ink. Please read carefully the attached instructions and supply the information requested on this form. Use additional sheet(s) if necessary.

4. Guideline

Requirement

Number

5. Study Title Progress 

Reports

1 2 3

6. Use 

Pattern

7. Test 

Substance

8. Time

Frame 

(Months)

9. Registrant

Response

P

R

O

T

O

C

O

L

1. Company Name and Address 2. Case # and Name 3. Date and Type of DCI and Number

Signature and Title of Company's Authorized Representative _________________________________________________________________

 

Product Chemistry Data Requirements (Conventional 

Chemical)

Terrestrial and Aquatic Nontarget Organisms Data 

Requirements (Conventional Chemical)

830.7050

850.2300

850.3030

850.3040

SS-1107

SS-1108

UV/Visible absorption

Avian reproduction test

Honey bee toxicity of residues on foliage

Field testing for pollinators

Fate, uptake and translocation of residues using 

EUP's

Honey bee acute oral toxicity

4031 - 2-(2-Ethoxyethoxy)ethyl 2-benzimidazole carbamate

Chemical # and Name: 115001

2-(2-Ethoxyethoxy)ethyl 2-benzimidazole carbamate

16-Jul-2010

GENERIC

ID # GDCI-115001-921

C

C

C

C

C

C

TGAI/PAI

TGAI

TEP

TEP

8

24

12

24

24

24

Page 1 of 

(5, 7)

(6, 8, 9)

(2, 4, 8)

(1, 3, 8)

(1, 3, 8)

N

N

N

N

N

N

1
United States Environmental Protection Agency 

Washington, D.C. 20460

FOOTNOTES AND KEY DEFINITIONS FOR GUIDELINE REQUIREMENTS

4031 - 2-(2-Ethoxyethoxy)ethyl 2-benzim

GDCI-115001-921

1

2

3

4

5

6

7

8

9

Key: Residue of Concern = Residue of Concern; TEP = Typical End Use Product [TEP]; TGAI = Technical Grade Active Ingredient [TGAI]; TGAI/PAIRA = Technical Grade of the Active Ingredient or Pure Active 

Ingredient, Radio Labelled; TGAI, TEP = Technical Grade of the Active Ingredient or Technical End-Use Product; TGAI/PAI = Technical Grade Active Ingredient, Pure Active Ingredient

This study will take 12 months to complete; however, an extra 12 months has been included in the timeframe, as the Agency is requiring that a study protocol be submitted to OPPand approved 

by OPP prior to initiation of the study.

This study should be completed for Imisol (TM) and Abasol (TM).

This study should be completed for Fungisol (TM), Imisol (TM), and Abasol (TM).

Required if any of the following conditions are met: (i) data from other sources (Experimental Use Permit program, university research, registrant submittals, etc.) indicate potential adverse 

effects on colonies, especially effects other than acute mortality (reproductive, behavioral, etc.); (ii) data from residual toxicity studies indicate extended residual toxicity; (iii) data derived from 

studies with arthropods other than bees that indicate potential chronic, reproductive, or behavioral effects.

Data using the TGAI are required to support all ourdoor-end use product uses including, but not limited to turf. Data are generally not required to support end-use products in the form of a gas, a 

highly volatile liquid, a highly reactive solid, or a highly corrosive material.

Data are required only when the formulation contains one or more active ingredients having an acute LD50 of <11 microgram per bee as determined in the honey bee acute contact study 

(guideline 850.3020) and the use pattern(s) indicate(s) that honey bees may be exposed to the pesticide.

Data are preferred on waterfowl and upland game bird.

Conduct with EP

A magnitude of residue study should be completed for Imisol (TM) and Abasol (TM) and should include analysis of leaves, flowers, pollen and nectar.

Case # and Name:

DCI Number:

Page: 1 of 1

Footnotes: The following footnotes are referenced in column two (5. Study Title) of the Requirements Status and Registrant's Response form. 

These footnotes apply in addition to any test notes included in 40 CFR Part 158 with respect to the particular data requirement.

Use Categories Key:

C - Terrestrial nonfood crop
United States Environmental Protection Agency 

Washington, D.C. 20460

LIST OF ALL REGISTRANTS SENT THIS DATA CALL-IN NOTICE

Case # and Name: 4031 - 2-(2-Ethoxyethoxy)ethyl 2-benzim

Page: 1 of 1

7946 J. J. MAUGET CO.

Co. Nr. Company Name Agent For Company

SCIREG, INC. 12733 DIRECTOR'S LOOP

Address City ZIP

WOODBRIDGE 22192 

OMB Approval 2070-0174

State

VA

 DCI Number: GDCI-115001-921
LINKS TO FORMS:

The pesticide registration forms that are listed below can be found at:

http://www.epa.gov/opprd001/forms/

Link to Confidential Statement of Formula and Instructions (Form # 8570-4)

http://www.epa.gov/opprd001/forms/8570-4.pdf

Certification of Attempt to Enter Into an Agreement With Registrants for 

Development of Data (Form # 8570-32)

http://www.epa.gov/opprd001/forms/8570-32.pdf

Certification With Respect to Citation of Data (Form # 8570-34)

http://www.epa.gov/opprd001/forms/8570-34.pdf