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HOLDING TANK SERVICING CONTRACT <br />Contract Date: A",k s} z1, 2-011 <br />This contract is made between the Holding Tank Owner and the Pumper. <br />Holding Tank Owner(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 />0 7- 0/z/ -'A-38, /S- cZ1 S /S - 685- 0/6000 <br />X. y T 381,/ /� /-,r- w <br />SA.n oP 4/e- s4 e • -e-f <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 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 />Owner(s) Names(s) (Print) Owner's Signature(s) <br />__.._.._._...._—___.._..._......_.._.__._.__._................... ............. _ <br />Pumper's Name (Print) Pumper's Signature <br />S4 e v e Ca, , f, f <br />Pumper's Registration Number <br />o q IF Cl <br />