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uepartmentofToxicSubstuc Con SCHEDULV# - MANIFEST FEE CALCUL`ION SHEET (1993) This form must be completed and returned for each EPA ID number your organization holds. If no manifests were submitted to the Department under the EPA ID number reported on Line 2 below,you must complete Line 1, Name of Organization;Line 2, EPA ID Number; and enter a "0" on Line 3 and Line 7, and attach this form to Schedule B. 1. Name of Organization: SPRECKELS SUGAR COMPANY, INC, 2. EPA ID Number: CAT 000624635 3. Enter total number of manifests used in calendar year 1993 under the EPA ID number given on Line 2: 17 Fees for manifests are divided into two categories: those manifests used solely for recycled waste ($6), and those manifests used solely or partially for non-recycled waste($12). If your organization has less than 100 employees, you may deduct the first four(4)manifests used by your organization in 1993. This deduction may be taken in any combination of the two categories (e.g. 0 recycled+4 non-recycled; 3 recycled+ 1 non-recycled, etc.). Enter your deductions in Column II, Box 4b and/or Box 5b of the table below. If you do not qualify for this deduction, enter "0"in Column II, Box 4b and Box 5b. Note: If you have more than one EPA ID number, this deduction maybe taken only once;not for every EPA ID number you hold. I II III 4a) From the total manifests 4b) Enter the number of 4c) Subtract Box 4b from reported on Line 3, enter the manifests used solely for Box 4a. Use this new total number of manifests which recycled waste you are to calculate your fees for were used solely for recycled deducting: manifests used solely for waste: recycled waste. 14 0 14 5a) From the total manifests 5b) Enter the number of 5c) Subtract Box 5b from reported on Line 3, enter the manifests which were used Box 5a. Use this new total number of manifests which solely or partially for non- to calculate your fees for were used solely or partially recycled waste you are manifests used solely or for non-recycled waste: deducting: partially for non-recycled 3 waste. 0 3 (Box 4a+Box 5a should equal (Box 4b +Box 5b should the amount in line 3) equal no more than 4) 6) Manifest Fee Calculation: a)Enter the figure given in Column III, Box 4c and multiply by$6: 14 x $ 6.00 = $ as b) Enter the dollar amount from Line 6a OR "$5,000.00", whichever $ 84 amount is less. c)Enter the figure given in Column III, Box 5c and multiply by$12: 3 x $12.00 = $ �6 7) Total Manifest Fee due for the EPA ID Number on Line 2: (Add Line 6b and Line 6c and enter the total. ) $ 120 I1 DTSC 1194A(3/95)