Form BOE-506-PO Fillable Terminal Operator Information Report

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( PRODUCT DESCRIPTION Other Products Benzene PRODUCT CODE 248 ENDING INVENTORY (Net Gallons)) ( PRODUCT DESCRIPTION Other Products Butylene PRODUCT CODE 198 ENDING INVENTORY (Net Gallons)) ( PRODUCT DESCRIPTION Other Products Compressed Natural Gas (CNG) PRODUCT CODE 224 ENDING INVENTORY (Net Gallons)) ( PRODUCT DESCRIPTION Other Products Crude (any) PRODUCT CODE 001 ENDING INVENTORY (Net Gallons)) ( PRODUCT DESCRIPTION Other Products E 85 PRODUCT CODE 079 ENDING INVENTORY (Net Gallons)) ( PRODUCT DESCRIPTION Other Products Ethane PRODUCT CODE 052 ENDING INVENTORY (Net Gallons)) ( PRODUCT DESCRIPTION Other Products Ethylene PRODUCT CODE 196 ENDING INVENTORY (Net Gallons)) ( PRODUCT DESCRIPTION Other Products Excluded Liquid (mineral spirits) PRODUCT CODE 077 ENDING INVENTORY (Net Gallons)) ( PRODUCT DESCRIPTION Other Products Isobutane PRODUCT CODE 058 ENDING INVENTORY (Net Gallons)) ( PRODUCT DESCRIPTION Other Products Jet Fuel PRODUCT CODE 130 ENDING INVENTORY (Net Gallons)) ( PRODUCT DESCRIPTION Other Products Liquefied Natural Gas (LNG) PRODUCT CODE 225 ENDING INVENTORY (Net Gallons)) ( PRODUCT DESCRIPTION Other Products Marine Diesel Oil PRODUCT CODE 279 ENDING INVENTORY (Net Gallons)) ( PRODUCT DESCRIPTION Other Products Marine Gas Oil PRODUCT CODE 280 ENDING INVENTORY (Net Gallons)) ( PRODUCT DESCRIPTION Other Products Methane PRODUCT CODE 265 ENDING INVENTORY (Net Gallons)) ( PRODUCT DESCRIPTION Other Products Mineral Oils PRODUCT CODE 281 ENDING INVENTORY (Net Gallons)) ( PRODUCT DESCRIPTION Other Products Organic Oils PRODUCT CODE 960 ENDING INVENTORY (Net Gallons)) ( PRODUCT DESCRIPTION Other Products Propane (LPG) PRODUCT CODE 054 ENDING INVENTORY (Net Gallons)) ( PRODUCT DESCRIPTION Other Products Propylene PRODUCT CODE 075 ENDING INVENTORY (Net Gallons)) ( PRODUCT DESCRIPTION Other Products Transmix PRODUCT CODE 100 ENDING INVENTORY (Net Gallons)) ( PRODUCT DESCRIPTION Other Products Undefined (Other) Products PRODUCT CODE 092 ENDING INVENTORY (Net Gallons)) ( PRODUCT DESCRIPTION Other Products Waste Oil PRODUCT CODE 091 ENDING INVENTORY (Net Gallons)) ( PRODUCT DESCRIPTION Other Products: Asphalt PRODUCT CODE 188 ENDING INVENTORY (Net Gallons)) ((a) COMPANY NAME) ((a) COMPANY NAME) ((b) BOE ACCOUNT NUMBER) ((b) BOE ACCOUNT NUMBER) ((c) TCN) ((c) TCN) ((d) PRODUCT CODE) ((e) NAME/YEAR) ((e) NAME/YEAR) (8 Gross Gallons TOTAL (add amounts in columns 7 and 8 and enter the totals)) (a) COMPANY NAME (b) BOE ACCOUNT NUMBER (BOE USE ONLY) (button) CLEAR (button) PRINT (c) TCN (Column 2 Carrier FEIN) (Column 2 Carrier FEIN) (Column 2 Carrier FEIN) (Column 2 Carrier FEIN) (Column 2 Carrier FEIN) (Column 2 Carrier FEIN) (Column 2 Carrier FEIN) (Column 2 Carrier FEIN) (Column 2 Carrier FEIN) (Column 2 Carrier FEIN) (Column 2 Carrier FEIN) (Column 2 Carrier FEIN) (Column 2 Carrier FEIN) (Column 2 Carrier FEIN) (Column 2 Carrier FEIN) (Column 2 Carrier FEIN) (Column 2 Carrier FEIN) (Column 2 Carrier FEIN) (Column 2 Carrier FEIN) (Column 2 Carrier FEIN) (Column 2 Carrier FEIN) (Column 3 Mode) (Column 3 Mode) (Column 3 Mode) (Column 3 Mode) (Column 3 Mode) (Column 3 Mode) (Column 3 Mode) (Column 3 Mode) (Column 3 Mode) (Column 3 Mode) (Column 3 Mode) (Column 3 Mode) (Column 3 Mode) (Column 3 Mode) (Column 3 Mode) (Column 3 Mode) (Column 3 Mode) (Column 3 Mode) (Column 3 Mode) (Column 3 Mode) (Column 3 Mode) (Column 4 Destination State) (Column 4 Destination State) (Column 4 Destination State) (Column 4 Destination State) (Column 4 Destination State) (Column 4 Destination State) (Column 4 Destination State) (Column 4 Destination State) (Column 4 Destination State) (Column 4 Destination State) (Column 4 Document Date) (Column 4 Document Date) (Column 4 Document Date) (Column 4 Document Date) (Column 4 Document Date) (Column 4 Document Date) (Column 4 Document Date) (Column 4 Document Date) (Column 4 Document Date) (Column 4 Document Date) (Column 4 Document Date) (Column 5 Document Date) (Column 5 Document Date) (Column 5 Document Date) (Column 5 Document Date) (Column 5 Document Date) (Column 5 Document Date) (Column 5 Document Date) (Column 5 Document Date) (Column 5 Document Date) (Column 5 Document Date) (Column 5 Document Number) (Column 5 Document Number) (Column 5 Document Number) (Column 5 Document Number) (Column 5 Document Number) (Column 5 Document Number) (Column 5 Document Number) (Column 5 Document Number) (Column 5 Document Number) (Column 5 Document Number) (Column 5 Document Number) (Column 6 Document Number) (Column 6 Document Number) (Column 6 Document Number) (Column 6 Document Number) (Column 6 Document Number) (Column 6 Document Number) (Column 6 Document Number) (Column 6 Document Number) (Column 6 Document Number) (Column 6 Document Number) (Column 6 Net Gallons) (Column 6 Net Gallons) (Column 6 Net Gallons) (Column 6 Net Gallons) (Column 6 Net Gallons) (Column 6 Net Gallons) (Column 6 Net Gallons) (Column 6 Net Gallons) (Column 6 Net Gallons) (Column 6 Net Gallons) (Column 6 Net Gallons) (Column 7 Net Gallons TOTAL (add amounts in columns 7 and 8 and enter the totals) ) (Column 7 Net Gallons) (Column 7 Net Gallons) (Column 7 Net Gallons) (Column 7 Net Gallons) (Column 7 Net Gallons) (Column 7 Net Gallons) (Column 7 Net Gallons) (Column 7 Net Gallons) (Column 7 Net Gallons) (Column 7 Net Gallons) (Column 7 Net Gallons) (Column 8 Gross Gallons) (Column 8 Gross Gallons) (Column 8 Gross Gallons) (Column 8 Gross Gallons) (Column 8 Gross Gallons) (Column 8 Gross Gallons) (Column 8 Gross Gallons) (Column 8 Gross Gallons) (Column 8 Gross Gallons) (Column 8 Gross Gallons) (d) PRODUCT CODE (DATE) (Diesel Fuel PRODUCT DESCRIPTION Biodiesel Undyed: Biodiesel Undyed (B100) PRODUCT CODE 284 ENDING INVENTORY (Net Gallons)) (Diesel Fuel PRODUCT DESCRIPTION Biodiesel Undyed: PRODUCT CODE 170 ENDING INVENTORY (Net Gallons)) (Diesel Fuel PRODUCT DESCRIPTION Biodiesel Undyed: Soy Oil PRODUCT CODE 285 ENDING INVENTORY (Net Gallons)) (Diesel Fuel PRODUCT DESCRIPTION Diesel Fuel Undyed: Clear Diesel PRODUCT CODE 160 ENDING INVENTORY (Net Gallons)) (Diesel Fuel PRODUCT DESCRIPTION Diesel Fuel Undyed: Diesel Fuel #1 High Sulfur Undyed PRODUCT CODE 282 ENDING INVENTORY (Net Gallons)) (Diesel Fuel PRODUCT DESCRIPTION Diesel Fuel Undyed: Diesel Fuel #1 Low Sulfur Undyed PRODUCT CODE 161 ENDING INVENTORY (Net Gallons)) (Diesel Fuel PRODUCT DESCRIPTION Diesel Fuel Undyed: Diesel Fuel #2 High Sulfur Undyed PRODUCT CODE 283 ENDING INVENTORY (Net Gallons)) (Diesel Fuel PRODUCT DESCRIPTION Diesel Fuel Undyed: Diesel Fuel #2 Low Sulfur Undyed PRODUCT CODE 167 ENDING INVENTORY (Net Gallons)) (Diesel Fuel PRODUCT DESCRIPTION Diesel Fuel Undyed: Diesel Fuel #2 Low Sulfur Undyed with 20% Water Emulsion PRODUCT CODE 168 ENDING INVENTORY (Net Gallons)) (Diesel Fuel PRODUCT DESCRIPTION Diesel Fuel Undyed: Diesel Fuel #4 Undyed PRODUCT CODE 154 ENDING INVENTORY (Net Gallons)) (Diesel Fuel PRODUCT DESCRIPTION Diesel Fuel Undyed: Fuel Oil #1 Undyed PRODUCT CODE 150 ENDING INVENTORY (Net Gallons)) (DUE ON OR BEFORE) (e) MONTH/YEAR (EMAIL ADDRESS) (If additional space is needed please photocopy the schedule before making entries ) (Motor Vehicle Fuel PRODUCT DESCRIPTION Aviation Gasoline PRODUCT CODE 125 ENDING INVENTORY (Net Gallons) ) (Motor Vehicle Fuel PRODUCT DESCRIPTION E 75 PRODUCT CODE 078 ENDING INVENTORY (Net Gallons) ) (Motor Vehicle Fuel PRODUCT DESCRIPTION Gasohol 10% PRODUCT CODE 139 ENDING INVENTORY (Net Gallons) ) (Motor Vehicle Fuel PRODUCT DESCRIPTION Gasohol 5 7% PRODUCT CODE 140 ENDING INVENTORY (Net Gallons) ) (Motor Vehicle Fuel PRODUCT DESCRIPTION Gasohol 7 7% PRODUCT CODE 141 ENDING INVENTORY (Net Gallons) ) (Motor Vehicle Fuel PRODUCT DESCRIPTION Gasohol: PRODUCT CODE 124 ENDING INVENTORY (Net Gallons) ) (Motor Vehicle Fuel PRODUCT DESCRIPTION Gasoline Blendstocks: Butane including butane propane mixes PRODUCT CODE 055 ENDING INVENTORY (Net Gallons)) (Motor Vehicle Fuel PRODUCT DESCRIPTION Gasoline Blendstocks: Ethyl Tertiary Butyl Ether (ETBE) PRODUCT CODE 249 ENDING INVENTORY (Net Gallons)) (Motor Vehicle Fuel PRODUCT DESCRIPTION Gasoline Blendstocks: Methyl Tertiary Butyl Ether (MTBE) PRODUCT CODE 093 ENDING INVENTORY (Net Gallons)) (Motor Vehicle Fuel PRODUCT DESCRIPTION Gasoline Blendstocks: Mixed Xylene not including any separated isomer of xylene PRODUCT CODE 076 ENDING INVENTORY (Net Gallons)) (Motor Vehicle Fuel PRODUCT DESCRIPTION Gasoline Blendstocks: Naphthas including light and straight run naphtha PRODUCT CODE 126 ENDING INVENTORY (Net Gallons)) (Motor Vehicle Fuel PRODUCT DESCRIPTION Gasoline Blendstocks: Natural Gasoline (including condensate) PRODUCT CODE 061 ENDING INVENTORY (Net Gallons)) (Motor Vehicle Fuel PRODUCT DESCRIPTION Gasoline Blendstocks: Pentanes including isopentane and pentane mixtures PRODUCT CODE 059 ENDING INVENTORY (Net Gallons)) (Motor Vehicle Fuel PRODUCT DESCRIPTION Gasoline Blendstocks: Raffinate PRODUCT CODE 223 ENDING INVENTORY (Net Gallons)) (Motor Vehicle Fuel PRODUCT DESCRIPTION Gasoline Blendstocks: Tertiary Amyl Methyl Ether (TAME) PRODUCT CODE 121 ENDING INVENTORY (Net Gallons)) (Motor Vehicle Fuel PRODUCT DESCRIPTION Gasoline Blendstocks: Toluene PRODUCT CODE 199 ENDING INVENTORY (Net Gallons)) (Motor Vehicle Fuel PRODUCT DESCRIPTION Gasoline: PRODUCT CODE 065 ENDING INVENTORY (Net Gallons) ) (Motor Vehicle Fuel PRODUCT DESCRIPTION Other Gasoline Blendstocks including Alkylate Butene Catalytically Cracked Gasoline Coker Gasoline Hexane Hydrocrackate Isomerate Polymer Gasoline Reformate Straight Run Gasoline Thermally Cracked Gasoline Tertiary Butyl Alcohol (TBA Gasoline Grade) and any other product determined to be a gasoline blendstock by IRS or BOE PRODUCT CODE 122 ENDING INVENTORY (Net Gallons)) (Motor Vehicle Fuel PRODUCT DESCRIPTION Reformulated Gasoline with MTBE PRODUCT CODE 071 ENDING INVENTORY (Net Gallons) ) (Net Gallons) (Net Gallons) (Other Products PRODUCT DESCRIPTION Additives Miscellaneous PRODUCT CODE 090 ENDING INVENTORY (Net Gallons)) (Other Products PRODUCT DESCRIPTION Alcohol: Ethanol PRODUCT CODE 241 ENDING INVENTORY (Net Gallons)) (Other Products PRODUCT DESCRIPTION Alcohol: Methanol PRODUCT CODE 243 ENDING INVENTORY (Net Gallons)) (Other Products PRODUCT DESCRIPTION Alcohol: PRODUCT CODE 123 ENDING INVENTORY (Net Gallons)) (Other Products PRODUCT DESCRIPTION Kerosene Dyed: Kerosene High Sulfur Dyed PRODUCT CODE 074 ENDING INVENTORY (Net Gallons)) (Other Products PRODUCT DESCRIPTION Kerosene Dyed: Kerosene Low Sulfur Dyed PRODUCT CODE 073 ENDING INVENTORY (Net Gallons)) (Other Products PRODUCT DESCRIPTION Kerosene Undyed: Kerosene High Sulfur Undyed PRODUCT CODE 147 ENDING INVENTORY (Net Gallons)) (Other Products PRODUCT DESCRIPTION Kerosene Undyed: Kerosene Low Sulfur Undyed PRODUCT CODE 145 ENDING INVENTORY (Net Gallons)) (Page) (PH FEIN) (POSITION HOLDER (PH) NAME (enter one name per page)) (PRINT NAME AND TITLE) (PRODUCT DESCRIPTION Biodiesel Dyed: Biodiesel Dyed (B100) PRODUCT CODE 290 ENDING INVENTORY (Net Gallons)) (PRODUCT DESCRIPTION Biodiesel Dyed: PRODUCT CODE 171 ENDING INVENTORY (Net Gallons)) (PRODUCT DESCRIPTION Diesel Fuel Dyed: Diesel Fuel #1 Dyed PRODUCT CODE 231 ENDING INVENTORY (Net Gallons)) (PRODUCT DESCRIPTION Diesel Fuel Dyed: Diesel Fuel #4 Dyed PRODUCT CODE 153 ENDING INVENTORY (Net Gallons)) (PRODUCT DESCRIPTION Diesel Fuel Dyed: Diesel Fuel High Sulfur Dyed PRODUCT CODE 226 ENDING INVENTORY (Net Gallons)) (PRODUCT DESCRIPTION Diesel Fuel Dyed: Diesel Fuel Low Sulfer Dyed with 20% Water Emulsion PRODUCT CODE 228 ENDING INVENTORY (Net Gallons)) (PRODUCT DESCRIPTION Diesel Fuel Dyed: Diesel Fuel Low Sulfur Dyed PRODUCT CODE 227 ENDING INVENTORY (Net Gallons)) (Row 1 (1) Carrier Name ) (Row 1 (1) Carrier Name) (Row 10 (1) Carrier Name ) (Row 11 (1) Carrier Name ) (Row 12 (1) Carrier Name ) (Row 13 (1) Carrier Name ) (Row 14 (1) Carrier Name ) (Row 15 (1) Carrier Name ) (Row 16 (1) Carrier Name ) (Row 17 (1) Carrier Name ) (Row 18 (1) Carrier Name ) (Row 19 (1) Carrier Name ) (Row 2 (1) Carrier Name ) (Row 20 (1) Carrier Name ) (Row 21 (1) Carrier Name ) (Row 3 (1) Carrier Name ) (Row 4 (1) Carrier Name ) (Row 5 (1) Carrier Name ) (Row 6 (1) Carrier Name ) (Row 7 (1) Carrier Name ) (Row 8 (1) Carrier Name ) (Row 9 (1) Carrier Name ) (TELEPHONE AREA CODE ( )) (TELEPHONE) (text) (text) (YOUR ACCOUNT NO ) **RT Removal from a terminal **RT Removal from Terminal (other than by truck or rail) for sale or consumption A Terminal Operator should use this code: *BA Book Adjustments *BA Book adjustments are product reclassifications or conversions of products at the terminal that result in a product code [ FOID] 800 400 7115 (TTY: 711); from the main menu select the option Special Taxes and Fees Account Number (c) TCN and (e) Month/Year are already filled in when you receive monthly paper forms from the BOE Additives Miscellaneous 090 Alcohol: 123 As a terminal operator you are required to report your monthly receipts and disbursements of liquid Asphalt 188 at: http://www boe ca gov/sptaxprog/spftdmfuels htm Aviation Gasoline 125 B Barge BEFORE PREPARING Benzene 248 Biodiesel Dyed (B100) 290 Biodiesel Dyed: 171 Biodiesel Undyed (B100) 284 Biodiesel Undyed: 170 BOARD OF EQUALIZATION BOARD OF EQUALIZATION BOARD OF EQUALIZATION BOE 506 PO (S1) REV 3 (3 11) STATE OF CALIFORNIA BOE 506 PO (S2B) REV 3 (3 11) BOE 506 PO (S2F) REV 3 (3 11) BOE 506 PO (S3B) REV 3 (3 11) BOE 506 PO (S3F) REV 3 (3 11) BOE 506 PO (S4) REV 3 (3 11) BOE 506 PO (S5) REV 3 (3 11) BOE ACCOUNT NO BOE USE ONLYRA B/A AUDREG Butane including butane propane mixes 055 Butylene 198 by Product Code) Photocopy additional schedule pages as required to report only one product code per page For CARRIER CARRIER CERTIFICATION change Examples include conversion of diesel fuel #2 undyed to diesel fuel low sulfur dyed and reclassification of jet fuel to CLEAR BUTTON Clear Diesel 160 Column 1 Enter the name of the carrier that transported the product into the terminal Column 1 Enter the name of the carrier that transported the product out of the terminal Column 2 Enter the carrier's FEIN Column 2 Enter the carrier's FEIN (Federal Employer Identification Number) Column 3 Enter the mode from the mode codes list Column 4 Enter the date of the document identified in column 5 (enter as mm/dd/yy) Column 4 Enter the destination state must be a valid two character U S Postal Service abbreviation (obtain from the Column 5 Enter the date of the document identified in column 6 (enter as mm/dd/yy) Column 5 Enter the identifying number from the document provided by the carrier that reflects the details of the Column 6 Enter the identifying number from the document provided by the terminal operator to the carrier that reflects the Column 6 Enter the net gallons received into the terminal For non bulk deliveries to a terminal where net gallons are not Column 7 Enter the net gallons disbursed from the terminal Column 8 Enter the gross gallons disbursed from the terminal COMPANY NAME Compressed Natural Gas (CNG) 224 concerning my transactions with such person as reported in this report CONTINUE Cracked Gasoline Coker Gasoline Hexane Hydrocrackate Isomerate Crude (any) 001 deliveries only If a fuel transport truck is receiving fuel destined for different states the terminal operator will delivery of reportable products to any person identified by me in this report as being involved in a reported destination is a terminal enter the TCN destination You are required to report each separate shipping document as a separate transaction If the DESTINATIONSTATE(5) details of the transaction This should be a bill of lading (If no bill of lading use the shipping document or Diesel Fuel Diesel Fuel #1 Dyed 231 Diesel Fuel #1 High Sulfur Undyed 282 Diesel Fuel #1 Low Sulfur Undyed 161 Diesel Fuel #2 High Sulfur Undyed 283 Diesel Fuel #2 Low Sulfur Undyed 167 Diesel Fuel #2 Low Sulfur Undyed with 20% Water Emulsion 168 Diesel Fuel #4 Dyed 153 Diesel Fuel #4 Undyed 154 Diesel Fuel Dyed: Diesel Fuel High Sulfur Dyed 226 Diesel Fuel Low Sulfer Dyed with 20% Water Emulsion 228 Diesel Fuel Low Sulfur Dyed 227 Diesel Fuel Undyed: disbursed at a California terminal rack for the reporting period You must file a separate report for each approved terminal that DOCUMENT DOCUMENT DUE ON OR BEFORE E 75 078 E 85 079 Each terminal operator is required to file BOE 506 PO for each approved terminal ENDING INVENTORY Ending Inventory by Product Code Schedule 15C Enter the actual physical ending inventory for each product in net gallons at the terminal Enter the name and FEIN of the position holder whose product was disbursed at the terminal Enter the physical inventory for each product code in net gallons at the end of the reporting period Ethane 052 Ethanol 241 Ethyl Tertiary Butyl Ether (ETBE) 249 Ethylene 196 exchange all three parties (the delivering supplier receiving supplier and terminal operator) must meet certain requirements Excluded Liquid (mineral spirits) 077 Filing Requirements following the reporting period to which it relates You must file a report even if you have no activity for the reporting period Fuel Oil #1 Undyed 150 fuel will be consumed in the operation of the vessel; when the disbursement is from a hydrant system at an airport; or when GALLONS Gasohol 10% 139 Gasohol 5 7% 140 Gasohol 7 7% 141 Gasohol: 124 Gasoline Blendstocks: Gasoline Tertiary Butyl Alcohol (TBA Gasoline Grade) and any other Gasoline: 065 General Information GROSSGALLONS has a unique IRS terminal control number (TCN) The report must be filed on or before the last day of the calendar month I hereby certify that this report including any accompanying schedules and statements have been examined by I hereby consent to disclosure and authorize the BOE to release as necessary certain otherwise confidential If you are interested in filing your Terminal Operator Information Report electronically with the BOE please contact Special If you need additional information please contact the State Board of Equalization Special Taxes and Fees P O Box 942879 including filing electronic tax forms with us INSTRUCTIONS Isobutane 058 issue a bill of lading manifest or other shipping document on behalf of the position holder for each state of J Truck Jet Fuel 130 Kerosene Dyed: Kerosene High Sulfur Dyed 074 kerosene high sulfur dyed or diesel fuel #1 undyed Book adjustments must be reported in summary For book adjustments Kerosene High Sulfur Undyed 147 Kerosene Low Sulfur Dyed 073 Kerosene Low Sulfur Undyed 145 Kerosene Undyed: licensed Industrial User and the removal is made from a vessel or pipeline; when the removal is made from a vessel and the Liquefied Natural Gas (LNG) 225 Make a copy of this document and the accompanying schedules for your records manifest number ) Both the carrier and terminal operator must report the same document number to the BOE Marine Diesel Oil 279 Marine Gas Oil 280 me and to the best of my knowledge and belief is a true correct and complete report measured enter gross gallons Methane 265 Methanol 243 Methyl Tertiary Butyl Ether (MTBE) 093 Mineral Oils 281 Mixed Xylene not including any separated isomer of xylene 076 Mode Codes MONTH/YEAR Motor Vehicle Fuel must report the same document number to the BOE Naphthas including light and straight run naphtha 126 Natural Gasoline (including condensate) 061 No activity to report Note: Two Party Exchange Transactions NUMBER one product code on each schedule page for the period using the product code table (from Schedule 15C Ending Inventory Organic Oils 960 Other Gasoline Blendstocks including Alkylate Butene Catalytically Other Products Other Products: Pentanes including isopentane and pentane mixtures 059 PH FEIN PL Pipeline Please check the applicable schedules that are attached to this report: PO BOX 942879 Polymer Gasoline Reformate Straight Run Gasoline Thermally Cracked Position Holder (PH) Name Position Holder FEIN POSITION HOLDER (PH) NAME(enter one name per page) Postal Abbreviations list available on our website) This information is required for non bulk (truck or rail car) Preparation of the Schedules PRINT BUTTON PRINT NAME AND TITLE PRODUCT DESCRIPTION PRODUCT CODE PRODUCT DESCRIPTION PRODUCT CODE ENDING INVENTORY PRODUCT DESCRIPTION PRODUCT CODE ENDING INVENTORY product determined to be a gasoline blendstock by IRS or BOE products to and from your approved terminal and the ending inventory of all products in the terminal Propane (LPG) 054 Propylene 075 R Rail Raffinate 223 READ INSTRUCTIONS Receipts); and a disbursement schedule (Schedule 15B Terminal Operator Disbursements by Position Holder) Report only Reformulated Gasoline with MTBE 071 REFREF REGREG RR QS FILEREF S Ship (ocean marine vessel) Sacramento CA 94279 0088 You may also visit the BOE website at www boe ca gov or call the Taxpayer Information Section at SACRAMENTO CA 94279 2074 schedule (Schedule 15C Ending Inventory by Product Code); a receipt schedule (Schedule 15A Terminal Operator Schedule 15A report the book adjustments for a product code along with the other transactions for the product code On Schedule 15A Terminal Operator Receipts Schedule 15B Schedule 15B do not report book adjustments on any position holder's schedule Instead use a separate Schedule 15B Schedule 15B Terminal Operator Disbursements by Position Holder Schedule 15C Ending Inventory by Product Code Schedules 15A and 15B complete the information in box (d) in the header of the schedule Boxes (a) Company Name (b) showing "book adjustment" as the position holder for each applicable product code SIGNATURE EMAIL ADDRESS Soy Oil 285 SPECIAL TAXES AND FEES STATE OF CALIFORNIA STATE OF CALIFORNIA summary reporting means the combining of all book adjustment transactions by product code for the reporting period On Taxes and Fees at the number listed at the bottom of page (S3B) TELEPHONE Terminal Operator Disbursements by Position Holder Schedule 15B TERMINAL OPERATOR INFORMATION REPORT Terminal Operator Receipts Schedule 15A Terminal operators may not participate in two party exchanges if they are filing paper returns To participate in a two party Tertiary Amyl Methyl Ether (TAME) 121 the disbursement is from qualifying truck removals at a secured airport The Terminal Operator Information Report allows terminal operators to report receipts and disbursements of liquid products There are three types of supporting schedules included with every Terminal Operator Information Report; an ending inventory to and from each approved terminal To obtain the latest information on any product codes or if you need help completing this form please visit the BOE's website Toluene 199 TOTAL (add amounts in column 6 and enter the total) TOTAL (add amounts in columns 7 and 8 and enter the totals) transaction for the sole purpose of verifying the accuracy of the reportable product transaction information transaction information regarding volumes invoice numbers bills of lading locations dates or method of transaction This could be a bill of lading shipping document or manifest Both the carrier and terminal operator Transmix 100 Undefined (Other) Products 092 Use this schedule to report each disbursement of product (bulk and non bulk) from your terminal by position holder Use this schedule to report each receipt of product (bulk and non bulk) by the terminal operator Waste Oil 091 when a sale or transfer is made within the bulk transfer/terminal system to an unlicensed customer; when the sale is to a You must file a report with the BOE and report every gallon of liquid products you received at a California terminal or You should use this table to identify the appropriate product codes to use when reporting terminal activity on Schedule 15A and YOUR ACCOUNT NO

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