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HOLDING TANK SERVICING CONTRACT <br /> Contract Date <br /> q_ /o _ p^, This contract is made between the <br /> 0 1 — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — <br /> Holding Tank Owners)Name(s) and I Pumper's Name <br /> I <br /> rYlCe <br /> We acknowledge the installation of(a) holding tank(s)on the following property: (Provide legal description:) <br /> -- - -------------- <br /> --------- ---- <br /> EGSf Sic( c' t jc/"',ySo,, -- -- -- ---------------- <br /> - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - I- - - - - - - - - - - <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 & #-ne'4 <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 /> 17 <br /> _ Subscribed and sworn to before me on this date: <br /> I <br /> Pumper's Name(Print) ,Pumper's Signature ��(`J^�'�/� Notary�6fic <br /> �C�� C/ f11PSSfdrlpfr�9PnnMnnnnh. �1 <br /> C300J1 "S S�o�tc Se�Jlc(� �crn�.lr ANN E. KRENTZ Z"/ <br /> Pumper's Registration Number `� RAMSEY COUNTY <br /> MY COMM.EXPIRES JULY 29, 1991 <br /> w <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 />