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SITE . riESS : 3263 East Cherokee Road , Stockton , CA PERMIT # :
<br /> Piot Plan :
<br /> GIS Coordinate : Latitude : Longitude :
<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 /> 1 . Indemnity :
<br /> a . From and against any and all claims , demands , actions , proceedings , lawsuits , losses , damages , judgments and/or liabilities arising out
<br /> 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 part ,
<br /> approval or denial of the applied for permit by the County , and any environmental review documents related to the applied for 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 by
<br /> law , including but not limited to damages , costs , expenses , attorney ' s fees , or expert witness costs that may be asserted by any person
<br /> or entity , private attorney general fees claimed by or awarded to any party against the County , and the County ' s costs incurred in preparing
<br /> 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 indemnify , 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 separate
<br /> 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 JOAQUIN
<br /> COUNTY ORDINANCES , STATE LAWS , AND RULES AND REGULATIONS , I ALSO CERTIFY THAT MY REQUIRED LICENSE IS CURRENT AND
<br /> ACTIVE WITH THE CALIFORNIA CONTRACTORS STATE LICENSE BOARD AND THAT I AM IN COMPLIANCE WITH ALL WORKERS
<br /> COMPENSATION LAWS .
<br /> PROPERTY OR : _
<br /> SIGN : �71MEN PRINT : DATE
<br /> LICENSED Wt L DRILLER/PUMP (1ONTR TOR :
<br /> SIGN : PRINT : _ Garret Hubbart , VP DATE 12 - 19 - 2022
<br /> AUTHORIZATION FOR OTHER THAN C - 57 SIGNING PERMIT APPLICATION
<br /> I , Neil Anderson , hereby authorize Garret Hubbart
<br /> (Name of C-57 Licensed Authorized Representative) ( Print Name of Authorized Agent)
<br /> to sign this San Joaquin County Well & Boring Permit Application on my behalf. I understand this authorization is valid for one year and
<br /> is limited to the work plan dated on the front page of this application .
<br /> EHD 43 -08 WELL DESTRUCTION PERMIT
<br /> 11 /23/21
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