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MULUINU I ANK StHV1UNU UUN 1 KAU i <br /> Contract Da e <br /> h-� This contract is made between the <br /> Holding Tank Owner(s)Name(s) and I Pumper's Name t <br /> z,v B�Ttf 10'i TZ I-Z A I �Q S <br /> I <br /> We acknowledge the installation of(a)holding tank(s)on the following property: (Provide legal description:) <br /> '1 -22r r 1 .P/%. ho ./ <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—. <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 member 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 /> Subscribed and sworn to before me on this date: <br /> _D4 - ,3 I <br /> Pumper's Name(Pint7— Pumper's Signature 'Rotary—t1"ulbw <br /> P✓ My commission expires: <br /> 0,12RAEA Ki. N <br /> Pumper's Registration Number WARY PUB!IC-MINNIICTA <br /> /Dj , CAMSEY COUNTY <br /> MY Oo ar..EXPtres Oct.16.1995 <br /> v A'.' W/V/II <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 />