Form Boe-501-Hg - Hazardous Waste Generator Fee Return Page 3
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4STATE OF CALIFORNIA
BOE-501-HG (S2F) REV. 20 (4-13)
BOARD OF EQUALIZATION
SCHEDULE G - GENERATOR FEE SCHEDULE
(Instructions on Reverse)
ACCOUNT NUMBER
NAME
PERIOD
DUE
INDICATE THE APPROPRIATE FEE CATEGORY IN THE COLUMNS BELOW
0 to
5 to
25 to
50 to
250 to
500 to
1000 to
2000
SUB NUMBER
4.9
24.9
49.9
249.9
499.9
999.9
1999.9
plus
GENERATING SITE ADDRESS
EPA NUMBER
tons
tons
tons
tons
tons
tons
tons
tons
Line 2
Line 3
Line 4
Line 5
Line 6
Line 7
Line 8
Line 9
Line 2
Line 3
Line 4
Line 5
Line 6
Line 7
Line 8
Line 9
TOTAL NUMBER OF SITES BY CATEGORY
Add total fees separately for each category in its respective column and bring
this amount forward to column B on the Hazardous Waste Generator Fee Return.
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