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a <br />SITE ADDRESS: 12555 S. Murphy Rd. PERMIT #: <br />Plot Plan: <br />I. the Owner/Applicant/Licensed Well Driller/Pump Contractor agrees to indemnify, defend with counsel reasonably approved by County. and hold harmless <br />the County and its officers, officials, employees. agents. boards. and commissions (collectively "County) as follows <br />Indemnitv <br />a. From and against any and all claims. demands, actions, proceedings lawsuits. losses. damages, judgments and/or liabilities arising <br />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 or in <br />part, approval or denial of the applied for permit by the County, and any environmental review documents related to the applied for <br />permit: <br />b. For any and all costs and expenses incurred by the County on account of any Claim, except where such indemnification is prohibited <br />by law, including but not limited to damages. costs. expenses. attorney's fees. or expert witness costs that may be asserted by any <br />person or entity, private attorney general fees claimed by or awarded to any party against the County, and the County's costs incurred <br />in preparing an administrative record which are not paid by the petitioner <br />c. Except as to the County s sole negligence or willful misconduct <br />2. Defense <br />a. The County may participate or direct the defense of any Claim. The County's actions in defense of any claim shall not relieve me of any <br />obligation to indernnify, defend. and hold harmless the County. <br />b. In the event of a disagreement between County and me regarding defense of any Claim, the County shall have the authority to control <br />the litigation and make litigation decisions. including, but not limited to. the manner in which the defense is conducted <br />If County reasonably determines that having common counsel presents such counsel with a conflict of interest, or if I fail to promptly assume the defense of <br />any Claim or to promptly employ counsel reasonably satisfactory to the County. then County may utilize the Office of the County Counsel or employ <br />separate outside counsel to represent or defend the County. and I shall pay the reasonable attorneys fees and costs of such counsel <br />I HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THAT THE WORK WILL BE DONE IN ACCORDANCE WITH SAN <br />JOAQUIN COUNTY ORDINANCES, STATE LAWS. AND RULES AND REGULATIONS. I ALSO CERTIFY THAT MY REQUIRED LICENSE IS <br />CURRENT AND ACTIVE WITH THE CALIFORNIA CONTRACTORS STATE LICENSE BOARD AND THAT I AM IN COMPLIANCE WITH ALL <br />WORKERS COMPENSATION LAWS. <br />PROPERT OWNER: <br />Lh hNSI.D NN'1•.1 1 :H i'IIIP a ON I"HACI-0 <br />SIGN: L <br />PRINT: )'v" ail 1 ���1.'ti DATE <br />PRINT: Austin Loock CEO <br />DATE 5/5/2022 <br />AUTHORIZATION FOR OTHER THAN C-57 SIGNING PERMIT APPLICATION <br />. hereby authorize <br />Nair ,,r C-57 Licensed Awww.l Rgncunl.n c Pnm Nair •1 .\mlwrval :1::rnt <br />to sign this San .Joaquin County Well K, Boring Permit Application Im my behalf I understand this authorization is valid for one vear and <br />is limited to the work plan dated on the li-ont huge of this application. <br />L'1I1N1,1i-06 1015/2021 Ilmw _2 ,.1 ' \\'d1 , INunp pMnlit <br />