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ET-501-HG FROM REV.2(72:91) P.O. f 7 BOARD ALIZATION <br /> STATE OF CALIFORNIA SACRAAKL((JJTO, CA 95803-0647 SPECIAL TAa $DIVISION BOARD USE ONLY <br /> HAZARDOUS WASTE GENERATOR FEE AND (916)323-9555 FRE <br /> RR PR <br /> WASTE REPORTING SURCHARGE FEE RETURN <br /> AUD NR <br /> DUE ON OR BEFORE 01/31/92 FOR <br /> JAN - DEC 1991 DD PI <br /> Mail To: HWCA RVHGOI 9191 EHG HQ 36-033192 6 FILE <br /> STATE BOARD OF EQUALIZATION <br /> SPECIAL TAXES DIVISION NEWARK SIERRA PAPERBOARD CORP PM <br /> P.O. BOX 647 800 W.CHURCH ST <br /> SACRAMENTO, CA 95803-0647 STOCKTON CA 95203-3206 <br /> READ INSTRUCTIONS <br /> � (�s r , BEFORE PREPARING <br /> /0 O Q 0 4T5 LQ�A`PS, 42-a Ctjes,eC'// Make Changes If Name <br /> //caD981375157 �4 or Address is Incorrect <br /> 800 W.CHURCH ST STOCKTON <br /> A B <br /> NUMBER C D <br /> OF SITES TOTAL FEES <br /> CLASSIFICATION OF GENERATING SITES •(Do not AMOUNT OF DUE <br /> list tonnage) FEES (Col B X C) <br /> Generators which generale less than <br /> 1. 5 tons of hazardous waste during the 0.00 <br /> calendar year or portion thereof. <br /> Generators which generate an amount equal to or more <br /> 2. than 5 tons. but less than 25 tons, of hazardous 139-00 <br /> waste during the calendar year or portion thereof. <br /> Generators which generate an amount equal to or more <br /> 3. than 25 tons, but less than 50 tons, of hazardous 1 , 1 15.00 <br /> waste during the calendar year or portion thereof. <br /> Generators which generate an amount equal to or more <br /> 4. than 50 tons, but less than 250 tons, of hazardous 2,787-00 <br /> waste during the calendar year or portion thereof. <br /> Generators which generate an amount equal to or more <br /> 5. than 250 tons, but less than 500 tons, of hazardous - 13,937-00 <br /> waste during the calendar year or portion thereof. <br /> Generators which generate an amount equal to or more <br /> 6. than 500 tons, but less than 1,000 tons, of hazardous 27,874.00 <br /> waste during the calendar year or portion thereof. <br /> Generators which generate an amount equal to or more <br /> 7. than 1,000 tons, but less than 2,000 tons, of hazardous 41 ,810.00 <br /> waste during the calendar year or portion thereof. <br /> Generators which generate an amount equal to <br /> 8. or more than 2,000 tons of hazardous waste 55,747-00 <br /> during the calendar year or portion thereof. <br /> 9. Total amount of fees. (Add amounts in Column D, Lines 1 thru 8) / $ 3 b <br /> 10. See instructions for credit for local fees. <br /> 11. Total amount of fees due. I� <br /> (Subtract Line 10 from Line 9. If Line 11 is less than zero, enter zero.) $ — 6 <br /> 12. Penalty of 10% (.10) if payment is made after due date shown above. Penalty $ (j <br /> 13 INTEREST OF 13 PER ANNUM 0.010 33 PER MONTH <br /> IS DUE IF PAYMENT IS MADE AFTER THE DUE DATE. Interest $ <br /> 14. TOTAL AMOUNT DUE AND PAYABLE. (Add lines 11, 12, 13) $ O <br /> hereby certify nar this re urn, including any accompanying schedules ana statements, as been <br /> examined by me and to the best of my knowledge and belief is a true, correct and complete return. <br /> MAKE CHECK OR MONEY ORDER PAYABLE TO TATE BOARD OF EQUALIZATION. <br />