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HOLDING TANK SERVICING CONTRACT <br /> Contract Date <br /> This contract is made between the <br /> ----------------------------------------------- <br /> - <br /> -- — -------------------------- <br /> Holding Tank owner(s)Name(s) and I Pumper's Name <br /> 1 IIA, <br /> c ANh� I e Cfs0-Al <br /> /7/j [/�e f' ✓' 1 <br /> 1 <br /> I <br /> We acknowledge the installation of(a)holding tank(s)on the following property: (Provide legal descriptions:) <br /> 6 0 foo 0 <br /> 7 <br /> ------------------------------------------------------------------ <br /> 1. The owner agrees to file a copy of this contract with the local governmental unit that has signed the pumping agreement <br /> required in Ch. II-HR 83.18(4)(b),Wis.Adm.Code and with the County of Y..f.f- — <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 <br /> to enter upon the property for the purpose of servicing the holding tank(s). The owner agrees to maintain the access road or <br /> drive so that the pumper can service the holding tank(s)with the pumping equipment. The owner further agrees to pay the <br /> 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 local governmental unit which has signed the pumping agreement required by s. II-HR <br /> 83.18(4) (b),Wis.Adm.Code, and to the County, a report for the servicing of the holding tank(s)on a semiannual basis. The <br /> pumper further agrees 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 /> I. 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 local <br /> govemmental unit and the County named above within ten(1b)business days from the date of change to this service contract. <br /> 0 er(s)Name(s)(Print) I Owner's Signature(s) Subscribed and swum to me on this date: <br /> 4F 1� ;�� CdL <br /> ' Today's Date <br /> IV <br /> 1 <br /> I <br /> Pumpers Name(Print) I Pumper's Signature Notary Public Signature <br /> I c <br /> I <br /> I <br /> ' C ,.� 0 3 <br /> � <br /> Commission Expiration <br /> Pumper's Registration Number <br /> i <br /> Drafted by <br />