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. ,8T-314 REv.4 p-871 P"O.BOX I BOARD OF EQUALIZATION
<br /> 4STATEOFZALIFORNIA-=
<br /> SACRAMMW,CA,95803-0647 EXCISE TAX UNIT
<br /> ,
<br /> HAZARDOUS WASTE DISPOSAL REPORT - ANNUAL `SUPERFUND' TAX
<br /> IDUEONORBEFORE:MARCH 1s 1988 FOR CALENDAR YE AR 1397
<br /> . .
<br /> -_ MS Fi0 36-015784
<br /> Mail to:
<br /> BOARD OF EQUALIZATION
<br /> EXCISE TAX UNITS iV1A.FT kALKcR COMP ANY ,.; y �' �� �
<br /> P.O..BOX 647 �i
<br /> SACRAMENTO, CA 95803-0647 75 It. Y A L P I C 0 ROAD.
<br /> .✓�
<br /> TRACY CA" 95376
<br /> JUL 101999
<br /> r-f dl :ONMENKHEr....,4
<br /> -"- -_EPA NO . : CAKOiJQ11d48?
<br /> opRL!IIT/SERV ICE"
<br /> This report must be filed on or before the due date shown above by every person who submitted for disposal off-site,or who disposed of on-site.
<br /> hazardous waste or extremely hazardous waste in California during the above calendar year.Do not include wastes that are recycled or transported
<br /> -out of state for disposal.Any fraclion'of a ton must be Founded up to the next whole ton.Any person disposing of 500 pounds or less during the above
<br /> calendar year must report zero tonnage. ANY PERSON WHO KNOWINGLY REFUSES TO FILE THIS REPORT AS REQUIRED SHALL BE
<br /> "- LIABLE, UPON CONVICTION, FOR A CIVIL PENALTY PURSUANT TO SECTION 43602 OF THE HAZARDOUS SUBSTANCES TAX LAW.
<br /> "HAZARDOUS WATE"means a waste,or combination of wastes,which because of its quantity,concentration,or physical,chemical,or infectious
<br /> characteristics may either:
<br /> -.. a. Cause,or significantly contribute to an increase in mortality or an increase in serious irreversible,or incapacitating reversible,illness.
<br /> b."Pose a substantial present or potential hazard to human health or environment when improperly treated,stored,transported,or disposed of,or
<br /> otherwise managed.
<br /> _ "EXTREMELY HAZARDOUS"means any hazardous waste or mixture of hazardous wastes which,if human exposure should occur,may likely
<br /> result in death,disabling personal injury or serious illness caused by the hazardous waste or mixture of hazardous wastes because of its quantity,
<br /> concentration,or chemical characteristics.
<br /> HAZARDOUS WASTE CATEGORIES TOTAL TONS
<br /> A. The total tons of HAZARDOUS waste,the Federal Regulation of which has been suspended under the Solid
<br /> WasteDisposalAct by Act of Congress,disposed of,or submitted for disposal,in California,plus the total tons
<br /> of waste material transferred to a surface impoundment in California for the purpose of reducing water content
<br /> of such waste and material by evaporation,plus the total tons of hazardous waste disposed of into an injection
<br /> well or landfarm,exclusive of the waste reported in Categories D and E.
<br /> NOTE:LAND FILL DISPOSAL IS NOT LAND FARMING.
<br /> B. The tot6tons of HAZARDOUS waste disposed f,or sub fitted for disposal,in California exclusive o the
<br /> waste reported in Categories � _.r
<br /> f•-" ' - NOTE:LAND FILL-ON ""'-- flow -
<br /> C. The total tons of EXTREMELY HAZARDOUS waste disposed of,or sub fitted for dispos Imo, > al�fornia
<br /> exclusive of the waste reported in Categories A.B.D,and E.
<br /> NOTE:LAND FILL ONLY.
<br /> D. The total tons of HAZARDOUS waste disposed of,or submitted for disposal,in California from the extraction,
<br /> beneficiation and processing of ores or minerals including phosphate rock and overburden from mining or
<br /> uranium.ore.
<br /> 1`-. The total tons of HAZARDOUS waste disposed of,or submitted for disposal,in California that is a solid
<br /> hazardous waste residue resulting from incineration. -
<br /> I hereby certify that this report,including any accompanying schedule and statement, has
<br /> been examined by me and to the best of my knowledge and belief is true,correct and complete. -
<br /> SIGNATURE AND TITLE PHONE NUMBER DATE
<br /> If you have any questions regarding this report,please contact the
<br /> State Board of Equalization,Excise Tax Unit,Phone(916)322-9070
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