Form BOE-501-HF Fillable Hazardous Waste Facility Fee Return

Form BOE-501-HF Fillable Hazardous Waste Facility Fee Return - Annual

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(+ SECOND PREPAYMENT) (13 Less total prepayment credit FIRST PREPAYMENT + SECOND 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] $) (16 INTEREST $) (16 INTEREST: One month's interest is due on the total fee for each month or fraction of a month that payment is delayed after the due date The adjusted monthly interest rate is ) (17 TOTAL AMOUNT DUE AND PAYABLE (add lines 14 15 and 16) $) (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 ANNUAL 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 ANNUAL 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 ANNUAL 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 ANNUAL 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 ANNUAL 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 ANNUAL 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 ANNUAL FEE RATE ) (CLASSIFICATION OF FACILITY SITES 12 Amount of applicable fee rate (only one fee is due per facility; see instructions) $) (CLASSIFICATION OF FACILITY SITES 13 Less total prepayment credit FIRST PREPAYMENT ) (CLASSIFICATION OF FACILITY SITES 2 Large onsite treatment facility COLUMN A ANNUAL FEE RATE ) (CLASSIFICATION OF FACILITY SITES 3 Large offsite treatment facility COLUMN A ANNUAL FEE RATE) (CLASSIFICATION OF FACILITY SITES 4 Small treatment facility COLUMN A ANNUAL FEE RATE) (CLASSIFICATION OF FACILITY SITES 5 Minitreatment facility COLUMN A ANNUAL FEE RATE ) (CLASSIFICATION OF FACILITY SITES 6 Large storage facility COLUMN A ANNUAL FEE RATE) (CLASSIFICATION OF FACILITY SITES 7 Small storage facility COLUMN A ANNUAL FEE RATE) (CLASSIFICATION OF FACILITY SITES 8 Ministorage facility COLUMN A ANNUAL FEE RATE) (CLASSIFICATION OF FACILITY SITES 9 Standardized permit facility (enter fee for appropriate category) 9(a) SERIES A COLUMN A ANNUAL FEE RATE) (CLASSIFICATION OF FACILITY SITES 9 Standardized permit facility (enter fee for appropriate category) 9(b) SERIES B COLUMN A ANNUAL FEE RATE) (CLASSIFICATION OF FACILITY SITES 9 Standardized permit facility (enter fee for appropriate category) 9(c) SERIES C COLUMN A ANNUAL FEE RATE) (CLASSIFICATION OF FACILITY SITES 9 Standardized permit facility (enter fee for appropriate category) 9(d) SERIES C (Sm Qty ) COLUMN A ANNUAL 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 (TELEPHONE (AREA CODE)) (TELEPHONE) (text) (text) (text) (YOUR ACCOUNT NO ) [ FOID ] 1 000 tons of hazardous waste 1 1 Disposal facility (if you are a government agency please see instructions on reverse) $ 1 500 gallons per calendar month or total volume of solid hazardous waste treated is less than 3 000 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 the 11(a) 11(b) 11(c) 12 Amount of applicable fee rate (only one fee is due per facility; see instructions) 12 $ 13 Less total prepayment credit 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: One month's interest is due on the total fee for each month or fraction of a month that 17 TOTAL AMOUNT DUE AND PAYABLE (add lines 14 15 and 16) 17 $ 2 2 Large onsite treatment facility 3 3 Large offsite treatment facility 4 4 Small treatment facility 5 5 Minitreatment facility 500 tons solid hazardous waste 6 6 Large storage facility 7 7 Small storage facility 8 8 Ministorage facility 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 after the due date Fee returns and payments that are mailed must be postmarked on or before the due date shown 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 16 ANNUAL annual return in the form as provided by the Board of Equalization Any special circumstances which affect your reporting should based upon the size of the facility Definitions of facility sizes are attached be effective the fee period following the one in which the modification becomes effective be explained on an attachment to the form Under section 43155 of the Hazardous Substances Tax Law late payment will result BEFORE PREPARING BOARD OF EQUALIZATION BOARD OF EQUALIZATION BOE 501 HF (S1B) REV 15 (4 13) BOE 501 HF (S1F) REV 15 (4 13)STATE OF CALIFORNIA BOE USE ONLYRA B/A AUDREG CLASSIFICATION OF FACILITY SITES day are considered timely DEFINITIONS FOR HAZARDOUS WASTE FACILITY FEE RETURN ANNUAL Department of Toxic Substances Control (DTSC) to establish capacity and/or type If a facility's allowable capacity changes or is Disposal facility A facility used for the disposal of hazardous waste DUE ON OR BEFORE during any one month of the reporting period EMAIL ADDRESS 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 exceed 10 000 pounds per calendar month Facilities engaged in treatment and storage owe the highest fee to which the facility has ever been subject for the reporting FACILITIES THAT CEASE TO OPERATE facility operated during any one month of the current fee period and submit a certification or permit modification to the FEE DUE FEE RATE FILING REQUIREMENT FIRST PREPAYMENT 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 than gallons of liquid hazardous waste or greater than 500 tons of solid hazardous waste or any liquid or solid GENERAL 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 greater HAZARDOUS WASTE FACILITY FEE RETURN ANNUAL hazardous waste is stored for more than one calendar year hazardous waste or less than 30 000 pounds solid hazardous waste hazardous waste treated is greater than 10 000 pounds but less than 100 000 pounds per calendar month 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 fee return is postmarked after the due date penalty is due The penalty is 10 percent (0 10) of the fee due on 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 in a 10 percent (0 10) penalty and interest at an adjusted annual rate established under section 6591 5 of the Revenue and initially established as the result of certification or permit modification the fee that is due for the fee period in which the change INSTRUCTIONS FOR HAZARDOUS WASTE FACILITY FEE RETURN ANNUAL INTEREST 16 $ 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 permit 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 line 13 If delinquency charges were paid do not include those amounts in the credit Line 13 Prepayments are due the last day of February and August Enter the amount of prepayments previously paid on Line 14 Subtract amount on line 13 from the amount on line 12 line 14 The interest rate is noted on line 16 on the front of this form and applies for each month or fraction thereof Line 17 Add lines 14 15 and 16 Line 9 Enter the applicable fee in column B if you are operating under a standardized permit Please note that you cannot Line 9 Series A Standardized Permit (Treatment) Total influent volume of liquid hazardous waste treated is Lines 1 Lines 1 Enter in column B the rate for the highest category at which your facility is permitted for the current calendar year If Lines 10 Lines 15 liquid hazardous waste or less than 100 000 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 waste must pay two times the fee for the reporting period immediately following the period during which the facility ceased disposal not exceed 5 000 gallons per calendar month or total volume of solid hazardous waste treated does not occurs is the higher fee If a facility's type changes as the result of a permit or ISD modification any change in the facility fee will Offsite facility A hazardous waste treatment facility that is not an onsite facility on the return If the due date falls on a Saturday Sunday or legal holiday returns postmarked on the next business one calendar year one month of the reporting period Onsite facility A hazardous waste treatment facility at which hazardous waste is produced and payment is delayed after the due date The adjusted monthly interest rate is Payments: You can make your payment by paper check Online ACH Debit (ePay) or by credit card To use ePay go to our 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 PO BOX 942879 postclosure period (enter fee for appropriate category) pounds per calendar month 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 6017 SECOND PREPAYMENT SERIES A Series A Standardized Permit (Storage) Total facility storage design capacity is greater than 500 000 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 liquid Series C Small Quantity (Treatment) Total influent volume of liquid hazardous waste treated is less than Series C Standardized Permit (Storage) Total facility storage design capacity is less than 50 000 gallons Series C Standardized Permit (Treatment) Total influent volume of liquid hazardous waste treated does SERIES C(Sm Qty ) 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 hazardous Small treatment facility Treats land treats or recycles more than 0 5 tons (1 000 pounds) but less than SPECIAL TAXES AND FEES STATE OF CALIFORNIA Taxation Code TELEPHONE than 100 000 pounds per calendar month or any liquid or solid hazardous waste is stored for more than the amount due is the fee for the category with the highest rate The annual Hazardous Waste Facility Fee is imposed according 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 thru 8 thru 8 you are a government agency operating a disposal facility which did not dispose of hazardous waste during the tons of hazardous waste during any one month of the reporting period Under section 43152 6 of the Revenue and Taxation Code every facility operator who owes the facility fee is required to file an 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 which is owned by leased to or under the control of the producer of the waste 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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