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Ron Perrin Water Technologies EMPLOYMENT APPLICATIONPO Box 101614 Fort Worth, Texas 76185Notice: We maintain a drug and alcohol free work place pre employment drug testing may be required. Consent to random drug testing is a condition of employment. Applicant understands that this job requires out of town travel in addition to working evening and weekends. DATE____________________

1. Name:_______________________________________________________________ Last First Middle

2. Address:______________________________________________________________ Number Street

_____________________________________________________________ City State Zip code3. Telephone Number: ( )_____________ Cell Number: ( )________________

4. Date of Birth: _________/_________/__________ e-mail ______________________ Month Day Year5. Social Security Number: ___________________________

6. Are you a U.S. citizen? _________ ___________ Yes No

7. Do you have a valid driver’s license? Drivers License Number and State: ___________________________ __________

8. Height (Ft & Inches):____________ Weight (pounds): _________________

9. EMERGENCY CONTACT INFORMATION:

Name__________________________________ Phone_______________________Address________________________________ Cell Phone__________________

_________________________________ Relationship?_______________

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A. Work History – Beginning with your present or most recent job, list all employment for the previous 3 years. Attach extra pages if necessary.

1. From: ________ to _________ Employer:________________________________ Address: _____________________________________________________________

Phone: ____________________ Job title: __________________________________

Duties: _______________________________________________________________

Supervisor: ______________________ name of Co-worker: ____________________

Reason for leaving: ______________________________________________________

2. From: ________ to _________ Employer:________________________________ Address: _____________________________________________________________

Phone: ____________________ Job title: __________________________________

Duties: _______________________________________________________________

Supervisor: ______________________ name of Co-worker: ____________________

Reason for leaving: ______________________________________________________

3. From: ________ to _________ Employer:________________________________ Address: _____________________________________________________________

Phone: ____________________ Job title: __________________________________

Duties: _______________________________________________________________

Supervisor: ______________________ name of Co-worker: ____________________

Reason for leaving: _____________________________________________________

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B. Educational History –

1. High School - Graduated? Yes No Year______ GED?_____ Year______

2. College or University Attended: _____________________________________

Units completed: _______ Major / Minor: ______________________________

Degree received, if any, and date: ______________________________________

3. List other schools attended (trade, vocational, business, etc.)

List any specialized skills, license or machinery or equipment which you can operate.

_________________________________________________________________

_________________________________________________________________

D. ARRESTS, DETENTIONS AND LITIGATION At this time we contract with several federal prisons. Your background will be checked by these institutions before you are allowed to enter a federal prison. Employment is conditional upon being able to service federal prisons. 1. List any Felony or class A convictions ________________ Date________

___________________ Date________ ________________ Date________

2. Have you ever been arrested for a felony or DWI Yes ____ No ____

E. Traffic Record – This job requires a lot of drive time in a company truck.

1. Has your driver’s license ever been suspended or revoked?Yes ____________ No ___________

If yes, give date, location and reasons. __________________________________

_________________________________________________________________

2. With what company do you carry auto insurance? _________________________

3. List to the best of your memory all traffic citations you have received, excluding parking tickets.

Month & Year Charge City & State Disposition______________________________________________________________________________________________________________________

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Have you had more than three traffic accidents in the past three years? ____________________________________________________________

F. Medical History: Climbing 150’ Ladders requires good health, and that you are physically fit.

1. List the following information concerning all doctors consulted within the last 3 years and all periods of hospitalization within the past 5 years.

Reason(s) Month & year # of days Physician and or Hospital

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

2. Do you have any physical handicaps, chronic diseases or disabilities?

Yes____________ No ____________

If yes, explain. ______________________________________________________________________________________________________________________________________________________________________________________________________

3. Have you ever received workman's compensation or any other disability insurance payments? Yes _____________ No ___________

If yes, explain.__________________________________________________________________________________________________________________________________

4. Are you currently taking any medication prescribed by your physician that would affect you working in high places or cause drowsiness?

Yes ____________ No ____________

If yes, explain.__________________________________________________________________________________________________________________________________

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C. REFERENCES - List 3 persons who know you well enough to provide current

information about you. Do not list relatives or former employers.

Name: _________________________ Phone: _____________________________

E-Mail Address________________________ Years Known: _________________

Name: _________________________ Phone: _________________________

E-Mail Address________________________ Years Known: _________________

Name: _________________________ Phone: _________________________

E-Mail Address________________________ Years Known: _________________

Photo & Video acknowledgment;

All photos and video taken by employees, contractors or associates of RON PERRIN WATER TECHNOLOGIES are the property of Ron Perrin Water Technologies. Employees, contractors or associates are occasionally seen in photographs & video that is used to promote the company and or its services. There is no additional compensation should your image be in a photograph used to promote this company.

I hereby certify that there are no willful misrepresentations, omissions or falsifications in the forgoing statements and answers to questions. I am fully aware that any such willful misrepresentations, omissions or falsifications may be grounds for immediate rejection or termination of employment. My image in photos or video may be used to promote Ron Perrin Water Technologies.

_________________________________ ___________________Signature of applicant Date

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Office Use Only:

Interview notes:_________________________________________________________________________

Hire Date: __________________________ . Probationary End Date_____________________________.

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Agreements & Acknowledgements.

AGREEMENT RELATING TO EMPLOYMENT AND POST-EMPLOYMENT COMPETITION*

This Agreement is between the undersigned individual ("Employee") andRon Perrin Water Technologies("RPWT").

RECITALS --------

A. RPWT is a service company which provides a variety of servicesto the water utility industry, private and public institutions.

B. RPWT has a proprietary interest in its business methods and systems("Systems") which include, but are not limited to, policy and proceduremanuals, computer programs, inspection forms and information, supplierinformation, supplier information, and procedures. Client data base & information on the needs of clients, all of which information is not publicly disclosed and is considered by RPWT to be confidential trade secrets; and

C. RPWT intends to employ Employee in a position where Employee will haveaccess to information relating to RPWT's Systems and RPWT will encourageEmployee to develop personal relationships with RPWT's clients and prospectiveclients; and

D. RPWT will be vulnerable to unfair post-employment competition by Employeessince Employee will have access to RPWT Systems and will have a personalrelationship with RPWT's clients and prospective clients; and

E. In consideration of the severance and other employment benefits providedfor herein, Employee was willing to enter into this Agreement with RPWT as acondition of employment, pursuant to which Employee will limit his right tocompete against RPWT following termination of employment for any reason to thelimited extent set forth in this Agreement.

NOW, THEREFORE, intending to be legally bound, the parties agree as follows:

Article 1. NON-DISCLOSURE AGREEMENT: RPWT may, pursuant to Employee'semployment hereunder provide and confide to Employee RPWT's Systems,techniques and methods of operation developed at great expense by ARA andwhich Employee recognizes to be unique assets of RPWT's business. Employeeshall not, during or after the term of employment, directly or indirectly,in any manner utilize or disclose to any person, firm, corporation,association or other entity, except where required by law: (a) any suchSystems, techniques and methods of operation; (b) any sales prospects,customer lists, products, research or data of any kind; or (c) any informationrelating to strategic plans, sales costs, profits or the financial conditionof RPWT or any of its customers or prospective customers, which is notgenerally known to the public or recognized as standard practice in theindustries in which RPWT shall be engaged. Employee shall not divulge the condition of any water system nor shall an Employee post share or otherwise disclose photographs or video of the condition of a water system that RPWT has provided services for.

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Article 2. NONCOMPETITION AGREEMENT:

A. Subject to the provisions of Paragraph B below, Employee, for aperiod of two (2) years following termination of his employment, shall not,without RPWT's written permission, directly or indirectly, on Employee's behalfor on behalf of any other person, firm, corporation, association or otherentity, engage in, or in any way be concerned with or negotiate for, oracquire or maintain any ownership interest in any business or activity whichis the same, similar to or competitive with that conducted by, engaged in ordeveloped for later implementation by RPWT at any time during the term ofEmployee's employment.

B. The provisions set forth in Paragraph A, above, shall apply to allfifty states RPWT may be engaged in business at the termination of Employee's employment or at any time within twelve months prior thereto; but only if Employee was directly or indirectly involved or exposed to plans for such business at any time within twelve (12) months prior to termination.

C. Employee further agrees that Employee shall not for a period of twoyears, directly or indirectly, at any time in any manner, induce or attemptto influence any employees of RPWT to terminate their employment with RPWT.

D. Employee acknowledges that in the event of any violation by Employee ofthe provisions set forth in Article 1 above or this Article 2, RPWT willsustain serious, irreparable and substantial harm to its business, the extentof which will be difficult to determine and impossible to remedy by an actionat law for money damages. Employee agrees that, in the event of such violation or threatened violation by Employee, RPWT shall be entitled to an injunction before trial from any court of competent jurisdiction as a matter of course upon the posting of not more than a nominal bond, in addition to all such other legal and equitable remedies as may be available to RPWT. Employee further agrees that, in the event any of the provisions of this Agreement are determined by a court of competent jurisdiction to be contrary to any applicable statute, law or rule, or for any reason unenforceable as written, such court may modify any of such provisions so as to permit enforcement therefore as thus modified.

TERM OF EMPLOYEMENT: Employee acknowledges a 180 day probationary period Giving RPWT has the right to terminate Employee's employment at any time for any reason. After the 180 day probationary period the employee may qualify forTexas unemployment benefits if the termination is not for good cause. Employee acknowledges that RPWT has good cause to maintain a drug free workplace and agrees to pre-employment drug testing and or random drug testing to be conducted without notice and paid for by RPWT. RPWT contracts with the Federal Bureau of Prisons. Employees must pass a background check conducted by BOP.

MISCELLANEOUS:You may NOT bring a wife, girlfriend or pet with you on trips or to jobsites. Pursuant to Employee's employment illegal drugs are not allowed on job sites, property or in vehicles owned by RPWT. Other prohibited items include pornogra-phy, fireworks, firearms or other weapons. Money owed the company for training, damage of equipment, loss of equipment or insurance deductable may be withheld from my pay.

Applicant _____________________________________ _____________________________ Witness

RPWT Representative _______________________________ ___________________________ Ronald L. Perrin Print Witness Name Date ____________________