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HOLDING TANK SERVICING CONTRACT <br /> Contract Date <br /> i/ mv This contract is made between the <br /> Holding Tank Owner(s)Name(s) and I Pumper's Name <br /> I 1 <br /> zoz,,�f �Por�rl / jneS Set�l (G neo- ) rc� <br /> I <br /> We acknowledge the installation of(a)holding tank(s)on the following property:(Provide legal description:) <br /> h free/ %ztec�` 1/2 //if ,c/a//eas/ 06101fer /he �/or/he�sf <br /> QuOrfer Sec�ior� /� %ou/rz5/u o 3� /C/or1h, / J/�6 /7 rt/e,51 Z2�,7/66 <br /> �©turz�tep , .��mett Ca�r>>4�, /•e/%�Cxr�vr� . <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 SS.�GC//r ' <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) Owner's Signature(s)) <br /> l i <br /> "1- �- j Subscribed and sworn to before me on this date: <br /> Pumper's Name(Print) I Pumper's Signature Notary Public <br /> My commission expires: <br /> [/ I�flnJl�j C�end�ni� <br /> Pumper's Registration Nu <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 />