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HOLDING TANK SERVICING CONTRACT <br /> Contract Date <br /> This contract is made between the <br /> Holding Tank Owner(s)Name(s) and I Pumper's Name <br /> I <br /> Teeny Betizte I Daniel Clendentng <br /> I <br /> We acknowledge the installation of(a)holding tank(s)on the following property: (Provide legal description:) <br /> A paAcel o�, land located 1n GoveAnment Lot 1, (Lot 4 D-529) Section 6, Township 39 NoAth, <br /> Range 16 West, Town ob Meenon, Bmnett County, W4ACo"in, " AeeoAded to Volume 489, <br /> Page 200, at the Burnett County Reg(steA ob Deeds Ub{)dee. <br /> — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — <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 BuAnett <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 /> t 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) Owner's Signature(s) <br /> I <br /> �-- Subscribed and sworn to before me on this date: <br /> I <br /> I <br /> Pumper's Name(Print) I Pumper's Signature Notary Public <br /> I n Mycommissioltexpires: <br /> Pumper's Registration Number <br /> a3 <br /> SBD-7574(R 09188) This instrument was drafted by the State of Wisconsin Department <br /> of Industry,Labor and Human Relations <br />