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HOLDING TANK SERVICING CONTRACT <br /> Contract Date: <br /> This contract is made between the Holding Tank Owner and the Pumper. <br /> Holding Tank Owner(s)Name(s): 1�4Pumper's Name: <br /> .Tn,o�� J' Shgc'o� Sof\ <br /> lard+ sb <br /> We acknowledge the installation of(a)holding tank(s) on the following property(Provide legal <br /> description and computer number): Lot One (1) Certified Survey Map No. 3765 <br /> recordedc in Vol. 19, po 121-122, as Docmtt1356913, Register of Deeds, <br /> Burnett County and being located in Govm't Lot One (1) , Section Seventee <br /> (17) , Township Thirty-eight (38) , North, of Range Seventeen (17) West, <br /> Burnett County, Wisconsin <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 contractwith the mumcip 'ty and the County named above within ten(10) <br /> business days from the date of change to this se . contract. <br /> Owncr(s))'N`ame-(s)(Print) On Sig a r Subscribed and sworn to before me <br /> _(._I_ 1 :L .....__....�dt?2�-.------_. ._.._ -- M-�'..___.__ on this date: <br /> QLZ <br /> R5 04 <br /> Pumper's Name (Print) Notary gn ure Notary Public <br /> •, MQ My commission expires: <br /> ir ice, <br /> Pumper's Registration Number <br /> NOTARY <br /> PUBLIC i <br /> 9 <br /> 'SOF W <br /> T 'd 9929GE99TLI 9NIHWf1Dd AIN390A d9Z :G0 bO ZZ unr <br />