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. SITE ADDRESS: _ K Union Rd., Nlmrtoc.7- PERMIT w: ,, um �wnerrnpPctnuuCensed Yyell DrillerlPump ContrOCIM agrees to indemnify, defend with counsel reaeonahly approved by CoAWy. and hell harmless the Cau W and its officers. officws, �_nployees, zgens, brasirfa, and commission (collrrctevely -County') as fouows: Indemnity 3. F,,= and against any and all claans, demands, actions. proceedings. lawsuits. losses. damages. judgments andr'or liabilities arising out of, related to, or in connection with the application and applaud for wail or primp or to attack, set aside, void, or annul, in whole or in pan, approval of denial of the applied for pormd by the County. and any environmental review documents retated to the applied for permit; �. For any and all costs and exnerises incurred by the County on account of any Claim, except where such indemnification iv prohibited by law. Including but tool limited to damages, COSU, axpanses, attorneys Rees, or expert witness costs that may be asserted by any person Ur maty, private attorney tloneral fres claimed by or awarded to any parry against the Courtly, and the County s casts incurred in preparing an aa -minis M. tjve record which are not paid by the petitiomnr. _. Except as '.o the Crxjntys sole ripy genre or wiffful misconduct Ccfense. a. Tne County may parah9pate or direct the defense of any Claim. The County's actions in defense of any claim shall rte reVleve me of arty aorgal:on to fndamnrfy, defend, and hold harmless Ifie County. b. In the event of a disagreemert between County and me regarding defense Of any Claim, Lhe County shall have the artd'fonly, to control the litigation and make litigation decisions, including, but not limited td, the manner in which the defense is canducte-d It County reasonably determines that having common counsel presents such Counsaf with a caelficl of interest. or if; fait to promptly assume the defense of any Claim or to promptly employ counsel reasonably sulmlaCtory to the County, then County may utilize the OfFea of 1ho County Counsel or employ sepnrata Outside counsel to represent or defend the County, and 1117139 pay the reasonable anomcys' does and costs a such cvunsut. I HEREBY CERTIFY THAT I 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 CALIFORNIA CONTRACTORS STATE LICENSE BOARD AND THAT I AM IN COMPLIANCE WITH ALL WORKERS COMPENSATE Nom. /l PR— OWNa -/1 L2,1- IJa'F_1ln:a tVnl.t�Optl, .Mpu\ P C NTB,aCTON: SIGN: uf+�., 1 .EL�L1aL9 o„4'Y5 ��Pa,Nr. Henrtirtgs Bros, by Sean Roddy DME Mar.'!, 1022 AUTHORI7ATION FOR OTHER THAN C-57 SIGNING PERMIT APPLICATION . hereby authorize rsa„ir at -41 u� nwterwa a.�wo,v:„�r rPrn Arm orn.ao.,..er RRsm, to sign this San Joaquin County Well & Boring Permit Application on my behalf. 1 understand this authexization is valid for one year and is limited to the work plan dated on the front page of this application. tatO 41;ia 112122 WELL DE$TRUC7ION PEtRMR