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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 /> R1C1Y4KP ¢ SAAMR4 BOLT <br /> We acknowledge the installation of(a)holding tank(s)on the following property: (Provide legal description:) <br /> . 40T /D EONS ISE_ PLI/1 T FIRE m a o 6 9� <br /> _ sE'e a <br /> 9/00 _0,3 /0 0 <br /> - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - <br /> 1. The owner agrees to file a copy of this contract with the lova! governmental unit here!-after ca;led the "municipality",which ha-- <br /> signed <br /> assigned the pumping agreement required in Ch. ILHR 83.18(4) (b),Wis.Adm. Code and <br /> with the County of �D opilivie—tr <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 tc <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 pad <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 finis contract. in fhe uve(ii 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 /> Subsc ibed and sworn to before me on this date: <br /> 5fit/D.C'f} f�. Som 7- <br /> Pumper's Name(Print) I Pumper's Signature d / �Fd <br /> _SM <br /> y commi on expires: <br /> J a <br /> .7 S >i,..l�fJ <br /> Pumper's Re/giisttrration Number .. <br /> Y ✓ <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 />