Laserfiche WebLink
HOLDING TANK SERVICING CONTRACT <br /> Contract Date: h�� _0 <br /> This contract is made between the Holding Tank Owner and the Pumper. <br /> Holding Tank Owner(s)Name(s): Pumper's Name: <br /> We acknowledge the installation of(a)holding tank(s)on the following property(Provide legal <br /> description and computer number): Ge-L 4t Cir Pq J//d'40 _5',2 Cj 7-3 7 ✓ <br /> Igo /8 cv, AD. z <br /> GR�NTs73u>�G WI <br /> Y —/S 7d <br /> 1. The owner agrees to file a copy of this contract with the local governmental unit hereinafter called the <br /> ,'municipality",which has signed the pumping agreement required in Ch. ILHR 83.18(4)(b),Wis. <br /> Adm. Code and with the County of Burnett. <br /> 2. The owner agrees to have the holding tank(s)serviced by the pumper and guarantees to permit the <br /> pumper to have access and to enter upon the property for the purpose of servicing the holding tank(s). <br /> The owner agrees to maintain the all-weather access road or drive so that the pumper can service the <br /> holding tank(s)with the pumping equipment. The owner further agrees to pay the pumper for a <br /> 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 <br /> s.ILHR 83.18(4)(b),Wis.Adm. Code,and to the county,a report for the servicing of the holding <br /> tank(s)on a semiannual basis. The pumper further agrees to include the following in the semiannual <br /> 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 <br /> of a change in this contract,the owner agrees to file a copy of any changes to this service contract or a <br /> copy of a new service contract with the municipality and the County named above within ten(10) <br /> business days from the date of change to this service contract. <br /> Owner(s)Names(s)(Print) Owner's Signature(s) Subscribed and sworn to before me <br /> L7 .1 ..1 ... ..._.....✓..(SSE. ..L...0....�..................4✓... -...... e1lL. t^ Q.G.?1......................... on this date: <br /> Pumper's Name(Print) Pumper's Signature My commission expires:Notary Public <br /> _3CR cr\U\)5 .C\ � rGP� r—� - <br /> Pumper's Registration Number <br />