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SITE ADDRESS: _ 610 N. Hunter Road PERMIT#: -niie:u.,NNocanuLlcenseo well UnilerlPump Contractor agrees to indemnify, defend with counsel reasonably approved by County, and hold harmless the County and its officers, officials, employees, agents, boards, and commissions (collectively "County") as follows: Indemnity- a. From and against any and all claims, demands, actions, proceedings, lawsuits, losses, damages, judgments and/or liabilities arising out of, related to, or In connection with the application and applied for well or pump or to attack, set aside, void, or annul, in whole S In part, approval or denial of the applied for permit by the County, and any environmental review documents related to the applied for permtt; b. For any and all costs and expenses incurred by the County on account of any Claim, except where such indemnification is prohibited by law, including but not limited to damages, costs, expenses, attorney's fees or expert witness costs that may be asserted by any person or entity, private attorney general fees claimed by or awarded to any party against the County, arc the County's costs incurred In preparing an administrative record which are not paid by the petitioner. Except as to the County's sole negligence or willful misconduct. Detense: a. The County may participate or direct the defense of any Claim. The County's actions in defensc of any claim shall not relieve me of any obligation to indemnify, defend, and hold harmless the County. b. In the event of a disagreement between County and me regarding defense of any Claim, the County shall have the authority to control litigationthe decisions, e defense is conducted. If County reasonably determines that having common cousel presents such counsel manner el with a co n ct ofinte est. oin which r if I fail to promptly assume the defense of any Claim or to promptly employ counsel reasonably satisfactory to the County, then County may utilize the Office of the County Counsel or employ separate OutSide counsel to represent or defend the County, and I shall pay the reasonable attomeys' fees and costs of such counsel. I HEREBY CERTIFY THAT 1 HAVE PREPARED THIS APPLICATION AND THAT THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES, STATE LAWS, AND RULES AND REGULATIONS. I ALSO CERTIFY THAT MY REQUIRED LICENSE IS CURRENT AND ACTIVE WITH THE CALIFORNIA CONTRACTORS STATE LICENSE BOARD AND THAT 1 AM IN COMPLIANCE WITH ALL WORKERS COMPENSATION LAWS. PROPERTY OWNER: SIGN: LICENSED WELL DRILLER/PUMP CON- RACTOR: PRINT: DATE SIGN:Andre Ashour PRINT: DATE 6/1/2022 r U 7AT ON F R OTHER THAN C-5 (iNING E IT P I .TIO hereby authorize me c Lcen eC AuWurized Represo\ 'e f. 41 to sign this San J' aq ' i County Well Boring Permit Application on my be I I understated this a rization is valid for one year and is limited to the wor< plan dated on the front page of this application. EHD04J-Oo IU.252021 Page 2 of 2 lNell : Pum Permit