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HOLDING TANK SERVICING CONTRACT <br /> Contract Date <br /> 3> This contract is made between the <br /> Holding Tank Owner(s)Namets) and I Pumper's Name <br /> i <br /> i f ooie.5 S� tt� Sevo\cc <br /> It Lu �Ik�sC�, i ►� <br /> We acknowledge the installation of(a) holding tank(s)on the following property: (Provide legal description:) <br /> 'Go O e R m.e al% D oT z;7.e L7�� _ 4 F SRC_ T16-AJ Tw 0_AJ 7x_7 _00_ C2_3) <br /> Twivsti/D Fo2i4 / oR? f � v � ) UJ S7Ty7 �k/ , <br /> /u B v e AjI77- e e c,,t,% Lu/ 3 Cr,u S/AJ <br /> - - - - - - - - - - - - - -Y-4 — — — — — — — — — — — — — — — — — — — — — — — — — — — — — <br /> 1. The owner agrees to file a copy of this contract with the local governmental unit hereinafter called the "municipality", which has <br /> signed the pumping agreement//required in Ch. ILHR 83.18(4)(b),Wis.Adm.Code and <br /> with the County of <br /> 2. The owner agrees to have the holding tank(s)serviced by the pumper and guarantees to permit the pumper to have access and to <br /> enter upon the property for the purpose of servicing the holding tank(s). The owner agrees to maintain the all-weather access <br /> road or drive so that the pumper can service the holding tank(s) with the pumping equipment. The owner further agrees to pay <br /> the pumper for all charges incurred in servicing the holding tank(s)as mutually agreed upon by the owner and pumper. <br /> 3. The pumper agrees to submit to the municipality which has signed the pumping agreement required by s. ILHR 83.18(4) (b), Wis. <br /> Adm. Code,and to the county, a report for the servicing of the holding tank(s)on a semiannual basis. The pumper further agrees <br /> to include the following in the semiannual report: <br /> a. The name and address of the person responsible for servicing the holding tank; <br /> b. The name of the owner of the holding tank; <br /> c. The location of the property on which the holding tank is installed; <br /> d. The sanitary permit number issued for the holding tank; <br /> e. The dates on which the holding tank was serviced; <br /> f. The volumes in gallons of the contents pumped from the holding tank for each servicing; <br /> g. The disposal sites to which the contents from the holding tank were delivered. <br /> 4. This agreement will remain in effect until the owner or pumper terminates this contract. In the event of a change in this contract. <br /> the owner agrees to file a copy of any changes to this service contract or a copy of a new service contract with the municipality <br /> and the County named above within ten (10) business days from the date of change to this service contract. <br /> Owner(s)Name(s)(Print) i Owner's Signature(s) <br /> i <br /> r i5 cr p * w , Subscribed and sworn to before me on this date: <br /> Yvcvnw� Nk�S � iv��j � ,�Jrt,t ��� c/.Ar.AA„ <br /> n.l,AM a <br /> sora <br /> Pumper's Name(Print) (Pumper's Signature 'Notary u c <br /> *VV �� ^^� rxpl ,uty 16,1998 <br /> xOW'?/eI CAP^,Aerhnr � �p � my cc sslonexp ires, <br /> _�. <br /> Pumper's Registration Number L, <br /> SBD-7574(N.11/85) This instrument was drafted by the State of Wisconsin Department <br /> of Industry, Labor and Human Relations, Bureau of Plumbing. <br />