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HOLDING TANK SERVICING CONTRACT <br /> Contract Date <br /> This contract is made between the <br /> Holdln Tank Owner(s)Name(s) and I Pumper's Name <br /> It rIar �. �r�oR✓�' rrn A-Pl eexl j.9a ee <br /> Biumb We acknowledge the installation of(a)holding tank(s)on the following property: (Provide legal description:) <br /> S/9 Z yo�v <br /> - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - <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 ,���►- h� <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 Si ture(s) <br /> /l �i <br /> Gh Cc o v � r Subscribed and sworn to before me on this date: <br /> v/ I <br /> I <br /> Pump 's Name(Print) I Pu s Si tura otaryublic <br /> fisc I �� My commission expi s: <br /> N K CC4-AS I <br /> Pumper's Registration Number <br /> SBD-7574(R.09/88) This instrument was drafted by the State of Wisconsin Department <br /> of Industry,Labor and Human Relations <br />