MEMO and ROUTE 9up O · 2013. 2. 1. · p.o. box 898 keeau, hi 96749 dear mr. sev~rance: 0 0 state of hawaii department of land and natural resources commission on water resource

MEMO and ROUTE 9up (ver. o1m1oa) O [ WCR 1 Check for Well No. 3687-39 (survey to regulation memo)

1. Pump Tests Check Kevin Gooding__._lf4-L-::-:--(initial) Yes No

Step-Drawdown Test:

followed WCPI Stds !Sf analysis attached 0 proposed pump cap o.k. 0

Aquifer Pump Test:

followed WCPI Stds T & S analysis attached

Well Interference: estimated Steady-State drawdown at 1-mile radius is ft.

analysis attached 0

If no, describe deficiency

Stream Surface Water Impacted: 0 r;v-.- If yes, identify most probable stream

Geology Code for Well Index: &. It-

2. Construction Check Mitch Ohye \tJ (initial)

JYes/ No

data complete 0 followed Special Cond & elevation y 0 well database updated 0 0

If no, describe deficiency

11/13/06

Latitude

NAD27

Longitude

IS4- S?J 4::;?

NAD83 I ~~ I C,..~- C.'1 ?;JC5

3. charley/LenoS ~(initial) take action based on above analysis

ATIACHMENTS FOR PUMP INSTALLATION PERMIT (2x):

1COVER LETTER

2COUNTY COMMENTS (DWS/SMA)

3DOH COMMENTS

4DLNR COMMENTS (LD/OCCUDHP)

5WCR 1 Accept

6WELL CONST. COMPLETION CERTIFICATE

/not necessary- only WCP or BOTH.

} To be sent to driller/pump installer

<------To Landowner

} Staff internal checks

4. Roy ~ (initia check (Entered WCR 1/WCCC accept date into data..,...~---.--{~ 5. Susan H&\Jbin (initial) finalize ) <'{J n) 6. Mitch a signature (Entered PIP issue date if required) 0 .. p , ll'ilJ'I/" 7. Charley/Len e/Ryan "le v·

LINDA LINGLE GOVERNOR OF HAWAII

Mr. Rod Diamond

0 0

STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES

COMMISSION ON WATER RESOURCE MANAGEMENT P.O. BOX621

HONOLULU, HAWAII 96809

January 17, 2008

Diamond Construction and Water Well Drilling HCR#3 Box 14073 Keeau, HI 96749

Dear Mr. Diamond:

Well Completion Report Parts I & II for Well No. 3687-39

LAURA H. THIELEN CHAIRPERSON

KEN C. KAWAHARA, P.E. DEPUTY tMRECTOR

MEREDITH J. CHING JAMES A. FRAZIER NEAL S. FUJIWARA

CHIYOME L. FUKINO, M.D. DONNA FAY K KIYOSAKI, P.E. LAWRENCE H. MilKE, M.D., J.D.

We received your Well Completion Report Parts I & II for the Kalanikoa Well (Well No. 3687-39) on November 6, 2006 and acknowledge that they are complete.

This completes your obligation under the well construction and pump installation permits. Certificates of well construction and pump installation completion will be issued to the well operator/landowner and you will receive a copy. These certificates transfer responsibility of specific aspects of well usage and maintenance from you to the well operator/landowner.

If you have any questions, please contact Ryan Imata of the Commission staff at 587-0255.

RI:ss

c: Glenn Severance

Sincerely,

w.r-rl-1 1't

KEN C. KAWAHARA, P.E. Deputy. Director

0 0 LINDA LINGLE

GOVERNOR OF HAWAII LAURA H. THIELEN

QofAIRPERSON



HONOLULU. HAWAII 96809

January 17, 2008 /


CHIYOME L. FUKINO, M.D. DONNA FAY K. KIYOSAKI, P.E. LAWRENCE H. MilKE, M.D., J.D.

KEN C. KAWAHARA, P.E. DEPUTY DIRECTOR

3687-39.cwc

Mr. Glenn Severance P.O. Box 898 Keeau, HI 96749

Dear Mr. Severance:

Certificate of Well Construction Completion for Well No. 3687-39 (TMK 1-5-053:122)

We are pleased to inform you that the Well Construction work permitted for the Kalanikoa Well (Well No. 3687-39) is complete and acceptable and welcome you as a new member to the community of well owners and groundwater users in Hawaii.

To protect Hawaii's natural ground water resources for the benefit of all, the following requirements apply to the use of your well:

1. Before this well can be pumped on a regular basis, a certificate of pump installation completion must be obtained.

2. If the well is not in use it must be properly capped.

3. If the well is to be abandoned then the landowner must cause a licensed contractor to apply for a well abandonment permit in accordance with § 13-168-12(f) prior to any well sealing or plugging work.

4. In the event that the well operator and/or landowner changes, the Commission shall be notified of the change prior to the change, and all forms shall be transferred to the new owner.

5. In the event the benchmark in the concrete base of the well is altered in any way, an updated elevation survey (page 5 of the Well Completion Report Part I) shall be submitted to the Cormmssion. The Well Completion Report Part I can be obtained by contacting staff or at www .hawaii.gov/dlnr/cwrm/forms.htm

Because groundwater in Hawaii is a public trust, and adverse effects at one well may affect other water resources, any violation of the above conditions, or any other provision of the Hawaii Administrative Rules, may be subject to fines of up to $5,000/day. The CommissiOn needs your help and asks that you to do your part in utilizing this shared resource. We prefer to work with you in meeting the goal of protecting our ground water resources together.

If you have any questions, please contact Ryan lmata ofthe Commission staff at 587-0255.

RI:ss

c: Hawaii Department ofWater Supply Rod Diamond

Sincerely,

W.f7h 1't

KEN C. KAWAHARA, P.E. Deputy Director

/


Mr. Glenn Severance P.O. Box 898 Keeau, HI 96749

Dear Mr. Sev~rance:

0 0




January 17, 2008 /

LAURA H. THIELEN CHAIRPERSON


CHIYOME L. FUKINO, M.D. DONNA FAY K. KIYOSAKI, P.E. LAWRENCE H. MilKE, M.D., J.D.

KEN C. KAWAHARA, P.E. DEPUTY DIRECTOR

3687-39.cpi

Certificate ofPump Installation Completion for Well No. 3687-39 CTMK 1-5-053:122)

We are pleased to inform you that the Pump Installation work permitted for the Kalanikoa Well (Well No. 3687-39) is complete and acceptable and welcome you as a new member to the community of well owners and groundwater users in Hawaii. This certificate of pump installation completion allows you to commence pumping your well for reasonable & beneficial water use.

To protect Hawaii's natural ground water resources for the benefit of all, the following requirements apply to the use of your well:

1. If the well is not in use it must be properly capped.

2. If the well is to be abandoned then the landowner must cause a licensed contractor to apply for a well abandonment permit in accordance with § 13-168-12(f) prior to any well sealing or plugging work. ·

3. In the event that the well operator and/or landowner changes, the Commission shall be notified of the change prior to the change, and all forms shall be transferred to the new owner.

4. In the event the benchmark in the concrete base of the well is altered in any way, an updated elevation survey (page 5 of the Well Completion Report Part I) shall be submitted to the Commission. The Well Completion Report Part I can be obtained by contacting staff or at www.hawaii.gov/dlnr/cwrm/forms.htm.

5. Your approved pump has a capacity of 10 gpm at a head of220 ft. In the future, pump replacements of equal or lesser capacity will not require an additional permit from the Commission, but will require the submission of a Well Completion Report Part II by the licensed pump installer. If the pump replacement is greater than the existing pump, you will need to apply for a new pump installation permit.

Mr. Glenn Severance Page2 January 17, 2008

6. The landowner shall cause the well operator to maintain the installed meter or other appropriate means for measuring and reporting withdrawals and water levels, and appropriate devices or means for measuring chlorides and temperature. These data shall be measured monthly and reported to the Commission on a annual basis, on forms provided by the Chairperson (attached), in accordance with § 13-168-7, HAR.

7. The proposed use shall not adversely affect existing or future legal uses of water in the area, including any surface water or established instream flow standards. The authorization to drill a well and/or install a pump shall not constitute a determination of correlative water rights. The landowner and well operator are notified that the quantity of water taken from the well and/or the pump capacity could be reduced by the Commission in the future.

8. In the event that your installed pump is less than 70 gallons per minute, and no elevation survey has been completed, you may be required to do one in the future.

Because groundwater in Hawaii is a public trust, and adverse effects at one well may affect other water resources, any violation of the above conditions, or any other provision of the Hawaii Administrative Rules, may be subject to fines of up to $5,000/day. The Commission needs your help and asks that you to do your part in utilizing this shared resource. We prefer to work with you in meeting the goal of protecting our ground water resources together.

Ifyou have any questions, please contact Ryan Imata ofthe Commission staff at 587-0255 or toll-free at 974-4000 (Hawaii), 274-3141 (Kauai), 984-2400 (Maui), or 1-800-468-4644 (Lanai & Molokai).

RI:ss Encl: Water Use Report Forms

c: Hawaii Department ofWater Supply Rod Diamond

Sincerely,

W.f7h 1'1

KEN C. KAWAHARA, P.E. Deputy Director

I t

0 0

c 0 WELL CONSTRUCTION PERMIT

Kalanikoa Well, Well No. 3687-39 Note: This permit shall be prominently displayed at the construction site until the work is completed

In accordance with Department of Land and Natural Resources, Commission on Water Resource Management's Administrative Rules, Section 13-168, entitled "Water Use, Wells, and Stream Diversion Works", this document permits the construction and testing of Kalanikoa Well (Well No. 3687-39) at TMK 1-5-053:122, Hawaii, subject to the Hawaii Well Construction & Pump Installation Standards (HWCPIS- February 2004) which include but are not limited to the following conditions:

I.

2.

3.

4.

5.

6.

7.

8.

9.

10.

II.

12.

13.

14.

15.

The ChairQerson of the Commission on Water Resource Management (Commission), P.O. Box 621, Honolulu, HI 96809, shall be notified, in writing, at least two (2) weeks before any work authorized by this permit commences and staff shall be allowed to inspect installation activities in accordance with §13-168-15, Hawaii Administrative Rules.

This permit shall be prominently displayed, or made available, at the site of construction work until work is completed.

The well construction permit shall be for construction and testing of the well only. The permittee shall coordinate with the Chairperson and conduct apumping test in accordance with the HWCPIS (the latest rump test worksheet can be obtained by contacting Commission staff or at www .hawaii.gov/dlnr/cwrmlforms.htm ). The permittee shal sutimit to the Chairperson the test results as a basis for supporting an application to install a permanent pump. No permanent pump may be mstalled until a pump installation permit is approved and issued by the Chatrperson. No withdrawal of water shall be made for purposes other than testing without a Certificate of Pump Installation Completion. The permitted pump capacity described on the pump installation permit may be reduced in the event that the pump test does not support the capacity.

In basal ground water, the depth of the well may not exceed one-fourth (114) of the theoretical thickness (41 times initial head) of the basal ground water unless otherwise authorized by the Chairperson.

The permittee shall incorporate mitigation measures to prevent construction debris from entering the aquatic environment, to schedule work to avoid periods of high rainfall, and to revegetate any cleared areas as soon as possible.

In the event that historically significant remains such as artifacts, burials or concentrations of shells or charcoal are encountered during construction, the permittee shall stop work and immediately contact the Department of Land and Natural Resources' Division of Historic Preservation.

The proposed well construction shall not adversely affect existing or future legal uses of water in the area, including any surface water or established instream flow standards. This permit or the authorization to construct the well shall not constitute a determination of correlative water rights.

The Well Completion Report Part I shall be submitted to the Chairperson within sixty (60) days after completion of work (please contact staff or visit www.hawaii.gov/dlnr/cwrm/forms.htm for current form).

The permittee shall comply with all applicable laws, rules, and ordinances; non-compliance may be grounds for revocation of this permit.

The well construction permit application and any related staff submittal approved by the Commission are incorporated into this permit by reference. This permit is also subject to the HWCPIS. If the HWCPIS are not followed and as a consequence water is wasted or contaminated, a lien on the property may result. Any variances from the HWCPIS shall be approved by the Chairperson prior to invoking the variance.

The work proposed in the well construction permit application shall be completed within two (2) years from the date of permit ap~l, unless otherwise specified. The permit may be extended by the Chairperson upon a showing of good cause and good-faith performance.3'i~est to e~if the permit shall be submitted to the Chairperson no later than the date the permit expires. ~ >' -~:::: .. ~·-·· z· If the well is not to_b~ used it must~ prorerly capped. ~fthe well is to be ~andoned ~uring the course of the project ~od~permi~ust app~r a well abandonment permtt m accordance wtth § 3-168-12(f) pnor to any well seahng or pluggmg work. ; :; C:m ...._. . · ~

The permittee, its successors, and assigns shall indemnifY, defend, and hold the State of Hawaii harmless from and agaih~i ~loss, liaQey, claim~~emand for p~operty damage, personal injury, or death ft!ising ou.t of any act or omission of the applicant, assigns, officers, employees,~ntractors, and agenll!JJ)ider this permtt or relatmg to or connected wtth the grantmg ofthts permtt. ',.:: ___ ,.,.. ·

.· > ---This permit shall apply to the location shown on the application only. If the well is to be relocated, the permittee shall aeilt~ a new GOconstrubMWpump installation permit m accordance with Hawaii Administrative Rules §13-168-12(f). •_) --;:;:. •• ~ 0-

Special conditions in the attached cover transmittal letter are incorporated herein by reference. W J4,., ..}_,..~.. c~ ~-I .....::t· I /l--/ _., .£:-.

7't

Date of Approval: September 8, 2006 Expiration Date: September 8, 2008

PETER T. YOUNG, Chairperson

Commission on Water Resource Management

I have read the conditions and terms of this permit and understand them. I accept and agree to meet these conditions as a prerequisite and underlying condition of my ability to proceed and understand that I shall not commence work until I have signed, dated, and returned the permit to the Commission. I understand that this permit is not to be transferred to any other entity. I also understand that non-compliance with any permit condition may be grounds for revocation and fines of up to $5,000 per day starting from the permit date of approval.

Driller's Signature: ~A ,L2 · / ~ ba

Printed Name: Rod Diamond

C-57 License#: C-23379 Date: I 0 ZO a(

Diamond Construction Firm or Title: and Water Well Drilling

Please sign both copies of this permit, return one to the Chairperson, and retain the other for your records.

Attachment

State of Ha~aii 0 COMMISSION ON WATER RESOURCE MANAGEMENT Deparbnent of Land and Natural Resources WELL COMPLETION REPORT- PART I Well Construction

Instructions: Please print in ink or type and send completed report (wlh altactmenls, if appicable Commission on Water Resource Management, P.O. Box 621, Honoklk.l, Hawaii 96809. The Commission may nat accept incomplete reports. This form 8181 be submilled wllhin 60 days d the ~ d work. For aas·steace,

For Official Use Only:

.... SFlVcr_l //'

A 9 : 17

please consult the H~ Well~ •. Pwnp ~· Stlntardsorcallhe,~ ~ ~;; 1SSICH l;'l W.~TER 0225. For updates to this form oraddlionallifounaliDI•. pleasevislcuwat161ealhllp:/lwwW l!i.u!tldPic:wn / <:: r, Jt'C (/ · ~: . 1 ~r.r,1El 1 T

State Well No.: 3687-39 Well Name: Kalanikoa Island: Hawaii Address: PO Box 898, Keaau, m, 96749 Tax Map Key:

------------------~ Drilling Company: Diamond Drilling and Pump

1-5-053-122

Drilling method used during construction: ~ Rotary

1.

2.

3.

4.

5. Date Well Construction (drilled, cased, grouted) completed: ___ 1~0~{2=5)~06~-- RU oat altached Driller"s Log MclniiiiDavt'l'ear

In addition to the dl1ller's log, If a geologic log was~ please SllbiJIIt wllh this bin..

6. Was the subject well cored? DYes • No 7. Initial water-level encountered 81 ft below ground Date a1d time of measurement: __ l_0==/2=0r.:f=0:::-6,r,:P=-M---I

-y/year lime

8. Step-Drawdown Test completed?

9. Constant Rate Aquifer Test completed? Parameters prior to pump test:

• Nooves • No oves

10. Water-level: __ E_s_t,_4_,, ___ ft. above ms1 Date and time of measurement: __ l_O•/iiiiii2iiiii0/ii;li0;;;6.---P_M_-;;_;;---1

11. Chloride: ___ 3_4 ___ ppm Date and time of sampling: 10/20/06 PM time

12. Temperature: oF 67 Date and time of measurement: 10/20/06 PM -13. Fill in the as-buiH section on the other side of this sheet. 14. Attach photograph of well and concrete pad showing bem:hmark on concrete pad. 15. Fill in attached surveyor's report.

16. 17.

If a pump is not planned to be installed, please describe (below in the remarks section) how well is secured to prevent unauthorized access (example: lockable cover. threaded coupling. etc..) Remarks:

Rod Diamond C-57 Uc, No. __ B_C_2_3_3_7_9 __ Licensed Driller -----------------------------------

Signature ___ ____::flJ __ ~--~-L~ __ , _____ _ Date: ll-01-06 ------------------~1

WCR1 Form 10118104Page 1 of5

Benchrmrk elevation:

86.4 ft. msl" (SuNeyto~ 0.01 ft.)

Total Depth

86 ft.

Solid Casing Material:

0 0 13 • .AS-Bta. T WELL SECTION ,..._ allldl...-. 'c:lrlnnt tam cfiagJam ptOIIided below)

Annular space between hole .-.cl casir1g (1.5' for poailive displaceutelll. 3" for olher methods):

3 in.

water level EJewallon: ____ ft. msl"

12 in.

~oi'Z Radius & 4" Thick Concrete Pad

81 ft., msl

.&>------1 Solid Cal*1g: ~ 9()% X (Ground EJev.-WaW level EJev))

length: 81 ft.

Nominal Diameler. 6 inches in.

Schedule 40 in.

-0- ft., msl

Open Ceiling: 0 Partolldad 0 Screen l.englh:. _______ ~s _________ ft. Nominal Diameter: 6 inches in.

W8l Thickness: Schedule 40 in.

BolOn EJeualkXL ft., msl

Open Hole:

l.englh:_·--------~Nu/~AL_ _____ ft.

~~--------------------m. Bollom 8Eiellew•ali801on:t:_ ----,-..,--------- ft., msl

"mSI=IIIIWlseelewel~, ?b~1 ... ?J4 ~l ~A Carbon Steel: compliant wlh (check one or tnOI'B): o ANSIIAWWA C200 o API Spec. 5l o ASTM A53 o ASTM A 139

And compliant with (checlc one or tnOI'B): o ASTM A2Q or A606 o Type E o Type S o Grade B o Other

Stainless steel: (check one): o ASTM A409 (production wels) o ASTM A312 (rnonilorwells)

ASS Plastic conforming to ASTM F480 and ASTM 01527: (check one) o Schedule 40 o Schedule 80

PVC Plastic conforming to ASTM F480 and (ASTM 01785 or ASTM 02241): (check one): • Schedule 40 o Schedule 80 o Schedule 120 Thermoset Plastic: (check one) o Filament Wound Resin Pipe conforming to ASTM 02996

o Centrifugally cast Resin Pipe conforming to ASTM 02997 o Reillforced Plastic Mortar Pressure Pipe conforming to ASTM 03517 o Glass Fiber Reinforced Resin Pressure Pipe conforming to A WW A C950 o PTFE Fluorocarbon Tubing conforming to ASTM 03296 o FEP Fluorocalbon Tubing confomqtoASTM 03296

Ooen Casing Material: Carbon Steel: compliant with (check one or tnOI'B): o ANSIIAWWA C200 o API Spec. 5l o ASTM A53 o ASTM A 139

And compliant with (check one or mom): o ASTM A2Q or A606 o Type E o TypeS o Grade B o other Stainless Steel: (check one): o ASTM A409 (production wels) o ASTM A312 (monlorwels)

ASS Plastic conforming to ASTM F480 and ASTM 01527: (check one) o Schedule 40 o Schedule 80

PVC Plastic conforming to ASTM F480 and (ASTM 01785 or ASTM 02241): (check one): • Schedule 40 o Schedule 80 o Schedule 120 Thermoset Plastic: (check one) D Filament Wound Resin Pipe conforming to ASTM 02996

o Centrifugally cast Resin Pipe conforming to ASTM 02997 o Reinforced Plastic Mortar Pressure Pipe conforming to ASTM 03517

o Glass Fiber Reinforced Resin Pressure Pipe conforming to AWWA C950 o PTFE Fluorocarbon Tubing conforming to ASTM 03296 o FEP Fluorocarbon Tubing conforming to ASTM 03296

WCR1 Foml10118104 Page 2 of 5

0 DRILLER'S LOG 0 WELL NUMBER: 3687-39

Depths (ft.) s Rock Desa iptiol1, Wafi!Jr Level, ale. Dates

0 to 86 BASALT/WATER AT 81' 10/20/06

to

to

to

to

to

to

to

to

to

to

to

to

to

to

to

to

Remarks:

WCR1 Fonn 10118104 Page 3 of 5

N 11° aw.<3t w /6f0 87,51

tJ 10' .

House

SKETCH OF WELL LOCATION (Referenced to permanent landmark, i.e. building, road, fence, etc.)

WCR1 Form 10118104 Page 4 of 5

Well Elevation Site Photo

Benchmark Elevation EST86.4

I certifY that the elevation shown above: 1) Was done in accordance with acceptable surveying practices 2) Is accurate to the nearest 0.01 ft. 3) Is referenced to mean sea level

Surveyor license No. Date

WCR1 Form 10118104 Page 5 of 5

MEMO and ROUTE !uP (ver. 12/21to5) 0

11/13/06

I WCR 2 Check for Well No. 3687-39 (survey to regulation memo)

1. Pump Tests Check( special condition of PIP? Yes/No) Kevin Gooding (initial if yes) Yes No If no, describe deficiency

Step-Drawdown Test:

followed WCPI Stds D D analysis attached D D proposed pump cap o.k. D D

Aquifer Pump Test:

followed WCPI Stds D D T & S analysis attached D D

Well Interference: estimated Steady-State drawdown at 1-mile radius is ____ ft.

analysis attached D D

Stream Surface Water Impacted: D D .__ If yes, identify most probable stream

Geology Code for Well Index: ____ _

2. Pump Installation Check Mitch Ohye ~ es

data complete followed Special Cond & Elev.

well database updated

D .[J

/o

(initial) No If no. describe deficiency

D D D

3. Charley/LenoS ____ (initial) take action based on above analysis

ATTACHMENTS FOR ACCEPTANCE: 1WCR2 ACCEPTANCE LETIER

2PUMP INST. COMPLETION CERTIFICATE

3METER INSTALL. REPORT (IF NECCESSSRY) __ _

4WUR

~To be sent to driller

J To be sent to landowner/operator

} Staff internal checks

4. Roy (initial) check(Entered WCR 2/PICC accept date into database) 5. Susan Hoag~ ;) (initial) finalize 6. Charley/Len e/Ryan r; le

OPUMP INSTALLATION PERMITO Kalanikoa Well, Well No. 3687-39

Note: This permit shall be prominently displayed at the site until the work is completed

In accordance with Department of Land and Natural Resources, Commission on Water Resource Management's Administrative Rules, Section 13-168, entitled "Water Use, Wells, and Stream Diversion Works", this document permits the pump installation for Kalanikoa Well (Well No. 3687-39) at TMK 1-5-053: 122, Hawaii, subject to the Hawaii Well Construction & Pump Installation Standards (HWCPIS - February 2004) which include but are not limited to the following conditions:

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

II.

12.

The Chairperson to the Commission on Water Resource Management (Commission), P.O. Box 621, Honolulu, HI 96809, shall be notified, in writing, at least two (2) weeks before any work covered by this permit commences and staff shall be allowed to inspect installation activities in accordance with § 13-168-15, Hawaii Administrative Rules

No withdrawal of water shall be made other than for testing until a Certificate of Pump Installation Completion has been issued by the Commission.


The pump installation permit shall be for installation of a 12 gpm rated capacity, or less, pump in the well. This permanent capacity may be reduced in the event that the pump test data does not support the capacity.

A water-level measurement access shall be permanently installed, in a manner acceptable to the Chairperson, to accurately record water levels.

The permittee shall install an approved meter or other appropriate means for measuring and reporting withdrawals and appropriate devices or means for measuring chlorides and temperature at the well head.

Well Completion Report Part II shall be submitted to the Chairperson within 60 days after completion of work. This form can be obtained by contacting staff or on the internet at www.hawaii.gov/dlnr/cwrm.

The permittee, well operator, and/or well owner shall comply with all applicable laws, rules, and ordinances, and non-compliance may be grounds for revocation of this permit.

The pump installation permit application and any related staff submittal approved by the Commission are incorporated into this permit by reference. This permit is also subject to the HWCPIS. If the HWCPIS are not followed and as a consequence water is wasted or contaminated, a lien on the property may result. Any variances from the HWCPIS shall be approved by the Chairperson prior to invoking the variance.

The work proposed in the pump installation permit application shall be completed within two (2) y~ from theafte of permit approval, unless otherwise specified. The permit may be extended by the Chairperson upon a showi~ ~good cause and goodfaith performance. A request to extend the permit shall be submitted to the Chairperson no later than the"11a;i the pe~ expires;8

~= < m The permittee, its successors, and assigns shall indemnify, defend, and hold the State of Hawaii harmle$ii~ and a~st any

1

~s, liability, claim, or demand for property damage, personal injury, or death arising out of any act or_::;,~~sion of'rlfe appli~lfllt, assigns, officers, employees, contractors, and agents under this permit or relating to or connected with th¢~ting of this permit;;:

'.'- z , ..... . c"' -...... c•1'"t :.:::~ ·- ., rn ~-~ ,:;

83~ ..;:: :;:.; : I';) --1

Special conditions in the attached cover transmittal letter are incorporated herein by reference.

W.fif-7

"" Date of Approval: September 8, 2006

September 8, 2008 PETER T. YOUNG, Chairperson Commission on Water Resource Management Expiration Date:

I have read the conditions and terms of this permit and understand them. I accept and agree to meet these conditions as a prerequisite and underlying condition of my ability to proceed and understand that I shall not commence work until I and the pump installer have signed, dated, and returned the permit to the Commission. I understand that this permit is not to be transferred to any other entity. I also understand that non-compliance with any permit condition may be grounds for revocation and fines of up to $5,000 per day starting from the permit date of approval •

Installer's Signature:

Printed Name:

.n"""'-' ~Qit!ll //:..::'-4=-J~ /'7~-,..-.,c..../C-57, C-57a, or A License#: C-23379 ~~I> Date: 10 2(1

Rod Diamond Diamond Construction and

Firm or Title: Water Well Drilling


Attachments

State of Ha&ii 0 For Offidal Use Only:

COMMISSION ON WATER RESOURCE MANAGEMENT 8 E r " 1 EO Department of Land and Natural Resources n - '--· ·-- · '- --

WELL COMPLETION REPORT - PART II Pump Installation

Instructions: Please print in ink or type and send completed report (wlh a1tact.men1s, if applic;abe) to on Water Resource Management, P.O. Box 621, Honolulu, Hawai 96809. The Conmission may net accept i1cornplete reports. This form shaH be submitted wllhin 60 days of the corr.-uon of work. For as e" l•~ce, please consul the

A 9: 17

Hawaii Well Construction and Pump Installation Sbntards or cal the Regdalion Branch al: 587-8225. FOI(,~~ ~ ON W f\ TE~ this form or additional information, please visl 01.1'" website a1: hllp://www "*li usldlnrJcwrml , ' > ,.;,- • 1 "-J A r::. r: u ~t "lT

I! ,- ~ .~ 1~..-''"t/l~o\VL..l.,...l 11

//

1. State Well No.: 3687-39 Well Name: Kalanikoa Island: Hawaii

2. Address: PO Box 898, Keaau, In 96749 TaxMapKey: 1-5-053-122

3. Pumpln~~~~~nCom:~=n~y~:~D=i~am~o=~~~~·=·~~~~~~~~~~~~~~~~~~~~~~~ 4. Date Pump ln~alled: 10/24/06

~~~--n~-~~~~~~~~~-------

5. PERMANENT PUMP INFORMATION ~~~~~~~~~~~~~~~~~~~~~~~--~~--

Pump Type, Make, Serial No.: SUB/ GRUNDFOS /B09010012-Pl0520US /

Rated Ca~city: 10 gpm at head of: ji([ 'VW ft.

FRANKLIN/ 3 f. HP/230 V/3450 z:M Motor Type, H.P., Voltage, rpm: -~~~~~~~~~~--~'4~~~~~~-RP--~~~~~---Pump type (check one):

D Deep Well Turbine

X Submersible

D Centrifugal

6. Method of flow measurement

o Rotary

D Rotary-Displacement

o Rotary-Gear

o Propeller

0 Reciprocating

o Impulse

X Flowmeter

oWeir

Manufacturer master

0 Open Pipe 0 Orifice*

Model no. 3689882 Size

*attach schematic

7. Fill in the as-built section on the other side of this sheet.

8. Attach the rating curve for the installed pump.

9. Attach photograph of well clearly showing the benchmark on the concrete pad, the well

10. Other remarkslcomments:

Pump Installation Contractor (print) Rod Diamond

Signature

~~~~-----\

D Other*, explain below

C-57/C-57a/A Lie. No. BC 23379

Date 11-01-06

WCR2 Form 212:W5 Page 1 of 2

Bench mark elewltion surv~ed to nearest 0.01 ft. = 86.4 ft. mean sea level

{

'

1-.ofiDpofchaselube N/ A ft. mean sea \eve&

~·-

' !

" ----"-----------'---

' ! . 1"" !

'

J ;- -

~~--= 84 ~referenced to bench mark) ft.

I Chase tube deplh = N/ A ft. -- (referenced to bench mart<)

If airline ins1alled, boUom of airtine elevalion =

N/ A ft. mean sea level

WCR2 Fotm 2123105 Page 2 of 2

PERFORMANCE CURVES O 10 GPM

~,~~1,~4 ~\~Ok 0 MODEl lOS

OUTLET SIZE: 11J4 II NPT NOMINAL DIA. 4"

- -I~ 800 -10520.27 {2 HP)

I I .. _

I '- '

' ' I

' ' ·'

' I 1'-! l ~

I

' ' i

700 ~=~==t=~==t=~==t=~==~-=t,~~~~--~~.;~t~~t.=~~==ti=~==t=~-+'~~~~~~~~~~~~~t~~~~t~~'ri,~,~~,+~--~~-~4

600 r-10515-21 {11f2 HP) I 1__ ~-:.... I "",,I ' ~, ·--

I -..,. ..._ '- '-......_ i ~~ i

~4-~~-~F-~-~~~---"~~-+~r-+'~r-+,~1~+)-4~~~~~~~~--~4-~~~~'-t--~~~~,~~~~ ·-- ·~ ! ~ ' 500 1 ~ioo. I ,....,. . '

==10510.15{1HP)~~--~+·~--~~·~r-+-~-=-~~~·-4--~4-~~.,-+t-4_~,~~~~;~'~, I l ........._ ' ""'o.. ~~ i

200 = 10503-6 (1f3 HP) ....... I -- ' , __ ~

.._ ' ::'"""""' ..... -..... - - ... - -~4--+-4--~4-~-+·--~+.--1~. -+~~-+,~i~+:-~--+--~- -

•--+,-~+1 ---1-+-' -+~:i--- j t i ~ t !

0~~~~~~~~~~~~~~~~~~~~~~-~~

0 2 4 6 8

CAPACITY (GPM)

SPECIFICATIONS SUBJECT TO CHANGE WITHOUT NOTICE. 4" MOTOR STANDARD, 3450 RPM.

10 12 14

Performance conforms to ISO 9906. 1999 (E) Annex A Minimum submergance is 2 feel

GRUNDFOS'~ 4-15

QMISSION ON WATER RESOURCE MANAGEMEO ROUTE SLIP FOR PERMIT ISSUANCE 10/3/06

CHING, F. --DANBARA, S. --FUJII,N. --GOODING, K. -1-HARDY, R. --HEKEKIA, J. -2-HOAGBIN, S.

ICE, C. -4-IMATA, R.

KIMURA, J.

DATE: _________ SUSPENSE DATE:

KUNIMURA, I. --NAKAMA, L.

NAKANO,D. ~ -3-0HYE,M. -SAKODA,E. ==SWANSON, S.

UYENO, D. --YODA,K. ==YOSHINAGA, M.

Approval --Signature -3-lnformation

PLEASE:

See Me -1-Review & Comment --Take Action --Type Draft -2-Type Final -4-File --Xerox __ copies

WELL N\JMBER "'?f {_pf01 r? t; WELL NAME f??v lw ;\t--o A.-

~WELL CONSTRUCTION --~~~~~~~~~----------

ATTACHMENTS FOR WELL CONST~ION PERMIT: 1 COVER LETTER 2 PERMIT (2x) -;::::r

COMMENTS: 3 SDWB 4 WWB 5 CWB TO BE SENT TO APPLICANT

7 LD 8 HP 9 OCCL Or)

10 , s~ /)r

FOR OFFICE USE ONLY

PUMP INSTALLATION

ATTACHMENTS FOR PUMP INSTALLATION PERMIT: 1 COVER LETTER 2 PERMIT (2x)

COMMENTS:. 3 SDWB 4 WWB 5 CWB 6 LD 7 HP 8 OCCL 9 SMA

TO BE SENT TO APPLICANT

FOR OFFICE USE ONLY

\~-1~


Ref: 3687-39.wcp

Mr. Rod Diamond

0 0




Diamond Construction and Water Well Drilling HC #3 Box 14073 Keeau, lll 96749

Dear Mr. Diamond:

Well Construction Permit Kalanikoa Well (Well No. 3687-39)

PETER T. YOUNG CHAIRPERSON


CHIYOME L. FUKINO, M.D. LAWRENCE H. MilKE, M.D., J.D.

STEPHANIE A. WHALEN

DEAN A. NAKANO ACTING DEPUTY DIRECTOR

October 6, 2006

Enclosed are two (2) copies of your approved Well Construction Permit for the captioned well(s) that authorize well construction activities but excludes installation work for a permanent pump. As part of the Chairperson's approval, the following special conditions were added and are part of your permit under Permit Condition 13:

Special Conditions

I. Attached for your information are copies of the Department of Health's (DOH) review comments. Please note DOH's requirements relate!) to discharge of effluent from well drilling and testing activities.

Please refer to the Permit Processes Worksheet (transmitted with your acknowledgement letter) for further information regarding the process of drilling a well and installing a pump.

No withdrawal of water shall be made other than for testing purposes until a certificate of pump installation completion has been issued by the Commission.

Please sign both permit originals and return one for our files. For copies of the aquifer pump test worksheet, please call staff or visit www.state.hi.us/dlnr/cwrm/forms.htm.

IMPORTANT- Drilling work shall not commence until a fully signed permit is returned to the Commission. The permit shall be prominently displayed or made available at the construction site during construction. Be advised that you may be subject to fines of up to $5,000 per day for any violations of your permit conditions starting from the permit approval date.

If you have any questions, please call Ryan Imata of the Commission staff at 587-0255 or toll-free at 974-4000 (Hawaii), 274-3141 (Kauai), 984-2400 (Maui), or 1-800-468-4644 (Lanai & Molokai), extension 70255.

Sincerely,

W.f7h 1't

Peter T. Young Chairperson

Enclosures

c: Glenn Severence (with applicable comments- DOH SDWB, WWB, CWB) USGS Hawaii DWS

/

''"""•'' ._,, WELL CONSTRUCTION PERMIT /

Kalanikoa Well, Well No. 3687-39 Note: This permit shall be prominently displayed at the construction site until the work is completed

In accordance with Department of Land and Natural Resources, Commission on Water Resource Management's Administrative Rules, Section 13-168, entitled "Water Use, Wells, and Stream Diversion Works", this document permits the construction and testing of Kalanikoa Well (Well No. 3687-39) at TMK 1-5-053:122, Hawaii, subject to the Hawaii Well Construction & Pump Installation Standards (HWCPIS- February 2004) which include but are not limited to the following conditions:

I.

2.

3.

4.

5.

6.

7.

8.

9.

10.

II.

12.

13.

14.

15.

The ChaifP-erson of the Commission on Water Resource Management (Commission), P.O. Box 621, Honolulu, HI 96809, shall be notified, in writing, at least two (2) weeks before any work authorized by this permit commences and staff shall be allowed to inspect installation activities in accordance with §13-168-15, Hawaii Administrative Rules,


The well construction permit shall be for construction and testing of the well only. The permittee shall coordinate with the Chairperson and conduct a pumping test in accordance with the HWCPJS (the latest rump test worksheet can be obtained by contacting Commission staff or at www.hawaii.gov/dlnr/cwrm/forms.htm). The permittee shal submit to the Chairperson the test results as a basis for supporting an application to install a permanent pump. No permanent pump may be mstalled until a pump installation permit is approved and issued by the Chmrperson. No withdrawal of water shall be made for purposes other than testing without a Certificate of Pump Installation Completion. The permitted pump capacity described on the pump installation permit may be reduced in the event that the pump test does not support the capacity.

In basal ground water, the depth of the well may not exceed one-fourth (1/4) of the theoretical thickness (41 times initial head) of the basal ground water unless otherwise authorized by the Chairperson.

The permittee shall incorporate mitigation measures to prevent construction debris from entering the aquatic environment, to schedule work to avoid periods of high rainfall, and to revegetate any cleared areas as soon as possible.

In the event that historically significant remains such as artifacts, burials or concentrations of shells or charcoal are encountered during construction, the permittee shall stop work and immediately contact the Department of Land and Natural Resources' Division of Historic Preservation.

The proposed well construction shall not adversely affect existing or future legal uses of water in the area, including any surface water or established instream flow standards. This permit or the authorization to construct the well shall not constitute a determination of correlative water rights.

The Well Completion Report Part I shall be submitted to the Chairperson within sixty (60) days after completion of work (please contact staff or visit www.hawaii.gov/dlnr/cwrm/forms.htm for current form).

The permittee shall comply with all applicable laws, rules, and ordinances; non-compliance may be grounds for revocation of this permit.

The well construction permit application and any related staff submittal approved by the Commission are incorporated into this permit by reference. This permit is also subject to the HWCPIS. If the HWCPIS are not followed and as a consequence water is wasted or contaminated, a lien on the property may result. Any variances from the HWCPIS shall be approved by the Chairperson prior to invoking the variance.

The work proposed in the well construction permit application shall be completed within two (2) years from the date of permit approval, unless otherwise specified. The permit may be extended by the Chairperson upon a showing of good cause and good-faith performance. A request to extend the permit shall be submitted to the Chairperson no later than the date the permit expires.

If the well is not to be used it must be properly capped. If the well is to be abandoned during the course of the project then the permittee must apply for a well abandonment permit in accordance with § 13-168-12(f) prior to any well sealing or plugging work.

The permittee, its successors, and assigns shall indemnity, defend, and hold the State of Hawaii harmless from and against any loss, liability, claim, or demand for property damage, personal injury, or death arising out of any act or omission of the applicant, assigns, officers, employees, contractors, and agents under this permit or relating to or connected with the granting of this permit.

This permit shall apply to the location shown on the application only. If the well is to be relocated, the permittee shall apply for a new well construction/pump installation permit m accordance with Hawaii Administrative Rules §l3-168-l2(f).

Special conditions in the attached cover transmittal letter are incorporated herein by reference. W. h. h 1"t

Date of Approval: September 8, 2006 Expiration Date: September 8, 2008

PETER T. YOUNG, Chairperson Commission on Water Resource Management

I have read the conditions and terms of this permit and understand them. I accept and agree to meet these conditions as a prerequisite and underlying condition of my ability to proceed and understand that I shall not commence work until I have signed, dated, and returned the permit to the Commission. I understand that this permit is not to be transferred to any other entity. I also understand that non-compliance with any permit condition may be grounds for revocation and fines of up to $5,000 per day starting from the permit date of approval.

Driller's Signature:


C-57 License #: C-23379 ~~~~--------

Date:

Diamond Construction Firm or Title: and Water Well Drilling


Attachment

0 0 LINDA LINGLE

GOVERNOR OF HAWAII PETER T. YOUNG

CHAIRPERSON

MEREDITH J. CHING JAMES A FRAZIER NEAL S. FUJIWARA


STEPHANIE A WHALEN




DEAN A NAKANO ACTING DEPUTY DIRECTOR

October 6, 2006

Ref: 3687-39.pip.doc

Mr. Rod Diamond Diamond Construction and Water Well Drilling HC #3 Box 14073 Keeau, HI 96749

Dear Mr. Diamond:

Pump Installation Permit Kalanikoa Well (Well No. 3687-39)

Enclosed are two (2) originals of your approved Pump Installation Permit for the captioned well(s) that authorize permanent pump installation work for your well(s). As part of the Chairperson's approval, the following special conditions were added and are part of your permit under Permit Condition 11:

Special Conditions

1. If the elevation benchmark needs to be altered, the permittee, well operator, and/or well owner shall ensure that the benchmark is transferred (or the well resurveyed) and documentation of the new benchmark shall be submitted to the Commission within sixty (60) days after the pump is installed.

2. Attached for your information are copies of the Department of Health's (DOH) review comments. Please note DOH's requirements related to discharge of effluent from well drilling and testing activities.

The permittee is responsible for all conditions of the permit. This includes ensuring the submission of a completed Well Completion Ref?ort Part ll form within sixty (60) days after the pump installation work is completed. Be advised that you may be subject to fines of up to $5,000 per day for any violations of your permit conditions starting from the permit approval date.

Please sign both permit originals and return one for our files.

IMPORT ANT - Pump installation shall not commence until a fully signed permit is returned to the Commission.

If you have any questions, please call Ryan Imata of the Commission staff at 587-0255 or toll-free at 974-4000 (Hawaii), 274-3141 (Kauai), 984-2400 (Maui), or 1-800-468-4644 (Lanai & Molokai), extension 70255.

Sincere]~

w.n,--~ ~

Peter T. Young Chairperson

Enclosure

c: Glenn Severence (with applicable comments- DOH SDWB, WWB, CWB) USGS HawaiiDWS

O,uMP INSTALLATION PERMITO Kalanikoa Well, Well No. 3687-39

Note: This permit shall be prominently displayed at the site until the work is completed

In accordance with Department of Land and Natural Resources, Commission on Water Resource Management's Administrative Rules, Section 13-168, entitled "Water Use, Wells, and Stream Diversion Works", this document permits the pump installation for Kalanikoa Well (Well No. 3687-39) at TMK 1-5-053: 122, Hawaii, subject to the Hawaii Well Construction & Pump lnstall&tion Standards (HWCPIS - February 2004) which include but are not limited to the following conditions:

1. The Chairperson to the Commission on Water Resource Management (Commission), P.O. Box 621, Honolulu, HI 96809, shall be notified, in writing, at least two (2) weeks before any work covered by this permit commences and staff shall be allowed to inspect installation activities in accordance with § 13-168-15, Hawaii Administrative Rules

2. No withdrawal of water shall be made other than for testing until a Certificate of Pump Installation Completion has been issued by the Commission.

3. This permit shall be prominently displayed, or made available, at the site of construction work until work is completed.

4. The pump installation permit shall be for installation of a 12 gpm rated capacity, or less, pump in the well. This permanent capacity may be reduced in the event that the pump test data does not support the capacity.

5. A water-level measurement access shall be permanently installed, in a manner acceptable to the Chairperson, to accurately record water levels.

6. The permittee shall install an approved meter or other appropriate means for measuring and reporting withdrawals and appropriate devices or means for measuring chlorides and temperature at the well head.

7. Well Completion Report Part II shall be submitted to the Chairperson within 60 days after completion of work. This form can be obtained by contacting staff or on the internet at www.hawaii.gov/dlnr/cwrm.

8. The permittee, well operator, and/or well owner shall comply with all applicable laws, rules, and ordinances, and non-compliance may be grounds for revocation of this permit.

9. The pump installation permit application and any related staff submittal approved by the Commission are incorporated into this permit by reference. This permit is also subject to the HWCPIS. If the HWCPIS are not followed and as a consequence water is wasted or contaminated, a lien on the property may result. Any variances from the HWCPIS shall be approved by the Chairperson prior to invoking the variance.

10. The work proposed in the pump installation permit application shall be completed within two (2) years from the date of permit approval, unless otherwise specified. The permit may be extended by the Chairperson upon a showing of good cause and goodfaith performance. A request to extend the permit shall be submitted to the Chairperson no later than the date the permit expires.

ll. The permittee, its successors, and assigns shall indemnify, defend, and hold the State of Hawaii harmless from and against any loss, liability, claim, or demand for property damage, personal injury, or death arising out of any act or omission of the applicant, assigns, officers, employees, contractors, and agents under this permit or relating to or connected with the granting ofthis permit.

12. Special conditions in the attached cover transmittal letter are incorporated herein by reference.

Date of Approval: Expiration Date:

September 8, 2006 September 8, 2008

W.f7h 1'L

PETER T. YOUNG, Chairperson Commission on Water Resource Management

I have read the conditions and terms of this permit and understand them. I accept and agree to meet these conditions as a prerequisite and underlying condition of my ability to proceed and understand that I shall not commence work until I and the pump installer have signed, dated, and returned the permit to the Commission. I understand that this permit is not to be transferred to any other entity. I also understand that non-compliance with any permit condition may be grounds for revocation and fines of up to $5,000 per day starting from the permit date of approval.

Installer's Signature:


C-57, C-57a, or A License#: C-23379 Date:

Diamond Construction and Firm or Title: Water Well Drilling


Attachments

/

0

Well Check Program 4/1/04- Revised for update to Well Standards (February 2004)

Data Input

Well Number 3687-39 Well Name Kalanikoa Ground Elevation 85 Cement Grout 65 Grouting Method other Hole Diameter 12 Total Depth 85 Estimated Head 1 Public Water Supply Well? no Solid Casing Material pvc plastic plastic Solid Casing Specification Schedule 40 Solid Casing Length 85 Solid Casing Diameter 6 Solid Casing Wall Thickness 0.3125 Open Casing Length 5

Results

Well Depth Theoretical Thickness of Aquifer 41 1/4 Aquifer Thickness 10.25 Depth of Well below Sea Level 0 okay ' ':'''' Section 2.2

Well Casing Minimum Wall Thickness

Material pvc plastic Minimum Thickness per standards no requirement Wall Thickness Provided 0.3125 okay Section 2.4(b)

Minimum Length of Solid Casing 90% of ground to top of aquifer 75.6 Length of solid casing Provided 85 okay Section 2.4(c)

Casing Material Schedule 40 in compliance Section 2.4(d) (for pvc only- check for 200' limit) okay Section 2.4(d)

Annular Space Depth of Grouting

Calculated Depth of Grouting 58.8 Depth of Grouting provided. 65 okay Section 2.6(c)

Minimum Annular Space required 2 Thickness of Annular Space 3 okay Section 2.6(d)

/ " LINDA LINGLE GOVERNOR OF HAW All e

RECEIVF.D

0

SEP 19 All • '2? STATE OF HAWAII Dti>ARMNT OF LAND AND NATURAL RESOURCES

STATE HISTORIC PRESERVATION DIVISION

cm~it·USSION ON W.~.TE~01 ~~~~~o~k!:~:,~~oM 555

RES01. ~Ct ~-1•\.ll.\GEMEHT '

September 15, 2006

Dean Nakano, Acting Deputy Director Commission on Water Resource Management P.O. Box 621 Honolulu, HI 96809

Dear Mr. Nakano:


BOARD OF LAND AND NATURAL RESOURCES COMMISSION ON WATER RESOURCE MANAGEMENT

ROBERT K MASUDA DEPUTY DIRECTOR - LAND

DEAN NAKANO ACTING DEPUTY DIRECTOR- WATER

AQUA TIC RESOURCES BOATING AND OCEAN RECREATION

BUREAU OF CONVEYANCES COI\.iM.ISSION ON WATER RESOURCE MANAGEMENT

CONSERVATION AND COASTAL LANDS CONSERVATION AND RESOURCES ENFORCEMENT

ENGINEERING FORESTRY AND WILDLIFE HISTORIC PRESERVATION

KAHOOLA WE ISLAND RESERVE COMMISSION LAND

STATE PARKS

LOG NO: 2006.3017 DOC NO: 0609JT33 Archaeology

SUBJECT: Chapter 6E-42 Historic Preservation Review (County/Public Works)Well Construction/Pump Installation Permit Application Kea'au Ahupua'a, Puna District, Island ofHawai'i TMK: (3) 1-5-053:122

This project proposes to install a new well and pump

We believe that no historic properties will be affected by this undertaking because: D a) intensive cultivation has altered the land IZI b) residential development/urbanization has altered the land IZI c) previous grubbing/grading has altered the land D d) an acceptable archaeological assessment or inventory survey found no historic properties D e) this project has gone through the historic review process, and mitigation has been completed IZI f) other: This project is located in an established subdivision and the photo indicates that the area

has been previously graded. There is no record of historic sites at this location in our files.

In the event that historic resources, including human skeletal remains, are identified during the construction activities, all work needs to cease in the immediate vicinity of the find, the find needs to be protected from additional disturbance, and the State Historic Preservation Division, Hawai'i Section, needs to be contacted immediately at (808) 327-3691.

elanie Chinen, Administrator ---~tate Historic Preservation Division

JT:gvf

09-07-06 OZ:Z9pm Frcm-DOH/Safe Dri~l Water Branch

~

8085864351

STATE OF HAWAII DEPARTMENT OF lAND AND NATURAL RESOURCES

COMMISSION ON WATER RESOURCE MANAGEMENT P.O. SOXG21 ..

HONOLUW, HAWAII llBB09

August 7, 2006

T-603 P.OOZ/005 F-516

PeTeR T. YOUNG -

TO: Honorable Chiyome L. Fukino, M.D .. Director Department ofHealth Attention: Director's Office

Harold Yee, Wastewater BJallch Stuart Yamada, Safe Drinking Water Branch Alec Wong, Clean Water Branch

FROM: aerT. Young,Chajrperson ~ ...,./)_ · '"\ tJ Commission on Water Resou~~a~ SUBJECT: Well Construction/Pump Installation Pennit Application

Kalanikoa Well (Well No. 3687-39)

Transmitted for your review and comment is a copy of the captioned Well Construction/Pump Installation pennit application.

We would appreciate your comments on the captioned application for any conflicts or · inconsistencies with the programs, plans, and objectives specific to your department. Please respond bv returnjng this cover memo form by September 8. 2006. If we do not receive comments or a request for additional revjew time by this date, we will assume that you have no comments.

Please fmd the attached maps to locate the proposed we11. If you have my questions about this permit application, request additional information, or request additional review titne, please co~ Ryan hnata of the Commission staff at 587-0255.

RI:ss Attachment(s)

RESPONSE:

T I

[I(

[I

[ I

I I

I I

Ill I I

[ l

Thi& ~~ qu3li!Jes as a source wbic:b will &e:rVC as a liCUI'CC ofpolablc Wllk:r to a pllbiii: Wlh:r B)lliiCm (ddiat;d as serviDs ;25 01' DKR JICIII(III: it 1cut 60 da)>& pa- ywr or Jw 15 « mere service coD.Ilcc:tiaos) 111111- rcceillc Director of Health approval prior ID i1! IISII ro eomply witb Hin'lliii Admillislrarive Rlilts (HAR), Tit!~: 1 I, Cbaprer 20, Rules Rclatirlg m Polable Wara .Sysrems, §11·20-29.

'thi$ well docs not qualif¥ ~ ~ ~ ~ .. a JJ\Ibli~ Wllllll' li)'$llmJ (5C~WS I= II= l5 pegple or mo~ people: 111: least 60 days~ year 1)1' J~ ~ _,,.,ctio.u) and"if the wdl wan:r ~ URd for drillk:iDg, ~ privah:: vwm:r &lloi!W t;:;t fur ~tcriolojlil:l!l iDd c:hcmiAI JIICSCIICB beiQre ~ IHic:h usc snd rovtillt:ly moaiiOI' Ebc water ~ tbc:rcaftcr. HDwiM:r, if liltJR plamlcd llSC fium this 5lllll'CC iDa'casc!lm IIHI!t tile publl~ Wiler &y=m dcfiDitioo !hen Dil'llc!or of Haith zppmval .s requirtd prior 1.0 implemenwiCIIL ·

If~ well is used 10 511pply bOth pOI;Ibll!! -.! nQD~~ purp(IS4 ina PI\B'Je ;y$119!1, rbe ..._shall elimi"* ~0111 ud baddlaw CQitll~OIIS by pliysil:ally lqlill'li!Jng ~fable illd JIQII•poi;Jb!J: iS}'W:IIIi by illl ;W' !lilP VI' llll ~ ~kfloW jiR'VI:IIIU,IUid by dearly labeling ;all q~· ~!;lb~f!OIS With wamillg sign& 111 ~Dt illaclwttmt !:lllllllmpliou of DOII-JIIlUbil! wo=r, Baeldiow pm!CIIUOD devices sllilldd be I."'Odinely ~

It 0-= not o!ppe;ar' that tbi& MOll will ~ used for coosumpti~ PPJPO&CS a~d i& Dot sutgect 10 Sodi: Drinldllg W1111:r Rel!llatiaaa.

For tbc appliant's illformatioo.. a SD~=: of possible: ~tc:r colll3nlioatiro I Ji& I) is IIOt IOCilled IR'<ll' !he: propa;c:d wdl aile (iDfamlal:iam ab:lw:l). ·

An NPD£$ permit is mquired.

Otbcr Rlevom DOH rulcslrcgulaliom, infollll8tio11, Ill' recDIDIIII:IIdatiom BJC attac:hcd.

In U'l!! neftt tbat the locatim oflbc "'ell ch;m~ bill ~ JliP wilbin llle J);lrllel d~ oo thls appl~ out dii!U;on t.OilSidcr& lhc ~to SliD be appli~Je. omd we do oat Deed to ~Yi!:W tb<; m.,., 1~011. ·

No <Ommentololjoetj"""

Contact Person: Stuart Yamada Phone: 586-4258

Signed; ---~~(57-~-'--4_ .... _ .. _4_..,..:..._ ______ _ Date: 9/c; LDC..

SEP-07-2006 02:32PM FAX:8085864351 ID:DLNR CWRM PAGE:002 R=97%

09-07-06

--02:29pm From-DOH/Sat! Or~a Water Branch 8085864351 ·~ T-603 P. 003/005

&-3687-39 Hawaii

The Department of Health, Safe Drinking Water Branch has the following additional comments for the Well Construction I Pump Installation Permit Application for the K.alanikoa Well (Well No. 8-3687-39 Hawaii):

Undergound Injection Control (UIC) Comments:

1. In general, a shallow well, or a well that recharges quickly from local rainfall, should not be used as a potable water solll'ce because such a well increases the risk of having unsatisfactory groundwater quality that when consmned may compromise health. Factors that directly influence a well's groundwater quality include wastewater disposal systems (cesspools, septic systems, drainage wells), lawn/garden/crop-growing activities, and even the proximity to the ocean where salt water intrusion may occur; and

2. Check well details for accuracy. The casing lengths (i.e .• solid and perforated casings) do not add up to the total well depth.

9/6/06

F-516

SEP-07-2006 02:33PM FAX:8085864351 IO:DLNR CWRM PAGE:003 R=96%


Date:

To:

Attn:

From:

Subject:

c RECF,VFD CHIYOME LEINAALA FUKINO, M.D.

DIRECTOR OF HEALTH

STATE OF HAwii AUG 14 P 2: 4 3 DEPARTMENT OF HEALTH

P.O. BOX 3378 ,., \ 1 \IJ ~ Tr \! In reply, please refer to: HONOLULU, HAWAII 96801-337BCCl·!,[ \\SS\ntl 1- 'l'i · ', • ~1"~ File:

HFS'~:: ;CF:. ~,~,;~\\GEl'<\Ed I

Wastewater Branch 919 Ala Moana Blvd. Room 309 Honolulu, Hawaii 96814-4920

Phone (808) 586-4294 Fax (808) 586-4300

STATE MESSENGER DELIVERY

Commission on Water Resource Management Department of Land & Natural Resources State of Hawaii

Lori Kajiwara Morikami Ph 586-429 Fax 586-4300 Planning & Design Section Email: [email protected] water commission route.wpd sam as of 02-28-2006

Well Construction/Pump Installation Permit/Water Use Permit for

Well No. _:0_(o_<?J_l_-_ifl~ __ {<a_Ut_Vl_{ ~_O_C-\_VJ_tt_J __ _

well No. _a_1f(;_1-_o_· C1 ___ Pr_lt t_s_vJ_~_tl ____ _

Well No. -----------------------------------------

Well No. -----------------------------------------

Please find enclosed the application of the above subject project.

STATE MESSENGER DELIVERY

. ·~~···· t

LINDA LINGLE GOVERNOR Of HAWAI

0 0


COMMISSION ON WATER RESOURCE MANAGEMENT P.O.BOX621


August 7, 2006

TO: Honorable Chiyome L. Fukino, M.D., Director Department of Health Attention: Director's Office

Harold Yee, Wastewater Branch Stuart Yamada, Safe Drinking Water Branch Alec Wong, Clean Water Branch

FROM: ~er T. Young, Chairpers~- ~ ~/J-- '""""\ tJ Commission on Water Reso~~a~ SUBJECT: Well Construction/Pump Installation Permit Application


AUG 1 0 2006

PETER T. YOUNG CIWRI'ERIOH



STEPHANIE A. WHALEN

DEAN A. NAKANO ACTINQ DEPUTY DIRECTOR

Transmitted for your review and comment is a copy of the captioned WeJI Construction/Pump InstaJlation permit application.

we· would appreciate your comments on the captioned application for any conflicts or inconsistencies with the programs, plans, and objectives specific to your department. Please respond by returning this cover memo form by September 8, 2006. If we do not receive comments or a request for additional review time by this date, we will assume that you have no comments.

Please fmd the attached maps to locate the proposed well. If you have any questions about this permit application, request additional information, or request additional review time, please contact Ryan Imata of the Commission staff at 587-0255.

Rl:ss Attachment( s)

RESPONSE: ~c., U')c

I I This well qualifies as a source which willsel"\le as a source of potable water to a public water system (defined as serving :!ibF~ pcopi=I 60 ~ days per year or has IS or more service connections) and must receive Director of Health approval prior to its usc to colliPJy8 Hawaii · "strati Rules (HAR), Title II, Chapter 20, Rules Relatiug to Potable Water Systems, §11-20-29. . O ~

:nU') - (") This well does not qualify as a source serving a public water system (SCI"\IeS less than 2S people or more people at leas~ year or.&.etvice rfl connections) and if the well water is used for drinking, the private owner should test for bacteriological and chemical . ore initiVtin such usd • • and routinely monitor the water quality thereafter. However, if future planned usc from this source increases to meet iu!!!IDatcr syst finition '"":;:: then Director of Health approval is required Pli2l: to implementation. J> % ~· -- """"

G).~ N !"11 If the well is used to supply both potable and non-potable purposes in a single system, the user shall eliminate cross-co5 baclctJow c::J connections by physically separating potable and non-potable systems by an air gap or an approved bacldlow prevcnter, early labeling all non-potable spigots with warning signs to prevent inadvertent consumption of non-pollible water. Bacldlow prevention dcvi · be routilld¥ inspected and tested. ~ ~ W

I I

I I

I I It does not appear that this well will be used for consumptive purposes and is not subject to Safe Drinking Water Regulations.

[ 1 For the applicant's information, a source of possible wastewater contamination I Jis I I is not located near the proposed well site (information attached).

( I A.n NPDES permit is required.

( 1 Other relevant DOH rules/regulations, information, or recommendations are attached.

I I In the event that the location of the well changes but is still within the parcel descnbed on this application, our division considers the comments to still be applicable, and we do not need to review the new location. X No commcntslobjectio~ iJ 0 /(.!_ f:Ort1 J

Contact Person: U YJ fr1 0 Vl lcafn I ~ ~ !??d!1(,'U £.- !11 ~-~ 4 '·

Signed:_....~::(/_ lV__,_Y/_.L!_!_'"---'c....:.....-~---·,_v. _____ _

Phone:

Date:

0 r


•




STEPHANIE A WHALEN

STATE OF HAWAII DEAN A NAKANO

ACTING DEPUTY DIRECTOR

TO:

FROM:

SUBJECT:

DEPARTMENT OF LAND AND NATURAL RESOURCES COMMISSION ON WATER RESOURCE MANAGEMENT

P.O. BOX621 HONOLULU, HAWAII 96809

August 7, 2006

Russell Tsuji, Administrator Land Division _ j Dean Nakano, Acting Deputy Director~ Commission on Water Resource Management

Well Construction/Pump Installation Permit Application Kalanikoa Well (Well No. 3687-39)

--~ .•-

~,~~;:-}

:,.~·-· ....... _

\-~~;~ ~"~ :::.,..()~ .-- ~;

.(.,/)

Transmitted for your review and comment is a copy of the captioned Well Construction/Pump Installation permit application.

We would appreciate your comments on the captioned application with regard to the programs, plans, and objectives specific to your division. Please respond by returning this cover memo form by September 8, 2006. If we do not receive comments or a request for additional review time by this date, we will assume you have no comments.

Please find the attached maps to locate the proposed well. If you have any questions about this permit application, request additional information, or request additional review time, please contact Ryan Imata ofthe Commission staff at 587-0255.

Rl:ss Attachment( s)

RESPONSE:

[ ] A water lease/permit is required of this applicant and an application for such will be requested by our division.

A water lease/permit is not required of this applicant.

:0:

[ ]

[ ]

[ ]

[ ]

[ ]

A w...,. lease/penni! has been obtained by the applicant through lease no. !l: Other relevant Land Division rules/regulations, information, or recommendations arr ed.

~ ~

, No objections ; ~ Other comments:

Contact Person: -~~:::...::A-c....:..:..R....:-....Y.___..::...I'-t-=-"""....:..:...":1.L.r_t:._A.I~-------

Signed:_....,t.Ary::..__:_-=7---~-=--------=-·...L__ ____ _

?:~; Cj)

··~~ z ""' .....::· ·:7> ::&-rn:;::.r '3::----tl

Phone: S~ 7-i\i~/

Date: __ A_UG_2_1_20_0_6

t'9 .... (,') -·· r1J . '2

:II ...:,.

a fT1I .. c:J ..c. en

·Aua-1 0-2 ~Oj 1 0 : 39 am From-DEPT OF HEA~NVIRONMENTAL MNGMT 8085864352

TO: Honorable Chiyome L. Fukino, M.D., nir·,.,.,t,..,,. Depart:ment of Bealth Anention: Director's Office

Harold Y ee, Wastewater u 4.<1ll ... u

Stuart Y Safe rlri,nl<'li~~o-AlecWong,

FROM: ~erT. Young, . tJ Commission on Water Resource M<mageJn~llt

SVBJECT: Well Construction/Pump Installation Application Kalanikoa Well (Well No. 3687-39)

T-451 P.OOZ/002 F-181

PET~~G ~ MI!RfOITtl J. CHING JAMii$ A. FRAZIER NeAL S. FUJIWARA

CH~YOME L. fUKINO, M.D. {' J) lAWA.E:NC£ H. Mil~ M.D., JD. L/"

S1"EPHANie A. WHALeN

DliAN A. NAKANO -~ ....... ~

Transmitted for your review and comment is a Installation permit application.

of the captioned Well Construction/Pump

Please find the attached maps to locate the ........... n ... c..M well. If you have any questions about this penn it application, request additional information, or additional review time; please 1;ontact Ryan Imata ofthe Commission staff at 587·0255.

lU:ss

RESPONSE: ( )

[ ) This well docs n<>1 qaalil}i as a source~~ a Jll:lblic water system (&eMS c:oo~liQilS) and if the well waw ia used fot drinldnJ. lhe private IWl routinoly moui10r llle water qualilY thercal\«, Howcvc:r, if tlllllre !hen PirCI:Ior ofHcaltb approval is roq:llited .W:W: 10 iltlplcmcru~li011.

watcr s;Y*In ( ddilled aa &crYing 2S Olf more people at IOU! 60 approwlJUi!l: to its asc to 110mply witll Hawaii AdmiDiz~rai~

I 1 If du: 111"111 is ua;d IQ ~ply both eombh: and ll011"1101Bblo p~ in a the user WJI elimilllll; I:IV$:I<OMCCiiona 81111 ~ \101111CCtlom by p~&ieaUy scplltlllin& polllblc liD4 11011-potablc 5)'Sfems 811 appovc:d bilcJdlaw piC'Imet1 w\ by clearly lab:liiiSIIIIIIQII· potable &Jliaots Wllb wani11g sips to J)miC1II iruMIV111~ coo&umplioii or D<DD..PiltU,Icl w~cr. Backflow ~w.Uion clcviccs lboul4 toe I'OIIIinel)' in&pmed and ~,ted,

1 } lt doe1 AC>I Bppoilr WI: this wo\1 will be 11&011 ibt cooaumpriVII PlltJKl6C8 and i~

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~ All NPD:SS permit is requirccl.

011\er relevant DOH naleJ/rcplatiOIIS, illf0t11111lio~. or m:lt1111111$114atio11S an:

1t1 illc ~~ that llli!J localion cf 1M well dlllllge;J but i& &till wimi1 tile p111~l applicablo, Md w;: do 1'101 n=c:d 10 t~view the ne"" loc:ati<m.

l ) No I:OI'AIPI!Dl&lol!iccdom

ConmctPerson:~~~~~~~~-+-------------~----- Phone: ~~~~~~~

Date:

AUG-10-2006 10:21AM FAX:8085864352 ID:DLNR CWRM PAGE:004 R=97%

• ~ua-IO-tOj6 10:39am From-DEPT OF HE~ENVIRONIAENTAL UNG~ 8085864352

.;-;;Spartment of Health, Clean Wat~ranch bas the following mments: T-451 P.001/002 F-181

For Wen-Drilling Activities

'"y di&eharge to State waters of treated process wastewater effl ent associated with well drilling activities ls eeulated by Hawaii Admini;trative Rules, Title 11 I Chapter 55, A pendix I, effective Septe~ber 22, 1997 ... rreated-process wastewater effluent covered by this general per it includes well drilling slurries, lubricating Juids wastewaters, and well purge wastewaters. This general-pe mit does not cover we11 pump testing. The applicable Notice of Intent Forms and filing fee shall be submitte at least thirty (30) days-before the start of :nscharge to the' Department of Health, Clean Water Branch at 9 9 Ala Moans Boulevard, Room 3·01, Honolulu, Hawaii 96814--4920 or P.O. Sex 3378, Honolulu, Hawa i 96801-3378. Inquiries may be directed tc the aean Water Brand'l at (SOB) .586-4309 or by fax Bt (806) 586 . 352.

2. For WeU Pump Testing

The discharger shah talse aH me.asures necessary to prevent the ischsrge of pollutants from entering State· waters. Such measures shall indude, d necessary. containment of the initial discti.arge until~ discharge. I& e&sentially free of poUutants_. If the discharse is entering a str am or river bed, best management · · practices shall be implemented to prevent the discharge from di urbing the c:larity of the receiving water. If the diScharge is entering a storm drain, the dis~harger must ob in written pennission from the owner of that storm drain prior to discharge. Furthermore, best manage ent practices shall be irnplementecl to pr~Jtvent the discharge from collecting sediments and other pollut nts prior to entering the storrra drain.

·--·------......_,, ___ ,. ___ --·-·--·--H ·----·-- . . .

·.

AUG-10-2006 10:21AM FAX:8085864352 ID:DLNR CWRM

PAGE:003 R=96%

COM.CION ON WATER RESOURCE MANAGEMENT 0 ROUTE SLIP FOR NEW APPLICATIONS

FROM: RYAN DATE: 19-.Jun-06 SUSPENSE DATE:

TO: INIT. TO: INIT. FOR:

CHING, F. ~ jAKAMA, L. ~ 1 Approval FUJII, N. ~ ~AKANO, D. 1 Signature GOODING, K. 3 OHYE, M. 3 Information

1 HARDY, R. =z:::;:. == SAKODA, E. -

HIGA, D. W' SWANSON, S. 2 HOAGBIN, S. ==UYENO, D.

ICE, C. YODA, K. --IMATA, R. --YOSHINAGA, M.--

KUNIMURA, 1.- --

WELL NUMBER '}(o(O, ... ];, '::)

D WELL CONSTRUCTION

WELL NAME Kalanikoa

D PUMP INSTALLATION

ATTACHMENTS FOR APPLICA TltOCESSING - B<>lh apPU""' & otoff ge"'<aled 1 TRANS. LETTER 2 PERMIT PROCESS TABLE

3 CWRMMAP 4 APPL. FORM (11 COPIES) 5 USGS MAPS (11 COPIES) B< 6 TAX MAPS (11 COPIES) 7 PARCEL OWNER VERIF. --:J'7 MLS PRINTOUT 8 CONTRACTOR VERIF. =:;;zL DCCA LICENSE SCREEN PRINTOUT 9 ALL INFO FILLED IN -v.

10 BACKGROUND CHECK v;r 11 $25 FEE DEPOSIT SLIP

26-Jun-06

PLEASE:

See Me -1-Review & Comment

Take Action Type Draft acknow letter

-2-Type Final w/elec.signat., label file folder -4-File --Xerox copies

12 DHP/CDUP/SMA pre-screen ~~~IA"'1'faap printout http://gis.hicentral.com/website/parcelzoning/viewer.htm.,or INGRID'S SMA/CD MAP) (LUC map printout http://luc.state.hi.us/luc_maps.htm., or INGRID'S SMA/CD MAP)

FOLDER: 0 MADE NEW Fl E FOLDER, ATTACHED 0 FILE FOLDER LREADY MADE, IN FILE CABINET

INCOMPLETE ACTION OAT S:

DATE

-our side. 4 items. - ~lt · - ~~ Le. {


Mr. Rod Diamond

0 0




August 7, 2006

Diamond Construction and Water Well Drilling HC#3 Box 14073 Keeau, HI 96749

Dear Mr. Diamond:

PETER T. YOUNG ~

MEREDITH J. CHING JAMES A. FRAZIER NEAL S. FUJIWARA ,


STEPHANIE A. WHALEN

DEAN A. NAKANO ...,._ DEPIIIY I*WC1'0R

Well Construction/Pump Installation Permit Application for Well No. 3687-39

We acknowledge receipt, on July 26,2006, of your completed Well Construction/Pump Installation permit application and filing fee for the Kalanikoa Well (Well No. 3687-39). You can expect your application to be processed within ninety (90) days from this date.

For your information, the attached table describes the process, responsible parties, and deadline requirements for drilling or modifying a well and installing, modifying, or replacing a pump.

By this acceptance letter, we are also notifying the well operator/landowner that water may not be pumped for purposes other than testing until the certificate of well construction/pump installation completion letter is issued to the well operator and landowner. Additionally, the permitted pump capacity described on the pump installation permit may be reduced in the event that the pump test does not support the capacity. No certificate of pump installation will be issued until the Commission has determined that the pump capacity will not have adverse effects on the aquifer, other nearby wells, or streams. In other words, you may need to remove the pump and install a smaller pump at the Commission's discretion before you can withdraw water for purposes other than testing.

If you have any questions about your permit application, please contact Ryan lmata of the Commission staff at 587-0255 or toll-free at 974-4000 (Hawaii), 274-3141 (Kauai), 984-2400 (Maui), or 1-800-468-4644 (Lanai & Molokai) extension 70255.

Rl:ss Attachment

c: Glenn Severance

Sincerely,

4 ,J(2A_,A2_, j DEAN A. NAKANO Acting Deputy Director


0 0




August 7, 2006




STEPHANIE A. WHALEN

DEAN A. NAKANO ACTIG DEPUT"i DIRECTOR

TO: Honorable Chiyome L. Fukino, M.D., Director Department of Health Attention: Director's Office

Harold Yee, Wastewater Branch Stuart Yamada, Safe Drinking Water Branch Alec Wong, Clean Water Branch

FROM: ~erT. Young, Chairperso .. ~ _.,/) __ · ""'""\ tJ Commission on Water Reso~~a~ SUBJECT: Well Construction/Pump Installation Permit Application


Transmitted for your review and comment is a copy of the captioned Well Construction/Pump Installation permit application. .

We would appreciate your comments on the captioned application for any conflicts or inconsistencies with the programs, plans, and objectives specific to your department. Please respond by returning this cover memo form by September 8, 2006. If we do not receive comments or a request for additional review time by this date, we will assume that you have no comments.

Please find the attached maps to locate the proposed well. If you have any questions about this pe~it application, request additional information, or request additional review time, please contact Ryan Imata ofthe Commission staff at 587-'0255.

Rl:ss Attachment(s)

RESPONSE:

I I

I I

I I

I I

I I

I I

I I

I I

I l

· This well qualifies as a source whicb will serve as a source of potable water to a public water system (defined as serving 2S or more people at least 60 days per year or bas IS or more service connections) and must receive Director of Health approval.R!i2J: to its use to comply with Hawaii Administrative Rules (HAR), Title 11, Chapter 20, Rules Relating to Potable Water Systems, fll-20-~.

This well does not qualifY as a source serving a public water system (serves less tban 2S people or more people at least 60 days per year or IS service conneclions) and if tbe well water is used for drinking, tbe private owner should test for bacteriological and chemical presence before initiating sucb use and routinely monitor the water quality thereafter. However, if future planned use from this source increases to meet tbe public water system definition then Director of Health approval is required m:i2l: to implementation.

If the well is used to supply both potable and non-potable purposes in a single system, tbe user sball eliminate cross-connections and bacldlow connections by physically separating potable and non-potable systems by an air gap or an approved bacldlow preventer, and by clearly labeling all nonpotable spigots with warning signs to prevent inadvertent consumption of non-potable water. Bacldlow prevention devices should be routinely inspected and tested.

It does not appear tbat this well will be used for consumptive purposes and is not subject to Safe Drinking Water Regulations.

For tbe applicant's information, a source of possible wastewater contamination [ ]is I ) is not located near tbe proposed well site (information attached).

An NPDES permit is required.

Other relevant DOH rules/regulations, information, or recommendations are attached.

In tbe event tbat tbe location of the well changes but is still within tbe parcel described on this application, our division considers tbe comments to still be applicable, and we do not need to review the new location.

No comments/objections

Contact Person:----------------- Phone: --------

Signed:---------------- Date:

LINDA LINGLE GOVERNOR Of HAWM

TO:

FROM:

SUBJECT:

0



HONOLULU,HAVV~I ~

August 7, 2006

Russell Tsuji, Administrator Land Division _ J

Dean Nakano, Acting Deputy Director~ Commission on Water Resource Management


PETER T. YOUNG

MEREDITH J. CHING JAMES A FRAZIER NEAL S. FUJIVVARA

CHIYOME l. FUKINO, M.D. LAVVRENCE H. MilKE, M.D., J.D.

STEPHANIE A. VVHALEN

DEAN A. NAKANO ACTING DEI'UTY DOMCTOII


We would appreciate your comments on the captioned application with regard to the programs, plans, and objectives specific to your division. Please respond by returning this cover memo form by September 8, 2006. If we do not receive comments or a request for additional review time by this date, we will assume you have no comments.

Please find the attached maps to locate the proposed well. If you have any questions about this permit application, request additional information, or request additional review time, please contact Ryan Imata ofthe CommissiOn staff at 587-0255.

Rl:ss Attachment(s)

RESPONSE:

[ ] A water lease/permit is required of this applicant and an application for such will be requested by our division.

[ ] A water lease/permit is !!.!!! required of this applicant.

[ ] A water lease/permit has been obtained by the applicant through lease no. ----------

[ ] Other relevant Land Division rules/regulations, information, or recommendations are attached.

[ ] No objections

[ ] Other comments:

Contact Person:------------------ Phone: -------

Signed: _________________ _ Date: --------

LINDA LINGLE GOVERNOR OF HAWAI

TO:

FROM:

SUBJECT:

0 0

STATE OF HAWAII DEPARTMENT OF LAND AND.NATURAL RESOURCES



August 7, 2006

Melanie Chinen, Administrator Historic Preservation ~ \

Dean Nakano, Acting Deputy Directo~ Commission on Water Resource Management


PETER T. YOUNG



STEPHANIE A WHALEN

DEAN A NAKANO ACTING DEPUTY DltECTOft


We would appreciate your comments on the captioned application with regard to the programs, plans, and objectives specific to your division. Please respond bl returning this cover memo form by September 8, 2006. If we do not receive comments or a request or additional review time by this date, we will assume you have no comments.

Please find the attached maps to locate the proposed well. If you have any questions about this permit application or request additional review time, please contact Ryan Imata of the Commission staff at 587-0255. If you require additional information regarding specific information that can be provided by the applicant, please contact the applicant directly at the contact information provided on the application form.

RI:ss Attachment(s)

RESPONSE:

[ ] This is a [ ] public (county or state) project [ ] private project and [ ] will [ ] may disturb historic sites.

( ] We concur that the work described under this permit will not disturb historic sites.

[ ] We do not concur that the work described under this permit will not disturb historic sites. We require the following for our concurrence:

Contact Person:----------------- Phone: -----------

Signed: __________________ _ Date: _______ _

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License information on this site reflects information in the Professional and Vocational Licensing Division as of July 26, 2006; however, applications and forms are subject to standard processing time, and the information here does not reflect pending changes which are being reviewed. The site is updated daily, Monday through Friday, except holidays. The State of Hawaii makes no guarantees as to the accuracy of the information accessed, the timeliness of the delivery of transactions, delivery to the correct party, preservation of the privacy and security of users and makes no warranties, including warranty of merchantability and fitness for a particular purpose. User is advised that if the information obtained herein is to be reasonably relied upon, user should confirm the accuracy of such information with the provider thereof.

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~

Well Background Check ·\··

Approved Well No. Well Name

Kipukawai

Charlie

Piilani

Lamberson 1

D&D

Akana

Malat

Kalanikoa

11/18/2002 3688-05 Love

11/14/2003 3688-06 Raven

4/12/2004 3500-02 Nichols

4/1412004 3687-10 Fenn

61412004 3688-07 Webb

6/14/2004 3688-08 Lien

812712004 3586-04 Dennis

8/31/2004 3687-13 Camp

10/21/2004 3787-05 Bartlett

12123/2004 3686-04 Connie

113/2005 3786-01 Gapp

1/3/2005 3388-01 Hendershot

1/3/2005 3687-16 Duley

2/21/2005 3688-10 Wallace

31712005 3587-08 Oliver

31712005 3587-07 Hendershot 2

31712005 3686-05 Gibson

4/29/2005 3686-06 Polu Puka

61212005 3786-02 Peters

Monday, June 19,

Applicant

Marq Sims

Thomas Mullen

Arruda Properties

John Lamberson

Dean Schmitz

Amy Akana

Chris Malat

Glenn Severance

David Love

Dennis Rofkar

Greg Nichols

Isaac J. Fenn

Charles Webb

Oran & Sandra Lien

Ardis Dennis

Richard & Teresta Camp

Michael Bartlett

Connie Bouchard

John Gapp

Carolyn Hendershot

Robert Duley

William & Marietta Wallace

Patty Oliver

Carolyn Hendershot

Judith Gibson

Rick Carey

Martin W. Peters

Well Construction Driller Pump lnst. Type Issued Signed WCR1 Accept

BC-23379 BC-23379

BC-23379 BC-23379

BC-23379 BC-23379

BC-23379 BC-23379

BC-23379 BC-23379

BC-23379 BC-23379

BC-23379 BC-23379

BC-23379 BC-23379

BC-23379 BC-23379

BC-23379 BC-23379

BC-23379 BC-23379

BC-23379 BC-23379

BC-23379 BC-23379

BC-23379 BC-23379

BC-23379 BC-23379

BC-23379 BC-23379

BC-23379 BC-23379

BC-23379 BC-23379

BC-23379 BC-23379

BC-23379 BC-23379

BC-23379 BC-23379

BC-23379 BC-23379

BC-23379 BC-23379

BC-23379 BC-23379

BC-23379 BC-23379

BC-23379 BC-23379

BC-23379 BC-23379

BOTH

BOTH

BOTH

BOTH

BOTH

BOTH

BOTH

BOTH

BOTH 11/27/2002 7/29/2004 3/24/2005 5/18/2005

BOTH 11/17/2003 12/6/2003 10/18/2005 10/18/2005

BOTH 4/19/2004 7/13/2004 7/6/2005 9/1212005

BOTH 4/23/2004 9/13/2004 3/24/2005 5/18/2005

BOTH 6/9/2004 7/19/2004 3/2412005 5/11/2005

BOTH 7/14/2004 7/27/2004 6/7/2005 9/1212005

BOTH 9/23/2004 10/2912004 6/7/2005 9/1212005

BOTH 9/2112004 11/1/2004 3124/2005 5/18/2005

BOTH 10/26/2004 10/29/2004 3/24/2005 5/18/2005

BOTH 1/7/2005 1/27/2005 3/24/2005 5/18/2005

BOTH 1/6/2005 1/15/2005 3/24/2005 5/18/2005

BOTH 1/6/2005

BOTH 1/7/2005 211/2005 6/7/2005 9/1212005

BOTH 2123/2005 2126/2005 6/7/2005 9/1212005

BOTH 3/7/2005 3/9/2005 6/7/2005 9/12/2005

BOTH 3/30/2005 4/4/2005 6/7/2005 9/12/2005

BOTH 3/7/2005 3/9/2005 7/6/2005 9/12/2005

BOTH 5/3/2005 9/15/2005

BOTH 6/8/2005 6/13/2005

Pump Installation Issued Signed WCR2 Accept

0 6/3/2005 12/17/2004 3/24/2005 5/18/2005

10/18/2005 1 0/18/2005

11/7/2005 1118/2005 7/6/2005 9/12/2005

6/3/2005 2/22/2005 3/24/2005 5/18/2005

3/24/2005 5/11/2005

11/7/2005 11/8/2005 6/7/2005 9/1212005

11n12005 11/8/2005 6ni2005 9/1212005

6/3/2005 6/4/2005 3/24/2005 5/18/2005

6/3/2005 12/23/2004 3/24/2005 5/18/2005

613/2005 3/10/2005 3/24/2005 5/18/2005

6/3/2005 2/25/2005 3/24/2005 5/18/200!0

11n/2005 11/8/2005 6/7/2005 9/12/2005

11n/2005 1118/2005 6/7/2005 9/12/2005

11/7/2005 11/8/2005 6/7/2005 9/12/2005

11n/2005 11/8/2005 6/7/2005 9/1212005

11n/2005 1118/2005 7/6/2005 9/12/2005

5/3/2005

6/8/2005 6/13/2005

Page I of3

- ... Approved Well No. Well Name

6/2/2005 3787-06 Lucky Me

6/2/2005 3588-02 Jobst

6/2/2005 3688-11 Hyitt

6/2/2005 3688-12 Harrison

6/2/2005 3586-06 Oh

8/8/2005 3687-18 K&J

10/18/2005 3486-02 Campbell

11n12005 3586-07 Family

11nt2005 3686-07 Ariel

12/2/2005 3687-21 Jennings

12/2/2005 3687-20 Tour

12/2/2005 3586-09 Helenihi

12/3/2005 3688-14 Nielsen

12/3/2005 3687-22 Schneider

12/3/2005 3687-19 Suncloud

12/3/2005 3586-10 B. Bells

12/3/2005 3686-12 Terry

12/3/2005 3687-23 Takeda

12/3/2005 2485-03 Hosteler

12/3/2005 2385-01 Epperson

12/3/2005 3586-11 T Moore

12/3/2005 3687-24 P Moore

12/3/2005 3787-08 Nailoa

12/3/2005 3687-26 #58

12/3/2005 3687-25 #57

12/3/2005 3686-11 Zaulocki

12/3/2005 3686-10 Wishing

3/30/2006 3586-12 Erickson

Monday, June 19, 2006

Applicant Well Construction

Driller Pump lnst. Type Issued Signed WCR1 Accept Pump Installation

Issued Signed WCR2 Accept

Regina M. Lutz and Kayrene L BC-23379 BC-23379 BOTH 6/8/2005 6/13/2005 7/6/2005 9/12/2005 6/8/2005 6/13/2005 7/6/2005 9/12/2005

Russel & Joan Jobst

Carolyn Hendershot

Victor Chris Harrison

Shelley & Jeffery Hecht

Kenneth Spence

BC-23379 BC-23379

BC-23379 BC-23379

BC-23379 BC-23379

BC-23379 BC-23379

BC-23379 BC-23379

Christopher & Marta Campbell BC-23379 BC-23379

Gary & Meng-Ju De Vine

Bruce Martin

Scott Jennings

Charles Tour

James Helenihi

Greg Nielsen

Klaus Schneider

Scott Suncloud

John Acree

Roy & Bonnie Terry

Basil Takeda

Winna Marie Hosteler

Peter Epperson

Thomas H. Moore

Paul P. Moore

Roger Pogline

Tri Coast Development LLC

Tri Coast Development LLC

Paul & Tamara Zaulocki

Clifford Schommer

John Erickson

BC-23379 BC-23379

BC-23379 BC-23379

BC-23379 BC-23379

BC-23379 BC-23379

BC-23379 BC-23379

BC-23379 BC-23379

BC-23379 BC-23379

BC-23379 BC-23379

BC-23379 BC-23379

BC-23379 BC-23379

BC-23379 BC-23379

BC-23379 BC-23379

BC-23379 BC-23379

BC-23379 BC-23379

BC-23379 BC-23379

BC-23379 BC-23379

BC-23379 BC-23379

BC-23379 BC-23379

BC-23379 BC-23379

BC-23379 BC-23379

BC-23379 BC-23379

BOTH 6/8/2005 6/13/2005 10/1812005 10/18/2005

BOTH 6/8/2005 6/13/2005 3/30/2006 3/30/2006

BOTH 6/8/2005 6/13/2005 7/6/2005 9/12/2005

BOTH 6/8/2005 6/13/2005 7/612005 9/1212005

BOTH 8/24/2005 9/1212005 10nt2005 10nt2005

BOTH 11nt2005 11/10/2005 11/21/2005 1112112005

BOTH 11110/2005 11/14/2005 11/21/2005 11/21/2005

BOTH 11/10/2005 11/17/2005 11/21/2005 11121/2005

BOTH 121212005 121212005 12114/2005 12114/2005

BOTH 121212005 12114/2005 12/30/2005 12/30/2005

BOTH 121212005 1216/2005 12114/2005 1211412005

6/8/2005 6/13/2005 10/18/2005 1 0/18/2005

6/8/2005 6/13/2005 3/30/2006 3/30/2006

6/8/2005 6/13/2005 7/6/2005 9/12/2005

6/8/2005 6/13/2005 7/6/2005 9/12/2005

8/24/2005 9/26/2005 1 On/2005 1 On/2005

11n/2005 11/9/2005 11121/2005 11/21/2005

11/10/2005 11/14/2005 11/21/2005 11/21/2005

11/10/2005 11/17/2005 11/21/200511/21/2005

12/212005 12/212005 12/14/2005 12/14/20050

12/212005 12/14/2005 12/30/2005 12/30/2005

12/2/2005 1216/2005 12/14/2005 12/14/2005

BOTH 12115/2005 1/9/2006 1/27/2006 1/27/2006 12/15/2005 1/9/2006 1/27/2006 1/27/2006

BOTH 12115/2005 12119/2005 1213012005 12130/2005 12115/2005 12119/2005 12130/2005 12130/2005

BOTH 12115/2005 1212012005 12130/2005 12/30/2005 12115/2005 12120/2005 12/30/2005 12130/2005

BOTH 12115/2005 1/5/2006 1/11/2006 1/11/2006 12/15/2005 115/2006 1111/2006 1/11/2006

BOTH 12115/2005 12/15/2005

BOTH 12115/2005 1/2412006 213/2006 213/2006 12115/2005 1/24/2006 213/2006 213/2006

BOTH 12/15/2005 12/15/2005

BOTH 12115/2005 1115/2006 3130/2006 3/30/2006

BOTH 12115/2005 1/5/2006 1/11/2006 1/11/2006

12/15/2005 1/15/2006 3/30/2006 3/30/2006

12/15/2005 1/5/2006 1/11/2006 1/11/20060

BOTH 12116/2005 1212212005 12130/2005 12130/2005 12116/2005 12/2212005 12130/2005 12130/2005

BOTH 12115/2005 1/2412006 213/2006 213/2006 12115/2005 1/26/2006 21312006 2/3/2006

BOTH 12116/2005 3/3/2006 3/30/2006 3/30/2006 12116/2005 3/3/2006 3/30/2006 3130/2006

BOTH 12/1612005 3/112006 3/30/2006 3/30/2006 12116/2005 3/1/2006 3/30/2006 3/30/2006

BOTH 12115/2005 1/3/2006 1/11/2006 1/11/2006 12115/2005 11312006 1/1112006 1/11/2006

BOTH 12115/2005 1/412006 1/11/2006 2117/2006 12115/2005 21912006 2117/2006 2117/2006

BOTH 4/612006 411712006 4/24/2006 4/24/2006 4/6/2006 4/17/2006 4/24/2006 4/24/2006

Page

~ t ... Well Construction Pump Installation Approved Well No. Well Name Applicant Driller Pump lnst. Type Issued Signed WCR1 Accept Issued Signed WCR2 Accept

3/30/2006 3687-27 King Thomas King BC-23379 BC-23379 BOTH 4/6/2006 4/6/2006

3/30/2006 3686-13 Wohlschagel Fred Wohlschlagel BC-23379 BC-23379 BOTH 4/6/2006 4/12/2006 4/24/2006 4/24/2006 4/6/2006 4/12/2006 4/24/2006 4/24/2006

3/30/2006 3686-14 Bachman Christine Bachman BC-23379 BC-23379 BOTH 4/6/2006 4/6/2006

3/30/2006 3688-15 Young Hwa Joun Young Hwa Joung BC-23379 BC-23379 BOTH 4/5/2006 4f7/2006 4/24/2006 4/24/2006 4/5/2006 4f7/2006 4/24/2006 4/24/2006

4/13/2006 3687-31 Awa Puhi Springs Sean Paul Lai BC-23379 BC-23379 BOTH 4/18/2006 4/20/2006 5/3/2006 5/3/2006 4/18/2006 4/20/2006 5/3/2006 5/3/2006

4/13/2006 3384-01 Mydell Wayland Lum BC-23379 BC-23379 BOTH 4/18/2006 4/20/2006 5/3/2006 5/3/2006 4/18/2006 4/20/2006 5/3/2006 5/3/2006

4/13/2006 3585-04 My Dream Jeff Hecht BC-23379 BC-23379 BOTH 4/18/2006 4/20/2006 5/3/2006 5/3/2006 4/18/2006 4/20/2006 5/3/2006 5/3/2006

4/15/2006 3587-09 Makai Levi McKay BC-23379 BC-23379 BOTH 4/26/2006 5/1/2006 5/8/2006 5/8/2006 4/26/2006 5/1/2006 5/8/2006 5/8/2006

4/15/2006 3589-03 R&B Roy & Bonnie Terry BC-23379 BC-23379 BOTH 4/26/2006 5/5/2006 5/30/2006 4/26/2006 5/5/2006 5/30/2006

4/15/2006 5408-01 Bigpus II Gary Hajek BC-23379 BC-23379 BOTH 4/26/2006 4/26/2006 0 5/15/2006 3687-34 PPLC Christian Pearson BC-23379 BC-23379 BOTH

5/23/2006 3487-03 #242 Timothy Housman BC-23379 BC-23379 BOTH

0

Page3 of3

~ "'o:w,,.'

DEPARTMENT OF LAND AND NATURAL RESOUR~ DOCUMENT NO · .. UAC OR A IT ACHED WORKSHEET DATE· June 15 2006

' SRC/ COST

F YR APP D OBJ CTR PROJECT PH ACT AMOUNT NAME/DESCRIPTION ty/ANG INPUT)

s 06 326 c 1026 0752 (1) $25.00 Don Hashimoto

" " " " " " (2) $25.00 HFS

(3)

(4)

(5)

(6)

(7)

(8)

(9)

(10)

TOTAL $ 50.00

REMARKS: LINE (1) All's Well LINE (2) Kalanikoa Well LINE (3 LINE (4) LINE (5) LINE (6) LINE (7) LINE (8) LINE (9) LINE (1 0)

STATEOFHA,D 0 DEPARTMENT OF LAND AND NATURAL RESOURCES COMMISSION ON WATER RESOURCE MANAGEMENT APPLICATION FOR A WELL CONSTRUCTION I PUMP INSTALLAnON PERMIT

For Official Use Only:

ns m 14 AS: 3 Instructions: Please print In ink or type and send COli...., applicallon wilb allal:hnl8tlls ID lie Comrnis1lion on WeEr Resource Management, P.O. Box 621, Honolulu, Hawaii 961109. Application must be accoltlplllied II¥ 8 copies and a nonrefundable filing fee of $25..00 payable ID lie Depl. ol Land and Nalutal ReaJun:es.. The Cot•••lis6iot• 111aJ not accapl incomplete applications. For assisfance, calf the Regulation Branch at i8T-G225. For further inttrmalion and updates (0 fftis application fonn, visit http:IIYNM.haiwaii.govldlnrlcwrm.

COM~tSS!ON ON W~.TER RESOUi{CE MMMGf:ME1 T

WELL LOCATION INFORMATION 1 STATE WELl NO (If almady assigned) 2 WELl !WoE

Kalanikoa Well 3.1SlAND

Hawaii The following be attached before this application is accepted as complete (check off if attached):

4.TUK 1 5 53 ZONE SEC PLAT

0 Portion of 7.5-Minute Series USGS topographic map (scale 1 :24,000) with well location labeled and include the name of the quad map . 0 Property tax map, showing well location refelenced to established property boundaries. 0 Photograph of the J)loposed well sie.

A schematic ram · the well site, access road and 5. WELL OPERATOR'S NAME/COMPANY Well Operator"s Contact

Glenn Severance Glenn

Well Operator's Mailing Address

PO Box898 Keaau,HI96749

15~1508 4th St. HPP

well infrastructure if 6. LANDOWNER'S NAME/COMPANY

Same

landowner's Mailing Address

Same

Landowner's Contact

Same

122 PARC

Wei Operator's Phone Well Operator"s Fax Well Operator's E-mail Landowner's Fax Landowner's E-mail

8. Proposed Work . X Construct New Well. 0 Modify Existing Well. 0 Abandon/Seal Well .

9. Coostruction Type X Driled. DOug 0 Shaft. D Tunnel

11. Proposed Work. X lnstaH New Pump. 0 Replace Pump

12. Proposed Pumping Rale, gpm (gallons per minute) 14. Method of flow measurement

12 X Flow meter 1-=--------:-.,..--------,--; 0 Open Pipe

13. Proposed Amount of Withdrawal, gpd (galonS per day) 0 Weir

250 0 Orifice 0 Other

15. Proposed Surveyor name and license number (a surveyor is required for all Well Construction Permits and may be required for some

Pump Installation Permits) Deffered PROPOSED USE Site Photo

16. Municipal (water systems serving greater than 25 individuals or 15 service connections)

1

and no. of acres

22. Conservation District Use Permit (COUP) 0 Required, COUP# date approved-----x Not Required (attach documentation from OCCL) 23. Special Management Area Permit (SMAP) 0 Required, SMA# date approved x Not R uired attach documentation from a icable Coun;t;;;;;;;;:;;;;:;\

NOTE: Signing below indicates that the signatories understand and swear that the information provided is accurate and true to the best of their knowledge. Further, the signatories understand that upon pennit approval: 1) the proposed wort< is to be completed within two (2) years of the approval date; 2) the contractor shall submit to the Commission a well completion/abandonment report within 60 days after the completion date of the permitted work; 3) in the event that the application is not completed correctly, any permit may be suspended until the item is brought in to compliance, and any WOI1< done while the

rmit is in sus sion m result in fines of to ~ . 24. WELL DRILLER (Must be filled out if application is for Well Construction) 25. PUMP INSTALLER (Must be filled out if application is for Pump Installation)

Rodney K Diamond BC23379 Rodney K Diamond BC23379 Locens business name C-5TfC.57e/A l.icanse No.

k£2_jl Rodney K Diamond JUNE 8. 2006 ~name C-5TfC.57e/A License No.

~k£2_jl '!ri!ney K Diamond ~NE 8. 2006 Print

HCR #3 Box 14073 Keaau Hl96749 HCR #3 Box 14073 Keaau HI 96749 Address

987-8100 966-4129. 987-8100 966-4129 Phone Fax E-mail l'hane Fax

WCPI App. Form 10105104

""o'·. ('

J·-., G :

I J i tQ•

0 .. 39' 1

i 178MilS

12MILS v liTM GRID AND l'I'JII MAGNETIC NORTH

DEUINADON AT CF.NTEII OF SIIEET

' I

----.-.

0 0

PROPOSED WELL SECTION (Please attach schematic if different from diagram provided below)

Grouting method: OPositive

Displacemeld

X Other

Hole Diameter: 12 inches.

Elevation at top of casing 86 ft., ~· .. _ L_ _LL .

1'-:.f.r.: E..: ... .; :<I

.-----------··:.,»':t :::.:: ; .....

Cement Grout: ~ft. ;r~\· (min. 70% of distance from ~~:-~ ground elevation to top of -·· ~ water surface or 500ft., 1 ~::: whichever is less.) f b·?·

~~=o=~=~=ar=s====-ng=betwee=(1=.5=.=~===:-, r~~ positive displacement, 3· r ~if for other methods): {:_: .•..

:···of, _3_in.

Minimum of 2' Radius & 4• Thick Concrete Pad (to contain benchmark surveyed to nearest 0.01 ft.)

r Ground Elevation: 85 It msl*

Please refer to the HAWAII WELL CONSTRUCTION AND PUMP INSTALLATION STANDARDS

to ensure 1bat your as-buiJt .is in OOD¥Wance with applicable standards.

f . Solid casing: (= 90% x (Ground Elev. -Water Level Elev))

Total Length: 85 ft.

Nominal Diameter: 6 in.

Wall Thickness: __ .......;540='-----·in.

Bottom Elevation: __ -:.·,._0-_____ ft., msl* I Rock or Gravel Packing:

.-------'--1 Total Depth ~ft.

Material: ~ < §;:~ Open casing: • Perforated 0 Screen

_§§_feet. x Crushed Basalt ~- ·:s;:i '

Total Length: 5 ft.

~ ~~----i- Nominal Diameter: __ ..::6-:. _____ .in.

Wall Thickness: ---~S4=0 _____ in.

Estimated Water Lew! Elevation:

Bottom Elevation: -5 ft., msl*

Est. 4" ft. mst•

note: Neither bentonite nor mud should be used in saturated zone during drilling

Open Hole:

1 I Length: _ __,N~~.....,_ ______ ft.

i

1------~---·· Diameter: __________ ____:in.

.. J _ ___:L_

• The approximate elevation must be referenced to mean sea level (msl) at the time of application filing. Final elevations of wei componeuls shal be submitted in the Well Completion/Well Abandonment reports and referenced to a benchmark which has been established by a surveyor licensed by the State.

Bottom Elevation:

For non-salt water Basal Wells - bottom elevation of wei should not be deeper than 114 of aquifer Uickness or, Bottom Elevation of Well Umit = (Wel.er Elevation -) Example: Estimated + 2 ft. Wel.er Level Elev. Bdlom Elevation of Wei Ln1 = ( 2 - ) = -18.5 ft.

Solid Casing Material:

ft., mst•

Carbon Steel: compliant with (check one or more): 0 ANSI/AWWA C200 0 API Spec. 5L 0 ASTM A53 0 ASTM A 139 And compliant with (check one or more): oASTM A242 (or A606) oTypeE oTypeS oGrade B oOther

Stainless Steel: (check one): o ASTM A409 (production wells) o ASTM A312 (monitor wells) ABS Plastic conforming to ASTM F480 and ASTM 01527: (check one) o ScheduJe 40 o Schedule 80 PVC Plastic conforming to ASTM F480 and (ASTM 01785 or ASTM 02241): (check one): • Schedule 40 o Schedule 80 o Schedule 120 Thermoset Plastic: (check one) o Filament Wound Resin Pipe conforming to ASTM 02996

o Centrifugally Cast Resin Pipe conforming to ASTM 02997 o Reinforced Plastic Mortar Pressure Pipe conforming to ASTM 03517 o Glass Fiber Reinforced Resin Pressure Pipe conforming to AWWA C950 o PTFE Fluorocarbon Tubing conforming to ASTM 03296 o FEP Fluorocarbon Tubing conforming to ASTM 03296

Open Casing Material: Carbon Steel: compliant with (check one or more): 0 ANSIIAWWA C200 0 API Spec. 5L 0 ASTM A53 0 ASTM A139

And compliant with (check one or more): o ASTM A242 (or A606) o Type E o Type S o Grade B o Other Stainless Steel: (check one): o ASTM M09 (production wells) o ASTM A312 (monitor wells) ABS Plastic conforming to ASTM F480 and ASTM 01527: (check one) o Schedule 40 o Schedule 80 PVC Plastic conforming to ASTM F480 and (ASTM 01785 or ASTM 02241 ): (check one): • Schedule 40 o Schedule 80 o Schedule 120 Thermoset Plastic: (check one) o Filament Wound Resin Pipe conforming to ASTM 02996

o Centrifugally Cast Resin Pipe conforming to ASTM 02997 o Reinforced Plastic Mortar Pressure Pipe conforming to ASTM 03517 o Glass Fiber Reinforced Resin Pressure Pipe conforming to AWWA C950 o PTFE Fluorocarbon Tubing conforming to ASTM 03296 o FEP Fluorocarbon Tubing conforming to ASTM 03296

WCPI App. Form 10/05/04

0

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SUIJfCf TO CH.4NOf·

Documents

MEMO and ROUTE 9up O · 2013. 2. 1. · p.o. box 898 keeau, hi 96749 dear mr. sev~rance: 0 0 state of hawaii department of land and natural resources commission on water resource