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HOLDING TANK SERVICING CONTRACT <br /> Contract Oat* <br /> 'tr This contract its mado between the <br /> — — — — — <br /> .`' — — — — — — — —Holding Tank Owner(s)Nam•(s) � •7 - ,�„I ane I vamps:a N.m• — — — — — — — — — <br /> f 3 8oY•lc I BERGIES SEP.Ti-C SERVICE <br /> Ar+a Wi 5C6 <br /> We acknowledge the Installation of(a)holding tank(s)on the following property: Providirlegal doseriplio :) <br /> Z. . . <br /> 1. The owner agrees to file a copy of this contract with the local governmental unit hereinafter called the"municl pallty",which has <br /> signed the pumping agreement required in Ch.II-HR 89.18(4) (b).Wis.Adm.Code and <br /> with the County of- T a,A ..TJC <br /> 2. The owner agrees to have the holding tanks)serviced by the pumper and guarantees to permit tho pu per 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. Thea ner further agrees to pay <br /> the pumper for ail charges Incurred In servicing the holding tanks)as mutually agreed upon by the ow er and pumper, <br /> 3. The pumper agrees to submit to the municipality which has signed the pumping agreement required b s.ILNR 83.18(4) (b),Wis. <br /> Adm.Code,and to the county,a report for the servicing of the holding tanks)on a semiannual basis, o 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; t. <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 /> C. 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 zontract or a copy of a new service cor tract with the municipality <br /> and the County named above within ten(10)business days from the dale of change to this service contract. <br /> Ownartsl Name(sl tPaN) I Owner s SignaWrplsl <br /> Subscribed and sworn to b fore me on this date: <br /> Joe 2.A-V..Ter i �.._ ;;, $125)915 <br /> I ... f <br /> m ,`. <br /> Puper':Namp lPrmt u per•e, -- —" ` <br /> mare 1 -1 o ry •ubirt <br /> JIM DAHLGREN i Q j ' <br /> / My Commission ex " <br /> , , .. J` <br /> —._. <br /> Pumpo!'i Rapylpbm <br /> on Nuber - -- J 1— 1 <br /> SY 536 <br /> ot CHEyLd 'd'',"�'7 — —_ <br /> rtu,i;-siatq:. YIsgonairt <br /> SSO-7574(N.J+ras) tM.7fe:nm' sfun Expires Psb$'i88B• ; ' <br /> This instrument was drafted by the Stale of Wisconsin Department , <br /> of Industry,Labor and Human Relations. Bureau Of Plumbing, n ....... • <br />