Texas Commission on Environmental Quality
Waste Management Fee Monthly Summary & Payment Report Commercial Class 1
Non-Hazardous Waste
Mail To:
TCEQ
Attn: Revenue Section
MC-214
PO Box 13088
Austin TX 78711-3088
Company Name:
Registration No.:
Permit No.:
Payment Period:
Disposition
(mm/yyyy)
Tons
Managed
Exempt
Tons
(see page 3)
Net
Tons
Fee/Ton
Waste Generated In State
Incineration
Incineration – Aqueous Waste < 5% Total
Organic Carbon
Landfill
Land Treatment
Underground Injection
Underground Injection of Inorganic Salts
$3.20
$0.32
$6.00
$4.80
$3.60
$0.72
In State Fee Subtotal
Waste Generated Out of State
Incineration
Incineration – Aqueous Waste < 5% Total
Organic Carbon
Landfill
$4.00
Land Treatment
Underground Injection
Underground Injection of Inorganic Salts
$6.00
$4.50
$0.90
$0.40
$7.50
Out of State Fee Subtotal
Total Fee Due
TCEQ-20542 (11-01-09)
Page 1 of 3

This form shall be submitted to meet the requirements of 30 TAC 335.329, Records and
Reports.

This report shall accompany each monthly payment of a commercial class 1
nonhazardous waste management fee due under 30 TAC 335.325, Industrial Solid
Waste and Hazardous Waste Management Fee Assessment.

All weights are in short tons (2,000 pounds) except for underground injection which is in
dry weight tons.

This report must be submitted regardless of whether any storage, processing, or
disposal of class 1 nonhazardous waste was conducted during the subject month.
I certify under penalty of law that I have personally examined, and am familiar with, the
statements and information submitted in this document and all its attachments. Based on my
inquiry of those individuals with primary responsibility for obtaining the information, I certify
that the statements are to the best of my knowledge and belief true, accurate, and complete.
I am aware that there are significant penalties, including the possibility of fine or
imprisonment, for submitting false statements and information or omitting required
statements and information.
Signature of Authorized Representative or Agent
TCEQ-20542 (11-01-09)
Printed Name
Date
Page 2 of 3
Schedule of Exempt Wastes
Exempt Code
Incineration
Tons Generated in State
A
B
C
D
Total Exempt
Landfill
Underground
Injection
Land Treatment
Tons Generated Out of State
A
B
C
D
Total Exempt
Exempt Code
A – Waste generated in a removal or remedial action accomplished through expenditure
of State of Texas public funds.
B – Waste is stored within the time periods allowed by and in accordance with the
provisions of Texas Administrative Code § 335.69
C – Waste treated, processed, or disposed which is permitted under the Water Code,
Chapter 26, or the Federal national Pollutant Discharge Elimination System that
discharges into surface waters of the state
D – Other reconciling items (please attach an explanation).
TCEQ-20542 (11-01-09)
Page 3 of 3