Form BOE-501-FFP2 Fillable Hazardous Waste Facility Fee Prepayment Form

Form BOE-501-FFP2 Fillable Hazardous Waste Facility Fee Prepayment Form - Federal Second Prepayment

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(12 Enter amount of highest applicable fee rate from column B $) (13 Less fee paid with first prepayment $) (14 Total fee due (subtract line 13 from line 12) $) (15 PENALTY [multiply line 14 by 10% (0 10) if payment is made after due date shown above] $) (17 TOTAL AMOUNT DUE AND PAYABLE (add lines 14 and 15) $) (a) Postclosure permit small facility Manages 0 5 tons (1 000 pounds) or less of hazardous waste (b) Postclosure permit medium facility Manages more than 0 5 (1 000 pounds) but less than 1 000 (BOE USE ONLY) (c) Postclosure permit large facility Manages 1 000 or more tons of hazardous waste during any (CLASSIFICATION OF FACILITY SITES 1 Disposal facility (if you are a government agency please see instructions on reverse) COLUMN A FEE RATE $) (CLASSIFICATION OF FACILITY SITES 10 Postclosure permit facility within the first five years of the postclosure period (enter fee for appropriate category) 10(a) SMALL COLUMN A FEE RATE ) (CLASSIFICATION OF FACILITY SITES 10 Postclosure permit facility within the first five years of the postclosure period (enter fee for appropriate category) 10(b) MEDIUM COLUMN A FEE RATE ) (CLASSIFICATION OF FACILITY SITES 10 Postclosure permit facility within the first five years of the postclosure period (enter fee for appropriate category) 10(c) LARGE COLUMN A FEE RATE ) (CLASSIFICATION OF FACILITY SITES 11 Postclosure permit facility beyond the first five years of the postclosure period (enter fee for appropriate category) 11(a) SMALL COLUMN A FEE RATE ) (CLASSIFICATION OF FACILITY SITES 11 Postclosure permit facility beyond the first five years of the postclosure period (enter fee for appropriate category) 11(b) MEDIUM COLUMN A FEE RATE ) (CLASSIFICATION OF FACILITY SITES 11 Postclosure permit facility beyond the first five years of the postclosure period (enter fee for appropriate category) 11(c) LARGE COLUMN A FEE RATE ) (CLASSIFICATION OF FACILITY SITES 2 Large onsite treatment facility COLUMN A FEE RATE ) (CLASSIFICATION OF FACILITY SITES 3 Large offsite treatment facility COLUMN A FEE RATE ) (CLASSIFICATION OF FACILITY SITES 4 Small treatment facility COLUMN A FEE RATE ) (CLASSIFICATION OF FACILITY SITES 5 Minitreatment facility COLUMN A FEE RATE ) (CLASSIFICATION OF FACILITY SITES 6 Large storage facility COLUMN A FEE RATE ) (CLASSIFICATION OF FACILITY SITES 7 Small storage facility COLUMN A FEE RATE ) (CLASSIFICATION OF FACILITY SITES 8 Ministorage facility COLUMN A FEE RATE ) (CLASSIFICATION OF FACILITY SITES 9 Standardized permit facility (enter fee for appropriate category) 9(a) SERIES A COLUMN A FEE RATE ) (CLASSIFICATION OF FACILITY SITES 9 Standardized permit facility (enter fee for appropriate category) 9(b) SERIES B COLUMN A FEE RATE ) (CLASSIFICATION OF FACILITY SITES 9 Standardized permit facility (enter fee for appropriate category) 9(c) SERIES C COLUMN A FEE RATE ) (CLASSIFICATION OF FACILITY SITES 9 Standardized permit facility (enter fee for appropriate category) 9(d) SERIES C (Sm Qty ) COLUMN A FEE RATE ) (CLEAR) CLEAR (COLUMN B AMOUNT OF FEE DUE $) (COLUMN B AMOUNT OF FEE DUE) (COLUMN B AMOUNT OF FEE DUE) (COLUMN B AMOUNT OF FEE DUE) (COLUMN B AMOUNT OF FEE DUE) (COLUMN B AMOUNT OF FEE DUE) (COLUMN B AMOUNT OF FEE DUE) (COLUMN B AMOUNT OF FEE DUE) (COLUMN B AMOUNT OF FEE DUE) (COLUMN B AMOUNT OF FEE DUE) (DATE) (DUE ON OR BEFORE) (EMAIL ADDRESS) (PRINT NAME AND TITLE) (PRINT) PRINT (Sm Qty ) (TELEPHONE (AREA CODE)) (TELEPHONE) (text) (text) (text) (YOUR ACCOUNT NO ) [ FOID ] 1 Disposal facility (if you are a government agency please see instructions 10 Postclosure permit facility within the first five years of the 10(a) 10(b) 10(c) 11 Postclosure permit facility beyond the first five years of 11(a) 11(b) 11(c) 12 Enter amount of highest applicable fee rate from column B 12 $ 13 Less fee paid with first prepayment 13 $ 14 Total fee due (subtract line 13 from line 12) 14 $ 15 Penalty [multiply line 14 by 10% (0 10) if payment is made after due date shown above] PENALTY 15 $ 16 Interest does not apply to this program INTEREST16 17 TOTAL AMOUNT DUE AND PAYABLE (add lines 14 and 15) 17 $ 2 Large onsite treatment facility 2 3 000 pounds per calendar month 3 Large offsite treatment facility 3 4 Small treatment facility4 5 Minitreatment facility5 6 Large storage facility 6 7 Small storage facility 7 8 Ministorage facility 8 9 Standardized permit facility (enter fee for appropriate category) 9(a) 94279 0088 You may also visit the BOE website at www boe ca gov or call the Taxpayer Information Section at 1 800 400 7115 (TTY:711); A facility fee is due from the facility operator for a facility that has been issued a postclosure permit The fee is due activity If your facility ceased activity on or after January 1 1994 you will be deemed to have ceased activity when you have actually ceased the activity and notified DTSC of your intent to close allowable capacity and type of facility as specified in the permit interim status document (ISD) or Federal Part A Application If Always write your account number on your check or money order Make a copy of this document for your records AMOUNT OF and 11 and which is owned by leased to or under the control of the producer of the waste based upon the size of the facility Definitions of facility sizes are attached BEFORE PREPARING BOARD OF EQUALIZATION BOARD OF EQUALIZATION BOE 501 FFP2 (S1B) REV 13 (4 13) BOE 501 FFP2 (S1F) REV 13 (4 13) BOE 501 FFP2 (S2) REV 13 (4 13) BOE USE ONLY change occurs is the higher fee If a facility's type changes as the result of a permit or ISD modification any change in the CLASSIFICATION OF FACILITY SITES DEFINITIONS FOR HAZARDOUS WASTE FACILITY FEE PREPAYMENT FORM FEDERAL Department of Toxic Substances Control (DTSC) to establish capacity and/or type If a facility's allowable capacity changes or Disposal facility A facility used for the disposal of hazardous waste disposal or management of hazardous waste including the payment of the Hazardous Waste Facility Fee However the Federal does not exceed 10 000 pounds per calendar month does not exceed 5 000 gallons per calendar month or total volume of solid hazardous waste treated DUE ON OR BEFORE during any one month of the reporting period EMAIL ADDRESS enter applicable rate in column B for the proper fee category Enter in column B the rate for the highest category at which your facility is permitted for the current calendar year If enter the applicable rate in column B for the proper fee category examined by me and to the best of my knowledge and belief is a true correct and complete return FACILITIES THAT CEASE TO OPERATEFacilities engaged in treatment and storage owe the highest fee to which the facility has ever been subject for the reporting facility fee will be effective the fee period following the one in which the modification becomes effective facility operated during any one month of the current fee period and submit a certification or permit modification to the FEDERAL LIABILITY FOR THE FEE FEE DUE FEE RATE FILING REQUIREMENTS OF SCHEDULE from the main menu select the option Special Taxes and Fees gallons but less than 500 000 gallons liquid hazardous waste or greater than 100 000 pounds but less gallons liquid hazardous waste or less than 100 000 pounds solid hazardous waste gallons of liquid hazardous waste or greater than 500 tons solid hazardous waste or any liquid or GENERAL Government is not liable for interest imposed by the California Revenue and Taxation Code greater than 100 000 pounds per calendar month or any liquid or solid hazardous waste is stored for greater than 5 000 gallons but less than 50 000 gallons per calendar month or total volume of solid greater than 50 000 gallons per calendar month or total volume of solid hazardous waste treated is hazardous waste HAZARDOUS WASTE FACILITY FEE PREPAYMENT FORM FEDERAL hazardous waste treated is greater than 10 000 pounds but less than 100 000 pounds per calendar I hereby certify that this return including any accompanying schedules and statements has been If you need additional information please contact the State Board of Equalization Special Taxes and Fees P O Box 942879 Sacramento CA If your permit ISD or Federal Part A does not state the facility capacity and/or type report at the highest level at which the INSTRUCTIONS FOR HAZARDOUS WASTE FACILITY FEE PREPAYMENT FORM FEDERAL is initially established as the result of certification or permit modification the fee that is due for the fee period in which the LARGE Large onsite/offsite treatment facility Treats land treats or recycles 1 000 or more tons of hazardous Large storage facility Stores 1 000 or more tons of hazardous waste Line 10 If the reporting period is within the first five years of the postclosure period select the appropriate facility size and Line 11 If the reporting period is beyond the first five years of the postclosure period select the appropriate facility size and Line 12 Enter the applicable fee rate If you are permitted for more than one category enter the highest fee for those Line 13 Enter the amount of the fee paid with your first prepayment Your prepayment credit is the amount previously paid Line 14 Subtract amount on line 13 from amount on line 12 Line 15 If your fee is paid after the due date penalty is due The penalty is 10 percent (0 10) of the fee due on line 14 Line 17 Add lines 14 and 15 and enter total amount due and payable including late charge if applicable Line 9 Line 9 Enter the applicable fee in column B if you are operating under a standardized permit Please note that you cannot Lines 1 Lines 10 Lines 10and 11 Lines 1thru 8 liquid hazardous waste or less than 30 000 pounds solid hazardous waste Make check or money order payable to State Board of Equalization MEDIUM Ministorage facility Stores 0 5 tons (1 000 pounds) or less of hazardous waste Minitreatment facility Treats land treats or recycles 0 5 tons (1 000 pounds) or less of hazardous minus any delinquency charges included in your prepayment month more than one calendar year must not be less than 50 percent (0 50) of the applicable fee See "Return Preparation" below An annual return will be due and must pay two times the fee for the reporting period immediately following the period during which the facility ceased disposal Offsite facility A hazardous waste treatment facility that is not an onsite facility on reverse) one month of the reporting period Onsite facility A hazardous waste treatment facility at which hazardous waste is produced payable on the last day of February following the current year Payments: You can make your payment by paper check Online ACH Debit (ePay) or by credit card To use ePay go to our percent (0 10) penalty and interest at an adjusted annual rate established under section 6591 5 of the Revenue and Taxation period immediately following the period during which the facility ceased actively treating or storing waste Disposal facilities permit ISD or Federal Part A If no capacity is stated you must report based on your actual operations permitted categories PO BOX 942879 postclosure period (enter fee for appropriate category) Prepayments of the fee are due and payable by the last day of February and of August of the current year The prepayments RA B/A AUDREG READ INSTRUCTIONS report in this category until you have been approved by DTSC to operate under a standardized permit Otherwise reporting period enter $10 000 in column B for line 1 only RETURN PREPARATION RR QS FILEREF SACRAMENTO CA 94279 6015 SECOND PREPAYMENT SERIES A Series A Standardized Permit (Storage) Total facility storage design capacity is greater than 500 000 Series A Standardized Permit (Treatment) Total influent volume of liquid hazardous waste treated is SERIES B Series B Standardized Permit (Storage) Total facility storage design capacity is greater than 50 000 Series B Standardized Permit (Treatment) Total influent volume of liquid hazardous waste treated is SERIES C Series C Small Quantity (Storage) Total facility storage design capacity is less than 15 000 gallons Series C Small Quantity (Treatment) Total influent volume of liquid hazardous waste treated is less Series C Standardized Permit (Storage) Total facility storage design capacity is less than 50 000 Series C Standardized Permit (Treatment) Total influent volume of liquid hazardous waste treated SIGNATURE PRINT NAME AND TITLE SMALL Small storage facility Stores more than 0 5 tons (1 000 pounds) but less than 1 000 tons of Small treatment facility Treats land treats or recycles more than 0 5 tons (1 000 pounds) but less solid hazardous waste is stored for more than one calendar year SPECIAL TAXES AND FEES State Board of Equalization Under section 43155 of the Hazardous Substances Tax Law late payment will result in a 10 STATE OF CALIFORNIA TELEPHONE than 1 000 tons of hazardous waste than 1 500 gallons per calendar month or total volume of solid hazardous waste treated is less than than 500 tons solid hazardous waste the amount due is the fee for the category with the highest rate The annual Hazardous Waste Facility Fee is imposed pursuant to Health and Safety Code section 25205 2 based upon the The following definitions apply to the facility's allowable capacity during any one month as stated in your the postclosure period (enter fee for appropriate category) thru 8 to file two prepayments on or before the last day of February andAugust of the calendar year with a remittance payable to the tons of hazardous waste during any one month of the reporting period Under 42 U S C section 6961 federal departments instrumentalities or agencies are subject to state regulation concerning Under section 43152 12(a) of the Hazardous Substances Tax Law every facility operator who owes the facility fee is required waste website at www boe ca gov click on the eServices tab and log in to make a payment To pay by credit card go to our website or call 1 855 292 8931 Mandatory EFT accounts must pay by EFT or ePay Be sure to sign and mail your return you are a government agency operating a disposal facility which did not dispose of hazardous waste during the you should report under the appropriate facility category listed on lines 1 through 8 YOUR ACCOUNT NO your facility qualifies for more than one category (full permit standardized permit or postclosure permit) during the fee period

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