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INDIAN RIVER COUNTY <br />APPLICATION AND AGREEMENT FOR DISPOSAL OF SEPTAGE, FOOD ESTABLISHMENT <br />SLUDGE AND PORTABLE RESTROOM WASTEWATER <br />Date: <br />Applicant: <br />Contact Name: <br />Street Address: <br />City, State, Zip: <br />Business Phone: <br />After Hours Phone: <br />E-mail: <br />Website: <br />Number of trucks: <br />Total estimated monthly disposal volume or tonnage: <br />Under this Application and Agreement for Disposal of Septage, Food Establishment Sludge and Portable <br />Restroom Wastewater (Agreement), Indian River County will accept, for treatment and disposal process, <br />wastewater from septage, food establishment sludge and portable restroom wastewater. The applicant <br />desires to dispose of process wastewater in accordance with current regulations. <br />REQUIREMENTS OF ACCEPTANCE <br />1. All vehicles used must meet state and federal regulations governing transport of waste liquid on <br />public roadways. <br />2. Applicants must provide a copy of their Indian River County Occupational License and their Florida <br />Department of Health operating permit. <br />3. Applicant is responsible for any damages to Indian River County property or injuries to Indian River <br />County personnel arising from the Applicant's disposal activities. Applicant shall defend, hold <br />harmless and indemnify Indian River County with respect to any and all actions, causes of action, <br />liabilities, losses, damages or expenses (including reasonable attorneys' fees) arising out of or <br />relating to any negligence, intentional misconduct, breach of the requirements set forth herein, or <br />breach of applicable law by Applicant in conjunction with any of the activities described herein. <br />1 <br />104 <br />