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HOLDING TANK SERVICING CONTRACT <br /> Contract Date: . el <br /> This contract Is made between the Holding Tank Owner.and the Pumper. <br /> Holding Tank O ner(s)Name(s : Pumper's Name: <br /> We acknowledge the installation of(a)holding tank(s)on the following property(Provide legal <br /> description and computer number): <br /> o�S -A /;z - 3b - goo , 0�0�8 <br /> 1 3 —0410 -All 41dv,10 <br /> I. The owner agrees to file a copy of this contract with the local governmental unit hereinafter called the <br /> "municipality",which has signed theBumping agryement required in COMM 83,Wis. Adm. Code and <br /> with the County of ;04W/J ,-7T <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 /> COMM 83,Wis.Adm.Code,and to the county,a report for the servicing of the holding tank(s) on a <br /> semiannual basis. The pumper further agrees 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 sanitaryeermit number issued for the holding tank; <br /> e. The dates bii which the holding tank was serviced; <br /> f. The volumes in gallons of the contents pumped from the holding tank for each servicing; w <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 contract with the municipality and the County named above within ten(10) <br /> business days from the date of change to this service contract. <br /> Owners)Names(s) (Print) 0 er'a Sig atur (s)� Subscribed and swom to before me <br /> �( lC, on this date: <br /> Pumper's Name(Print) Pumper's Signature a y Public <br /> � My commission expires:: <br /> ;;,t, tit,,,,, <br /> Pumper's Registration Number �``�E <br /> gIS35, _•�� . OTAq�•�9�;, <br /> AUB�, - roc <br /> # : <br /> OFtWISC; �. <br />