Form Boe-501-Hd - Hazardous Waste Disposal Fee Return

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BOE-501-HD (S1F) REV. 23 (4-13)
STATE OF CALIFORNIA
BOARD OF EQUALIZATION
HAZARDOUS WASTE DISPOSAL FEE RETURN
BOE USE ONLY
AUD
RA-B/A
REG
DUE ON OR BEFORE
FILE
RR-QS
REF
YOUR ACCOUNT NO.
[
]
FOID
BOARD OF EQUALIZATION
SPECIAL TAXES AND FEES
PO BOX 942879
SACRAMENTO CA 94279-6003
READ INSTRUCTIONS
BEFORE PREPARING
D
B
B
C
A
TOTAL FEE
TONNAGE
TONNAGE
WASTE
APPLICABLE
(column B x C)
SUBJECT TO FEE
SUBJECT TO FEE
SUBMITTED
CATEGORIES
FEE
(Round column A
(Round column A
FOR
tonnage to next
tonnage to next
DISPOSAL
whole ton)
whole ton)
1. Exempt waste
1.
Non-RCRA
2a. Non-RCRA hazardous waste
2a.
(generally includes asbestos)
2b. Non-RCRA hazardous waste generated in
2b.
a cleanup action (excludes asbestos)
RCRA
3a. RCRA hazardous waste or hazardous
3a.
waste not elsewhere classified
3b. RCRA hazardous waste treated to be a
3b.
non-RCRA or nonhazardous waste
3c. RCRA hazardous waste generated in a
3c.
cleanup action and treated to be a
non-RCRA or nonhazardous waste
4. Mining waste
4.
5. Extremely hazardous waste and restricted
5.
hazardous waste
6. Solid waste residues resulting from
6.
incineration or dechlorination
7. Total fee (add the total amounts entered in column D, lines 1 through 6)
Enter in box 7a the total fees included on line 7 that apply to
7a. $
7. $
waste generated by a federal government agency.
8. Total fee from Designated Treatment Technology Waste Schedule (enter from Schedule C, line 7
8. $
if applicable) (Please see note under Schedule C instructions - Filing Requirements.)
9. Total fees due (add lines 7 and 8)
9. $
10. Penalty [multiply line 9 by 10% (0.10) if payment is made after due date shown
10. $
PENALTY
above]
11.
INTEREST: One month's interest is due on the total fee for each month or fraction of a month that
11. $
INTEREST
payment is delayed after the due date. The adjusted monthly interest rate is
12. TOTAL AMOUNT DUE AND PAYABLE (add lines 9, 10, and 11)
12. $
EMAIL ADDRESS
I hereby certify that this return, including any accompanying schedules and statements, has been
examined by me and to the best of my knowledge and belief is a true, correct, and complete return.
SIGNATURE
PRINT NAME AND TITLE
TELEPHONE
DATE
(
)
Make check or money order payable to State Board of Equalization.
Always write your account number on your check or money order. Make a copy of this document for your records.

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