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LINDA LINGLE GOVERNOR OF HAWAII
Mr. Mel Yanos Kona Village Partners P.O. Box 1299 Kailua-Kona, HI 96745
Dear Mr. Yanos:
c o
STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES
COMMISSION ON WATER RESOURCE MANAGEMENT P.O. BOX 621
HONOLULU, HAWAII 96809
August 26, 2009 I
Certificate of Pump Installation Completion for Chai Well- Well No. 4958-02, (TMK 7-2-010:010)
LAURA H. THielEN CHAIRPERsoN
SUMNER ERDMAN NEAL S. FUJIWARA
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
4958-02.cwc
We are pleased to inform you that the Pump Installation work permitted for the Chai Well (Well No. 4958-02) is complete and acceptable and welcome you as a new member to the community of well owners and ground water 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), HAR, 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 prior to the change.
4. In the event the benchmark in the concrete base of the well is altered in any way, an updated version of the Well Elevation page of the Well Completion Report Part I shall be submitted to the Commission. If a licensed surveyor had estimated the original benchmark elevation then a licensed surveyor must establish the new benchmark elevation. The Well Elevation portion of the Well Completion Report Part I can be obtained by contacting Commission staff or at www.hawaii.gov/dlnr/cwrmlforms.htm.
..... c Mr. Mel Yanos Page 2 August 26, 2009
5. Your approved pump has a capacity of 1350 gpm at a head of 10ft. 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.
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. Blank water use report forms are also available at www. hawaii. gov / dlnr/ cwrmlresources yermits.htm
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.
Because ground water 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 per 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 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).
Sincerely,
~f::l!KA~' P.E. Deputy Director
RI:ss Encl: Water Use Report Forms
c: Hawaii Department of Water Supply
o o LINDA LINGLE LAURA H. THIELEN
GOVERNOR OF HAWAII CHAIRPERSON
STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES
COMMISSION ON WATER RESOURCE MANAGEMENT P.O. BOX 621
HONOLULU, HAWAII 96809
August 26, 2009 I
SUMNER ERDMAN NEAL S. FUJIWARA
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
4958-02.cwc
Mr. Mel Yanos Kona Village Partners P.O. Box 1299 Kailua-Kona, HI 96745
Dear Mr. Yanos:
Certificate of Well Construction Completion for Well No. 4958-02 (TMK 5-8-001:008)
We are pleased to inform you that the Well Construction work permitted for the Chai Well (Well No. 4958-02) is complete and acceptable and welcome you as a new member to the community of well owners and ground water 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:
I. 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), HAR, 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 prior to the change.
5. In the event the benchmark in the concrete base of the well is altered in any way, an updated version of the Well Elevation page of the Well Completion Report Part I shall be submItted to the Commission. If a licensed surveyor had estImated the original benchmark elevation then a licensed surveyor must establish the new benchmark elevation. The Well Elevation portion of the Well Completion Report Part I can be obtained by contacting Commission staff or at our website at www.hawaii.gov/dlnr/cwrm/resources-permits.htm.
Because ground water 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 Admimstrative Rules may be subject to fines of up to $5,000 per 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 Imata of the Commission staff at 587-0255.
RI:ss
c: Hawaii Department of Water Supply
Sincef:±jelY,
W. KEN . KA AHARA, P.E. Deputy Director
LINDA LINGLE GOVERNOR OF HAWAII
Mr. Derrick Moreira Derrick's Well Drilling P.O. Box 2187 Keeau, HI 96749
Dear Mr. Moreira:
o o
STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES
COMMISSION ON WATER RESOURCE MANAGEMENT P.O. BOX 621
HONOLULU, HAWAII 96809
August 26, 2009
Well Completion Report Parts I & II for Well No. 4958-02
LAURA H. THielEN CHAIRPERSON
SUMNER ERDMAN NEAL S. FUJIWARA
CHIYOME l. FUKINO, M.D. DONNA FAY K KIYOSAKI, P.E. LAWRENCE H. MilKE, M.D, J.D.
KEN C. KAWAHARA, PE. DEPUTY DIRECTOR
We received y<JUr Well Completion Report Parts I & II for the Chai Well (Well No. 4958-02) on July 24, 2008 and acknowledge that they are complete.
This completes your obligation under the well construction and pump installation permits. Certificate 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 or toll-free at 974-4000 (Hawaii), extension 70255.
Sincerely,
lAJ'forM -fbr KEN C. KAWAHARA, P.E.
Deputy Director
RI:ss
c: Kona Village Partners
o o Well Check Program 4/1/04 - Revised for update to Well Standards (February 2004) Data Input
Well Number 4958-02 Well Name ChaiWell Ground Elevation 4 Cement Grout 25 Grouting Method other Hole Diameter 16 Total Depth 35 !Water Level 2 Depth to water 2 Public Water Supply Well? no Solid Casing Material II:>vc plastic plastic Solid CasinQ Specification Schedule 40 Solid Casing Length 25 Solid Casing Diameter 6 Solid Casing Wall Thickness 0.280 Open CasinQ Length 10
Results
a 0 MEMO and ROUTE '"SLIP (ver. 04/03/2008) 06/12/08
I WCR 1 Chec~ for Well No. 4958-02 (survey to regulation memo)
1. Pump Tests Check Diane England, ___ _ (initial)
Yes No
0 0 Step-Drawdown Test: followed WCPI Stds analysis attached 0 0 0<70 gpm no test required
Constant Rate Test: followed WCPI Stds analysis attached
Potential Well Interference:
Potential Stream Impacts:
Additional Testing or Data Required:
Pump Test Comments Attached:
Proposed Pump Capacity is OK.:
0 0 0 0 0<50 gpm no test required
0 0
0 0
0 0
0 0
0 0
2. Well Log Check Geology Code for Well Index: _~.--_ Fm Name: -t=::~~~:..u....t!.. D. England~tial)
3. Construction Check Mitch Ohye ~? (initial) R. Torres __ (initial) Yes No If no. describe deficiency
J6/
"
, -;
data complete 0,. followed Special Cond & elevations )1 well database updated 0 ~ l=; ~ 4evt~ 1'11'\ t\ C o~t.+
;'\11£. ~ P.~~ d~. Latitude Longitude - ~~'v......
NAD27 10 'So 03 /":,'<:; ,,",C( /j t NAD83 1\ > \ S'/- 1 ~/
4. Cha~RY? (}1~itial) take action based on above analysis
ATTACHMENTS FOR PUMP INSTALLATION PERMIT (2x): ~ necessary - only WCP ~. 1 COVER LETTER $= } 2COUNTY COMMENTS (OWS/SMA) 300H COMMENTS To be sent to driller/pump installer 40LNR COMMENTS (LO/OCCUOHP) =tz 5WCR 1 Accept C;~-::.-
6WELL CON ST. COMPLETION CERTIFICATE <------ To Landowner
}
, 1~l{I0f3 Staff internal checks
5. Roy ~ (initial) check (Entered WCR 1IWCCC accept date into database) 6. Susan H agbin (initial) finalize 7. Ken (initial) signature 8. Mitch (initial) signature (Entered PIP issue date if attached/required) 9. Chare:Ry5i1e '
e o
\ .'
o 0 State of Hawaii COMMISSION ON WATER RESOURCE MANAGEMENT Department of Land and Natural Resources
WELL COMPLETION REPORT - PART I We" Construction
Instructions: Please print in ink or type and send completed report (with attachments, if applicable) to the Commission on Water Resource Management, P.O. Box 621, Honolulu, Hawaii 96809. The Commission may not accept incomplete reports. This form shall be submitted within 60 days of the completion of work. For assistance, please consult the Hawaii Well Construction and Pump Installation Standards or call the Regulation Branch at 587-0225. For updates to this form or additional information, please visit our website at httD:/Iwww.state. hi. usldlnrlcwrml
I
For Official Use Only: /
R,--r "·'\1, n
\. ,,, . .:.. ........ i ' ".,'
1. State Well No.: 4958-02 Well Name: --::.Ch:;:;aI::.·...;.W;..;e;;::ll~ ________ _ Island: Hawaii --------Tax Map Key: 7-2-10-10 -------------2. Address: P.O. Box 1299 Kailua-Kona, HI 96745
3. Drilling Company: Derrick's Well Drilling & Pump Services, LLC
4. Drilling method used during contruction: 181 Rotary 0 Percussion 0 Other (describe)
5. Date Well Construction (drilled ,cased ,grouted) completed: 4/18/08 Attach completed Driller's Log
6. Was the subject we" cored? 0 Yes 181 No
7. Step-Drawdown Test completed? 181 No 0 Yes
8. Rate
11. After casing installation (this information should be before any pump tests are Performed with casing installed)
Chloride: ___ ppm, Temperature: ___ OF
for a/l referenced to mean sea level, take the ground elevation Subtract the depth to the water level.
12. As-built section filled in completely: yes
month/day/year
Dateltlme of measurement
13. Photograph of well and concrete pad showing benchmark on concrete pad attached: yes
14. GPS coordinates provided in degrees, minutes, seconds: Yes
15. 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.)
16. Remarks: n/a -------------------------------------------
Licensed Driller (print) Derrick Moreira --~~-------------------
D~~ C-S7 Lie. No. C-2800 1 ------------------
Date April 21, 2008 Signature
,.,
o
." 12. AS-BUlL T OL SECTION (Please attach as-built if different OiaglBm provided below)
16 in. Elevation at top of casing 4' 6" ft., msl* (to nearest 0.01 ft.) ___ ..j.,.- Minimum of 2' Radius & 4" Thick Concrete Pad
Bench marK elevation:
4.6 ft., msl* o (Survey to 0.Q1 ft.)
181 (Estimated)
Grouting method
o Positive Displacement (if annular space is less than two inches, attach photo of tremie)
181 Other
Total Depth
~ft.
Solid Casing Material:
Cement Grout: 25 ft. (min. 70% of distance from ground elevation to top of water surface or 500 ft., whichever is less.)
Annular space between
hole and casing (1.5" for positive displacement, 3" for other methods) _3 __ in.
Rock or Gravel Packing
10 ft
Lft.msl*
(item 11 from page 1)
*msl = mean sea level
~~o.l-T ... -J'-~!QI.L.'U Elevation: 4 ft., msl* Dsurveyed I8IEstimated
Please refer to the HAWAII WELL CONSTRUCTION AND PUMP INSTALLATION STANDARDS
to ensure that your as-built is in compliance with applicable standards.
Solid Casing: (2! 90% x (Ground Elev.-Water Level Elev»
Length: 25 ft. Nominal Diameter: 6" in. Wall Thickness: Schedule 40 in. Bottom Elevation: -21 ft., msl*
Open Casing: III Perforated 0 Screen
Length: 10ft. Nominal Diameter: __ ...;6:=.'-:' ---,--,--,-". __ ---, in. Wall Thickness: Schedule 40 in. Bottom Elevation: -31 ft., msl*
Open Hole:
Length: ____ --'-"n/"'a ________ ft.
Diameter: _____________ in.
Bottom Elevation: ft., msl·
Carbon Steel: compliant with (check one or more): 0 ANSIIAVWVA C200 0 API Spec. 5L 0 ASTM A53 0 ASTM A 139
And compliant with (check one or more): 0 ASTM A242 or A606 0 Type E 0 Type S 0 Grade B 0 Other
Stainless Steel: (check one): 0 ASTM A409 (production wells) 0 ASTM A312 (monitor wells)
ABS Plastic conforming to ASTM F480 and ASTM 01527: (check one) 0 Schedule 40 0 Schedule 80
PVC Plastic conforming to ASTM F480 and (ASTM 01785 or ASTM 02241): (check one): 181 Schedule 40 0 Schedule 80 0 Schedule 120
Thennoset Plastic: (check one) 0 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 AVWVA 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 ANSIIAVWVA C200 0 API Spec. 5L 0 ASTM A53 0 ASTM A 139
And compliant with (check one or more): 0 ASTM A242 or A606 0 Type E 0 Type S 0 Grade B 0 Other
Stainless Steel: (check one): 0 ASTM A409 (production wells) 0 ASTM A312 (monitor wells)
ABS Plastic conforming to ASTM F480 and ASTM 01527: (check one) 0 Schedule 40 0 Schedule 80
PVC Plastic conforming to ASTM F480 and (ASTM 01785 or ASTM 02241): (check one): 181 Schedule 40 0 Schedule 80 0 Schedule 120
Thennoset Plastic: (check one) 0 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 AVWVA C950
o PTFE Fluorocarbon Tubing conforming to ASTM 03296
o FEP Fluorocarbon Tubing conforming to ASTM 03296
'A'I"""" r-__ .. n, .. ninA " ___ '"' _~ r
.' o DRILLER'S LOG
WELL NUMBER: ....:4.::..95::.:8::..-.::..02=--____ In addition to the drillers log, if a geologic log was prepared, please submit with this form
Depths (ft.) Rock Description Water level CI- Dates Depths (ft.) Rock Description Water level CI- Dates
0 to _1_0_ Black Rock 2' 4/10/08 to
~ to 20 Blue Rock 2' 4111108 to
Black Rock wIRed 20 to ---1L Cinders 2' 4/11/08 to
~ to --1L Red Cinders 2' 4/11/08 to
to to
to to
to to
to to
to to
to to
to to
to to
to to
to to
to to
to to
to to
to to
Remarks:
weR1 Form 6112107 Page 3 of 5
.. '. r--. 0 --------------~--------------~----------~/
Attach photos of completed well and concrete pad
NAD83: ". Latitude: 19 degrees 49 min x/sec Longitude: 155 degrees;1 min~sec
EXAMPLE
lit: 19'36'4.5"
.--1. ____________ ---1. ______ . _______ .. ___ _
SKETCH OF WELL LOCATION (Referenced to permanent landmark, i.e. building, road, fence, etc.)
Provide latitude and longitude of well referenced to NAD83 to nearest~R~JWm 6112107 Page 4 of
o o
o
EXAMPLE
Lat: 19"36'45"
HCUSE
NAD83: Attach photos of completed well Latitude: 19 degrees 49 min 52 sec and concrete pad Longitude: 155 degrees 58 min 58 sec
SKETCH OF WELL LOCATION (Referenced to permanent landmark, i.e. building, road, fence, etc.)
Provide Latitude and Longitude of well referenced to NAD83 to nearestw§~~~ 6112107 Page 4 of
MEMO and ROUTE Ciup (ver.04/03/2008) o
I WCR 2 Check for Well No. 4958-02 (survey to regulation memo)
1. Pump Tests Check( special condition of PIP? Yes/No) D. England __ _ Yes No If no, describe deficiency
Step-Drawdown Test:
followed WCPI Stds analysis attached
Aquifer Pump Test:
o o
followed WCPI Stds 0 T & S analysis attached 0
Potential Well Interference:
Potential Stream Impacts:
Additional Testing or Data Required:
Pump Test Comments Attached:
Proposed Pump Capacity is OK.: .
o
o
o
o
o
o o
o o
o
o
o
o
o /
0<70 gpm no test required
0<50 gpm no test required
stream names:
06/12/08
;4\...07 1\ ;
2. Pump Installation Check Mitch Ohye ~:-\!-'-_/ --:-: (initial) R. Torres __ (initial) Yet No If no, describe deficiency
data complete followed Special Cond & Elev.
well database updated
A q ,P
/
DO Cl
3. Charl6an) ____ (initial) take action based on above analysis
AITACHMENTS FOR ACCEPTANCE: 1WCR2 ACCEPTANCE LEITER
2PUMP INST. COMPLETION CERTIFICATE
3METER INSTALL. REPORT (IF NECCESSSRy) __ _
1" 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 Hoagbin (initial) finalize
6. Ken (initial) signature
7. Faith Ching (initial) enter into WUR database
8. ChareRY~ile
o 0 State of Hawaii For Official Use Only: /
COMMISSION ON WATER RESOURCE MANAGEMENT Department of land and Natural Resources R. ~~("'r;'tr-O \"'-~~~' ,.,"-
WELL COMPLETION REPORT - PART II Pump Installation
Instructions: Please print in ink or type and send completed report (with attachments, if applicable) to the Commission on Water Resource Management, P.O. Box 621, Honolulu, Hawaii 96809. The Commission may not accept incomplete reports. This form shall be submitted within 60 days of the completion of work. For assistance, please consult the Hawaii Well Construction and Pump Installation Standards or call the Regulation Branch at 587-0225. For updates to this form or additional information, please visit our website at http://www.state.hi.usldlnr/cwrm/
1. State Well No.: 4958-02 Well Name:Chai Well
DB JUN 9
. . (- ,~ ,
Island:Hawaii 2. Address: 72-300 Maheawalu Drive, Kailua-Kona, HI 96745 Tax Map Key:7-2-1O:1O 3. Pump Installation Company:Derrick's Well Drilling & PumE Services, LLC 4. Date Pump Installed: May 20, 2008
monthlday/year
5. PERMANENT PUMP INFORMATION Pump Type, Make, Serial No.: Axial-FlowlLift, Aguatic Eco Systems, 3117 Rated Capacity: 1350 gpm at head of: 10 Motor Type, H.P., Voltage, rpm: Franklin Elec. Submersible, 10hQ, 460v, 3450rpm Pump type (check one):
o Deep Well Turbine o Rotary 181 Propeller . o Submersible o Rotary-Displacement o Reciprocating o Centrifugal o Rotary-Gear o Impulse
6. Method of flow measurement: o Flowmeter Manufacturer nla Model no. Size o Other, explain and 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.
ft.
Attach photograph of well clearly showing the benchmark on the concrete pad, the well head, and the 9. method of flow measurement.
10. Well Owner Company Kona Village Investors Contact Mel Yanos Address P.O. Box 1299, Kailua-Kona, ill 96745
Phone 325-5555 Fax
11. Land Owner Company KSBE Contact J effre~ Mau Address 567 South King Street, Suite 200, Honolulu, HI 96813
Phone 808-534-3843 Fax 808-534-3937
12. Remarks Flow meter not installed - salt water well
Pump Installation Contractor (print) Derrick Moreira C-57/C-57a1A Lie. No. C-28001
Signature 0~~ Date June 1, 2008
If
e o
o o 7. AS-BUILT PUMP SECTION (Please attach as-built if different from diagram provided below)
Bench mark elevation surveyed to nearest 0.01 ft. =
40' 6" ft. mean sea level
':. It.:: : .;. -It .. ' .... .6.: . • 'iii .... • .-.. ..
• It .·.A .... : -.C.' .• -;a
Elevation oftop of chase tube nla ft. mean sea level
-----,.._-- ---
Pump intake depth = 23' 2" ft. (referenced to bench mark)
Chase tube depth = nla ft . .jf-_-I-_ (referenced to bench mark)
If airline installed, bottom of airline elevation =
22' 2" ft. mean sea level
WCR2 Form 2/26107 Page 2 of 2
.r .; , ,
21
21
2'
12
.. 2D
: 18 IIrt .a 11
'1:1101 III tti 18
0; 10 ~
{! a a , 2
o --~ a
'- IIiP
r---.
ECo-SYSTEMS,lNC.
1767 Benbow Court Apopka, Florida 32103 USA Telephone 4071886·3939 Fax Email Website
407/886-6787 aesOaquatlceco.com www.aqulttlceco.com
PD26 10 HORSE POWER PERFORMANCE CURVE
~LLE S
~ ...... .......... ......... "- AJI"
.. ~ l"-
~ -... ~ {Ill ) ELL. R(' } ~ ~ ~ -'
V ...... ~ "-~ " '"
~ ~
~ -.. " .~
'" " ~ ~ ~
ala aoo aGO 'l00 ?"O 8UO 8.0 sou alSD lDDO 1060 11DG 11110 laaD 1.0 1300 '310 1.&Gfl 14ft l&GO
Flow ia U.S. Ganons oer Minute
3: .:n -< I ru
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ru ~ I:r: 00
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~ m -rJ ;u 0 3:
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l"\ Q C_ISSION ON WATER RESOURCE MANAGEMENT
ROUTE SLIP FOR PERMIT ISSUANCE 4117107 '"
FROM: RYAN DATE: 10/15/07
KUNIMURA, I. --"'7NAKAMA,L. ~OHYE,M. --SAKODA, E.
CHING, F. CHONG,R. DANBARA, S. ENGLAND, D. FUJII, N. -- --SWANSON, S.
~ --UYENO, D. ---1-HARDY, R.
-2-HOAGBIN, S. ICE, C.
-4-IMATA, R.
KIMURA, J.
WELL NUMBER
--YODA,K. --
==YOSHINAGA, M. == 4958-02 WELL NAME Chai
application type BOTH 1 WCP COVER LETTER 2WCP --' . ./ 3 WELL CHECK PRINTOUT V \ <7~at:5 V'"
4 PIP COVER LETTER 5 PIP
COMMENTS: 6 SOWB 7 WWB 8 CWB 9 LO
10 HP 11 LUC 12 OCCL 13 SMA
NOTES: DRILLER TMK PUMP CAPACITY WELL OWNER LANDOWNER COMMENT DEADLINE
~ -X.. ~ in conservation district ==z.i ~n conservation district?
V In sma
Derrick Moreira o o o o
1115/07
SUSPENSE DATE:
Approval --Signature -3-lnformation
PLEASE:
See Me -1-Review & Comment
Take Action Type Draft
-2-Type Final
4 File Xerox
, I .......
copies
\ \
LINDA LINGLE GOVERNOR OF HAWAII
Ref: 4958-02.wcp
Mr. Derrick Moreira
o o
STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES
COMMISSION ON WATER RESOURCE MANAGEMENT P.O. BOX 621
HONOLULU, HAWAII 96809
Derrick's Well Drilling and Pump Service P.O. Box2187 Keeau, HI 96749
Dear Mr. Moreira:
Well Construction Permit Chai Well (Well No. 4958-02)
LAURA H. THIELEN CHAIRPERSON
MEREDITH J. CHING JAMES A. FRAZIER NEAL S. FUJIWARA
CHIYOME L. FUKINO, M.D. DONNA FAY K KIYOSAKI, P.E. LAWRENCE H. M"KE, M.D., J.D.
KEN C. KAWAHARA, P.E. DepUTY DIRECTOR
November 28,2007
Enclosed are two (2) copies of your approved Well Construction Permit for the captioned welles) 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
1. 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.
2. The solid casing length shall be in compliance with Section 2.4(c) ofthe Hawaii Well Construction and Pump Installation Standards.
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 staffat 587-0255.
Sincerely,
Wf7f7 i't
LAURA H. THIELEN Chairperson
Enclosures
c: Kona Village Investors (with applicable comments - DOH SDWB, WWB, CWB) KSBE (with applicable comments - DOH SDWB, WWB, CWB) USGS HawaiiDWS
I
o o WELL CONSTRUCTION PERMIT
Chai Well, Well No. 4958-02 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, WeIIs, and Stream Diversion Works", this document permits the construction and testing ofChai Well (WeII No. 4958-02) at TMK 7-2-010:010, Hawaii, subject to the Hawaii WeII Construction & Pump InstaIIation Standards (HWCPIS - February 2004) which include but are not limited to the following conditions:
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The Chaif£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 §I3-168-15, 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 fOT 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 pennittee 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 ChaIrperson. 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 woIk to avoid periods of high rainfull, 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 woIk and immediately contact the Department of Land and Natural Resources' State Historic Preservation DiVIsion. WoIk may recommence only after written concurrence by the State Histonc Preservation Division.
The proposed well construction shall not adversely affect existing or future legal uses of water in the area, including any surfuce 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 woIk (please contact staff or visit www.hawaii.gov/dlnr/cwrmlforms.htm for current fonn).
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 pennit 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 perfonnance. 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 prorerly caf:,ped. 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 § 3-168- 2(f) prior to any well sealing or plugging woIk.
The permittee, its successors, and assigns shall indemnifY, defend, and hold the State of Hawaii harmless from and against any loss, liability, claim, or dertJand for property damage, personal injul)', 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.
This permit shall apply to the location shown on the application only. If the well is to be relocated, the pennittee shall apply for a new well construction/pump installation permit m accordance with Hawaii Administrative Rules § 13-168-12(f).
Special conditions in the attached cover transmittal letter are incorporated herein by reference.
WflM ~
Date of Approval: November 5, 2007 Expiration Date: November 5, 2009
LAURA H. THIELEN, 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-28001 ---'-...;;:..;;.----'-'----
Printed Name: Derrick Moreira Firm or Title:
Please sign both copies of this permit, return one to the Chairperson, and retain the other for your records.
Attachment
Date: ------Derrick's Well Drilling and Pum.12. Service
--~---.--"-.-.".-----------------------~
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LINDA LINGLE GOVERNOR OF HAWAII
Ref: 4958-02.pip
Mr. Derrick Moreira
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STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES
COMMISSION ON WATER RESOURCE MANAGEMENT po. BOX 621
HONOLULU, HAWAII 96809
Derrick's Well Drilling and Pump Service P.O. Box2187 Keeau, HI 96749
Dear Mr. Moreira:
Pump Installation Permit Chai Well(WelJ No. 4958-02)
LAURA H. THIELEN CHAIRPERSON
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.
KEN C. KAWAHARA, P.E. DEPUTY DIRECTOR
November 28,2007
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 II:
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 Report Part II 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.
IMPORTANT - 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 staffat 587-0255.
Sincerely,
WfiH ~
LAURA H. THIELEN Chairperson
Enclosure
c: Kona Village Investors (with applicable comments - DOH SDWB, WWB, CWB) KSBE (with applicable comments - DOH SDWB, WWB, CWB) USGS Hawaii DWS
• OPUMP INSTALLATION PERMI1()
Chai Well, Well No. 4958-02 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 Chai Well (Well No. 4958-02) at TMK 7-2-010:010, Hawaii, subject to the Hawaii WeIl Construction & Pump InstaIlation Standards (HWCPIS - February 2004) which include but are not limited to the following conditions:
I. 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 1400 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.
II. 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 of this permit.
12. Special conditions in the attached cover transmittal letter are incorporated herein by reference.
Date of Approval: Expiration Date:
November 5, 2007 November 5, 2009
Wfin ~
LAURA H. THIELEN, 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 J 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: Derrick Moreira
C-57, C-57a, or A License #: C-28001 Date:
Derrick's Well Drilling and Firm or Title: Pump Service
Please sign both copies of this permit, return one to the Chairperson, and retain the other for your records.
Attachments
HarryKim Mayor
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o o ~~erJ.Yuen
Q MJED Brad Kurokawa, ASLA
aInuntu nf ~afuaii PLANNING DEPARTMENT
07 Not!t~Jl: 49
November 2, 2007
Ms. Laura H. Thielen State of Hawaii- DLNR
101 Pauahi Street, Suite 3 • Hilo, Hawaii 96720-4224 (808) 961-8288 • FAX (808) 961-8742
Commission on Water Resource Management POBox 621 Honolulu, HI 96809
Dear Ms. Thielen:
Subject: Special Management Area (SMA) Consultation Project: Chai Well Construction and Pump Installation; Well No. 4958-02 Tax Map Key: (3) 7-2-10:10
This is in response to your letter dated September 24, 2007, in which you requested to know whether the subject property is within the County of Hawaii Special Management Area (SMA), and what permitting requirements, if any, would apply to the proposed project.
The subject 81.395-acre property is situated entirely within the Special Management Area. The Planning Commission issued SMA Permit #18 and #364 for the existing uses on the subject property, which included a requirement by the U.S. Army Corps of Engineers for the property owner to maintain the subject salt water pond
The property owner recently provided information to the Planning Department indicating that the proposed well will be used to maintain the existing pond by infusing 2,016,000 gallons per day of salt water withdrawn from the well into the pond to improve salt water circulation.
According to Planning Commission Rule No. 9-4(10)(B)(vi) relating to the Special Management Area, "development" does not include repair, maintenance, or interior alterations to existing structures or relating to existing uses. Since the salt water pond is an existing use and construction of the well will allow salt water to be circulated into the pond for maintenance purposes, the proposed project does not require further review against the SMA rules and regulations.
Hawai'i County is an Equal Opportunity Provider and Employer.
\
-Ms. Laura H. Thielen State of Hawaii- DLNR
o
Commission on Water Resource Management Page 2 November 2, 2007
o
Should you have questions, contact Maija Cottle of my staff at 961-8288 extension 253.
Sincerely,
(I~ -CHRisTOPHER J~ Planning Director
MJC:cd P:\wpwin60IMaija\DLNR\DLNR Chai- Kona Village Resort 7-2-1 O-IO.doc
xc: Esther Imamura, Long-Range Planning
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LINDA LINGLE GOVERNOR
ANTHONY J.H. CHING EXECUTIVE OFFICER
STATE OF HAWAII DEPARTMENT OF BUSINESS, ECONOMIC DEVELOPMENT & TOURISM
LAND USE COMMISSION P.O. Box 2359
Honolulu, Hawaii 96804-2359 Telephone: 808-587-3822
Fax: 808-587-3827
October 3, 2007
TO: Laura H. Thielen, Chairperson
FROM:
Commission on Water Resource Management partment of Land and Natural Resources
SUBJECT: Well Construction Permit Application Well No. 4958-02, Hawaii
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We have reviewed the subject application forwarded by your transmittal dated September 24, 2007, and are unable to determine the State land use designation of the proposed well site based on the generalized representation of said site on the USGS map.
We suggest that the application be resubmitted with a map that provides a more definitive representation of the well site.
Thank you for the opportunity to comment on the subject application. As requested, we are returning the cover memo for the subject application.
Please feel free to contact Bert Saruwatari of my office at 587-3822 should you require clarification or any further assistance.
Enclosure
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.. LINDA LINGLE
GOVERNOR OF HAWAII
TO:
FROM:
SUBJECT:
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STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES
COMMISSION ON WATER RESOURCE MANAGEMENT P.O. BOX 621
HONOLULU, HAWAII 96809
September 24, 2007
Mr. Anthony Ching, Executive Officer Land Use Commission
Laura H. Thielen, Chairperson 1 Commission on Water Resource Management
WELL CONSTRUCTION PERMIT APPLICATION Well No. 4958-02, Hawaii
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LAURA H. THiElEN CHAIRPERSON
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.
KEN C. KAWAHARA, P.E. DEPUTY DlRECTOR
We would appreciate your review of the proposed well that is described in the attached application that appears to be in the conservation district. Specifically, we request that you confirm inform us of the current state land use designation for the location of the weIl in the TMK parcel, or portion thereof. Please respond by returning this cover memo along with your review comments by October 25, 2007, which is the legal deadline for objections.
If you have any questions, require additional information, or would like to request an extension of the review period for this application, please contact Ryan Imata at 587-0255.
RI:ss Attachment(s)
Response:
( ) Is in the conservation district ( ) Is not in the conservation district (0'Only comments attached
Contact person: ~,.... Ut<};eGtW~~1'C'" /
Signed:~~-7
Phone: ?87-~z~. ~
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ClCT-09-2007 08: 10 From: DOW SAFE ,bl~{rER BRANH 8085854351 To: 8P~,,587 0219 , #
P.U1
LINDA UNGUi r:;t;)'YEIO,NQROF"IoIAW"U
TO:
FROM:
SUBJECT:
RECEIVED SAFE DRINKING WATER BRANCH
STATE OF HAWAII DC:PARTMENT OF LAND AND NATUFilAL RESOURCES
COMMISSION ON WATER.! R.ESOURCE MANAGEMENT F'O,flOXG~l
kONOLUW, HA\\IAII ~al)g
SqJtember 24, 2007
HonQrable Cruyome L. Fukino, M.D., 'Director Department of Health Anention: Director'S Office .
Uarold Yee, W astewa~er Branch vStuart Yamada, Safe Drinki.ng Water Branch
Alec Wong, Clean Water Branch
Laura H. Thielen, Chairperson 1i Commission on Water Resource MaMgement
Well Consu'UctioniPump Installation Permit Application Chai Well (Well No. 4958-021
LAURI\ H THI~LEN
t,ERI!OITH J. CHING J.o.Me8 A. FRAZIER NeAl S, FUJIWAFIA
CHIVOME L ,,"OKINO, M.O, OONNA FAY K. KIYQSAKI. P,E
LAWRelCE H, MilKE, M,D .• J.D.
!<EN C, KAWAHA.AA, P,E. «PIJ'T'VOI3f!.CT~
Transmjtted 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. PIMse respond bI returnin this cover memo fo .. m b October 2 2007. If we do not recejve comments or a request for a ditiona review time by this date~ we will assume t t you have no comments.
Please find the attached maps to locate the proposed well. If you have any questions about tbis pennit application, request additional information~ or request additional review time, please contact Ryan Imata of the Commission staff at 587-0255.
RI:ss Attachtnent(s )
RESPONSE; Ule.,: I\JD (ell\"",,(~~. IO/?//vlD1 I J
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Thi$ w.\I ql\~\j"~ n l/ &lUro~ which will sel'lle as a $OUl'(e of 1)olable wall:r 10 • public water g)'SlcM (~fl""d ., ...-v;ll~ Z5 or mono people .t lea .. 60 00y5 p'" year ur~ .. ,j or more •• rvi« eonl1<eliolls) and mllS1 r¢¢~iv" Dikolor of Health appfOIIalllXi.!!!". W ill> _ ~O COlllJ)ly witb Hawaii AdminiSCl'l1tiv~ Rule! (HAR). Tille 11. C,",pl;;r 20. Rule. Rel;lting to Po\;lblo W~1I:r 5ys«im .. ~ 11-20-29.
'I'll;. well does 00\ q .. Jify lO>" o;oorce .en'ing a public watersYllftlt (scrv~ \c$stllOln.5 people or tlOQI1! people oils" 60 d1Iys p\:r )'!!'ar or IS s'l'IIice ~O!1JJe<:liollS)Pod iflhc well wster is used for c!rmkinll. lilt private O",~er .Ilould IestfOI baolcriologic;ol."" </Ie",io,,) presence bcfure illilia,ing _h US!> IlJ1d mUline!y nlCnitor the waler qualily thereall(r. HOwever. if ilIturc plaiul<:d use /tQftIlhis 1C1un;. ilJG~se! to meet the plblic wllter $~tem (ldinition 111<11 Dit<ct"".I'Hc.11h oppn>vol" ""!pi",,, &tiu to implolllclItali<>n. .
If tile well is uud 10 ~upply bolh poIlIble Slid 1I011of)Otable 1l"'I'0' •• in ~ single syW:n •. the U~r 8h.'t1l eliminat. orol'$-CQnnocliona .nd backflo\\ connections by phy • .,ally ffplll'81ill~ poUlblc aiW nOll-potable systoms by an air gap Qr ;III "PPTQved backflow prev'llIer. arul by cl£arly 1a~lil\!,1 all nonpolllble iplgoti wilb wuninR Silll1S Wl plllvent inadvertent COI'I5UmptiQII of"l)n"Potab'" wate<, 5Kkfl" ... fnvoDOOn !kViofS $1I()~ld b.; roUlillOly inspeeled lind t4;::01cd.
II docs nOI appear tl1al1~ well will boo ..,.~ for ~o"su'lIpti,e pu~ooes a04 is not subieCllO Sa~ Drinking Water ~cguI8tionl,
An NPDES petmil is nquind,
Other nJeVllnl DOH rulc:s/regulmions. infonnatloft. ~ recOttiMorl<j"t;Qns "'" 01w.oll<:d.
In tile c:v~nt IUt IIx: location or,~ woU ch~nS". bUI i. still within tire p~nicJ described on Ulii aPI'JiCa1i<ln, o~rdivi&ion ~omidclS Ibe COrl1Jl1en\s to t<lilJ be lIpplic:ible. 311Ci we do 11()1 1)<!1!d I() """ew the new locatiotl.
No (Olllln~llI&'o*~tioll&
Contact Person: _~ _______________ _ Phonc; ___ ~ __
Signed: ---'7"'iL.,~~-'=-F--=f=~rc-....~-----r~--_ ?~t>J I ~ Date:
OCT-09-2007 08:20AM FAX: 8085864351 ID:OLNR CWRM PAGE: 001 R=94:~
(Oct-09-<£OOT J]9: 23am
--.I,
F rom-DEPT OF HEAL;p,:!".ENV I RONtAENTAL MNGMT 8085864352 T-472 P.002/004 F-143
TO;
fROM:
STATE OF HAWAII DEPARiME.NT OF ~AND AND NATURAL RESOURCES
COMMISSION ON WATER RESOURCE MANAGEMENT P.O.eox621
HONOLULU, HAWAII 96809
September 24,2007
Honorable Chiyome L.. Fukino, M .. D., Director Department of Health Anention: Director's Office
Harold Yee, Wastewater Branch Stuart Yamada, Safe Drinking Water Branch
/Alec Wong. Clean Water Branch
Laura H. Thielen, Chairperson 1 Conunissionon Waler Resource Management
!.AURA H. THIEl.EN <:t1~""E~$ON
MEREDITH J. CfilNG JAMES A. fRAZIER NEAL S. FuJIWARA
a"uvQMe l. FUKINO. MO. DONNA FAY K. I<IYOSAKI, P.I'. LAWRENCE H. I'tIIIKE, M 0,. J.O.
KEN C. KAWAHARA, p.e. oe",TYMeCT""
SUBJECT: Well ConstructionfPump Installation Permit Application Chai Well (Well r\o. 4958-02) .
. Transmitted for your review and conunent is a copy of the captioned Well Constructi.;m/Pump Installation permit application.
We would appreciate your COIIll11l;,.'D.ts on the captioned application for any conflicts ct'
inconsistencies with the programs, plans, and objectives specific to your depanmem. Please respond by returning this cover memo form by October 25. 2007. Ifwe do 110t receive comments or ~t request for additional review time by this date, we wIll assrune that 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 infonnation, or request additional review time, please CI)ntact Ryan Imata of the Commission staffat 587-0255.
RI:ss Anachmem(s)
RESPONSE: r 1
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Thi~ well qulific:s as it ~~ wb~h win ~(Vt:~:s 44 i!Ioc::x",;,;t;I QfJX1l~bl.; wilkr to i\ publiIW Wi1(t;T 2i,Y:m:m tdc:fmcd 8$ ;iCrvia~ ~5 or lDor~..pXtPkallC8S( 60 days per y.:ar Clr has IS or mor.: s.:rvi;1: ;QJ}ncQ,ion.;) illld must R~.:iV( Dirt(;lor ofH.:ahh approvl,l m:W: [0 illi lb!( IX) comply with Hawaii Admillisll'llliY~ ~l<Is (HA.R), Title I I. ChaplC.20, Rule. R.lllling to POl8ble Watcr SY'I~lus. § 11-20 .. 29.
nu, \WII docI.; nOl qllllliiy lIlS" $(I"':, ~l'\Iinil ~ !'Vbl" ",al",r ~y~~m (~av~ I~~~ IIJ;ln 2S ",,('pl.: Qr IlIDn! pcop\l: 111 ).a'6! 60 da~6 per)'olTor IS SCMCC connecTions) and ifrhe wcn waTCr is us«l'or drinkine. tho: priVDIC owner should Icst for bacrcriolo!lical and cho:mical prcscnu ~f_ initiatinG ... eh usc aIld ro~li'laly ,llO,lilOr dr water qll8lity mcr<a&r .. How~.cr. if fulW'C: planllCd use from Ihis SOuNa i,IOIIlaS<lS 10 .DOCl the public "'lI[c! sysle,(\ 4efiuilion tl~n Dir~<,.1ar ()fl1~lth 'pproval i$ rfq~iJ1l<l ~ 10 iIllPla'lIe,"a[ion.
Iflhe well ~ ~$ed IQ IIIpply botb potablr and non-potablc purpose. in a sinSk system, the user ;10111 elimiIUl!(t ~ross-CQllnectiom 4114 backflow conJH:O;'lion:l by "h~italIY ~I'<llillll pclabl~ all(! 110'I-p0l8bl~ Sy;lemS by ~Il air gap or a" ~PI''''Voti b(,~l<f'I(>W Jlr.! ...... nllll'l all4 by Cio!Arlr U~linli ;lIloon .. polsbJ.: sJligol~ wilh wurnine ~i!lllS 10 pl\!Vent in~dvcJ1tnl C(ln~~m"liDIl of Ilon-polilbll' Willlrr. BiI~ktlow pWlcmion deYlo;~ 6hollid be rolllincly inspecled aMlcs[cd ..
hdoes nOI appear !lUll !Ilia wtll will be used for con.lImplive JlIlTj)OiCi nod is no! 8IIbjCGI 10 SaC. Orillldn~ Wal~r Rq:UlatiODS.
Fot 1I1e: applicanl's infOl'llJ8[iOll. a SOl1rce ofpossibl.: \ll1I61~Wal~r contllDli'lIIliolllllsllls RO[ loc.,~d .Wltthc proposed w~1l si,~ linformalicl,fattaCll<:d).
An NI'Pa.~ poll'lllilis I'BQllite4.
(llber r~\evanl po" Nles/l'CSuJalions. illfoT~lalioa. Q~ l'C~oonll1c,lda[ioll~ a .... 1II1t1cl(lld.
In llie ;v~nl t\\;l! tll'l ItX.1tic)n ntll.e well CballgeR bill is still wIlhi,1 the p~MI (!~~cribe~ QI' Ihi. ""pli~~lkon, !,)\lr (livi~ion ~j)~idom til>: ~Dmtm:n\j 10 ~!ill be ~pp1iOilb", ~n<I w'" ~o!WI 1I\I~4 (o ..... i'"' "'" nolw 1Cl<~lion ..
( 1 No coDl'DCnwobjce[ion.l
Contact Person: cl)aMw~.~ Phone; 58& ~4-;O:J_
Signed: ~~ Date: D7...k-· 's;, , ZiXJ l
OCT-09-200709:11AM FAX: 8085864352 ID:DLNR CWRM PAGE:006 R=97%
Cct-Q9-CflQ7 ~:23~ From-DEPT OF HEAONVIR~I.I:NTAL "'GftlT 8085864352 o T-472 P.OOI/004 F-143
Fax to: Company:
Fax No.: SUbject:
FAX TRANSMITTAL State of Hawaii Department of Health Environmental Management Di'VisioD
Clean Water Branch - Engineering Section Phone No.: (808) 586-4309
Fax No.: (808) 586-4352
Mr. Ryan Ima Ms. Lenore Nakama / Mr. Charley Ice Co SSlon On Water Resource Management Deparnnent of Land and Nannal Resources 587·0219 Total Pases, indo cover: 1
Date: Dc:.A. C:J 12001 Fax from: Joanna L. Seto ~
WeD Construction/Pump Installation Permit Application(s) Wen No(s). 4-95'8-02-( q~ I t- 0\) (Q 04';) -00
The Department of Health, Clean Water Branch (CWB) has the following comments:
I, For Well-Drilling Activities
Any discharge to State waters of treated process wastewater effluent associated with well drilling activities is regulated by Hawaii Administrative Rules, Title 11, Chapter 55, Appendix 1, effective November 7, 2002. Treated process wastewater effluent covered by this general pennit includes well drilling slurries, lubricating fluids wastewater, and well purge wastewater. This genera) pennit does not cover well pump testing. The applicable Notice of Intent (NOI) Fonus and filing fee shall be sub mined at least thirry (30) days before the stan of discharge to the:
Department of Health Clean Water Branch 919 Ala Moana Boulevard, Room 301 Honolulu, Hawaii 96814-4920
The eWB-NOI Forms are available online at Intp::/www.hawaii.gov/healr.hicnvironmenta.)/wuter/clewwJ.lCrJfDrms!gcnl-in~J}lml,
Inquiries may be directed to the eWE at (808) 586-4309 or by fax (808) 586-4352.
2. For Well Pump Testing
The discharger shall take all measures necessary to prevenl the discharge of pollutants from entering State waters. Such measures shall include, ifnece:ssary, containnlent of initial discharge until the discharge is essentially free of pollutants. If the discharge is entering a stream or river bed) best management practices shall be implemented to prevent the discharge from disturbing the clarity of the receiving water. If the discharge is entering a storm drain, the discharger must obtain written permission from the owner of the stonn drain prior to discharge. Furthermore, best management practices shall be implemented to prevent the discharge from COllecting sediments and other pollutants prior to entf:ring the storm drain.
OCT-0'3-2007 09: 10AM FAX: 8085864352 ID: DLNR CWRM PAGE:005 R=96%
o o LINDA LINGLE
GOVERNOR OF HAWAII LAURA H. THIELEN
CHAIRPERSON
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.
STATE OF HAWAII KEN C. KAWAHARA, P.E.
DEPUTY DIRECTOR
TO:
DEPARTMENT OF LAND AND NATURAL RESOURCES
COMMISSION ON WATER RESOURCE MANAGEMENT P.O. BOX 621
HONOLULU, HAWAII 96809
September 24, 2007
Honorable Chiyome L. Fukino, M.D., Director Department of Health Attention: Qirector's Office
.JIarold Yee, Wastewater Branch ::::U;cf"j) ~
~~ ~ "'"; -:.r .'~"~ g :jJ Stuart Yamada, Safe Drinking Water Branch
Alec Wong, Clean Water Branch
Laura H. Thielen, Chairperson 'fi
;,~~ ''''''A n1~
-,. !i'fIJ ~.
;z: - (.j) ~ -.... FROM: -~'-':;.
~1"O' ~~~~.'
:"1'jJ Commission on Water Resource Management -c;') "'fC
:til ~-",.
SUBJECT: Well ConstructionlPump Installation Permit Application Chai Well (Well No. 4958-02)
rtl~' .~;:,..
G},ri =.~~'"
--. . -. ~
Transmitted for your review and comment is a copy of the captioned Well ConstructionlPump Installation permit application.
rrr 0
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 October 25, 2007. 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 permit application, request additional information, or request additional review time, please contact Ryan Imata of the Commission staff at 587-0255.
RI:ss Attachment( s)
RESPONSE: [ I This well qualifies as a source which will serve as a source of potable water to a public water system (defined as serving 25 or more people at least 60
days per year or has 15 or more service connections) and must receive Director of Health approval prior to its use to comply with Hawaii Administrative Rules (HAR), Title 11, Chapter 20, Rules Relating to Potable Water Systems. § 11-20-29.
[ I This well does not qualifY as a source serving a public water system (serves less than 25 people or more people at least 60 days per year or 15 service connections) and if the well water is used for drinking, the private owner should test for bacteriological and chemical presence before initiating such use and routinely monitor the water quality thereafter. However, if future planned use from this source increases to meet the public water system definition then Director of Health approval is required prior to implementation.
[ I lfthe well is used to supply both potable and non-potable purposes in a single system, the user shall eliminate cross-connections and backtlow connections by physically separating potable and non-potable systems by an air gap or an approved backtlow preventer, and by clearly labeling all nonpotable spigots with warning signs to prevent inadvertent consumption of non-potable water. Backtlow prevention devices should be routinely inspected and tested.
[ I It does not appear that this well will be used for consumptive purposes and is not subject to Safe Drinking Water Regulations.
[ I For the applicant's information. a source of possible wastewater contamination ( lis ( I is not located near the proposed well site (information attached).
[ I An NPDES permit is required.
[ I Other relevant DOH rules/regulations. information. or recommendations are attached.
[ I In the event that the location of the well changes but is still within the parcel described on this application. our division considers the comments to still be
\ ,/' applicable. and ~e d~ not ne~~ re~fion.
~ntact ;:;:~~IWY1P 'rt; VV YhC1~ i n Kona Sign~~'
Phone:
Date:
o
o LINDA LINGi£': r. .r- r::- : \ !'r:- Ii
GOVERNOR OF HAn i-. t.., L_ "f lb. ~._
TO:
01 SEP 27 p 3: 22
I"N''I.~''~\''\ I'IN \~h~Tta STATE OF HAWAII IJ ",.. '1!-l¥1,;'i' v,. nt\ ... J\ DEPARTMENT OF LAND AND NATURAL RESOURCES
RESO':.{Cf t;t\JL~Gr)~EId"OMMISSION ON WATER RESOURCE MANAGEMENT P.O. BOX 621
HONOLULU, HAWAII 96809
September 24, 2007
Samuel J. Lemmo, Administrator Office of Conservation and Coastal Lands
FROM: Ken C. Kawahara, P.E., Deputy Director 'f1 Commission on Water Resource Management
SUBJECT:
LAURA H. THIELEN CHAIRPERSON
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.
KEN C. KAWAHARA, P.E. DEPUTY DIRECTOR
Well Construction/Pump Installation Permit Application Chai Well (Well No. 4958-02) w
co
Transmitted for your review and comment is a copy of the captioned Well Construction/Pump Installation permit application.
It appears that the subject well project is in conservation land. 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 October 25, 2007. Ifwe 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 of the Commission staffat 587-0255.
RI:ss Attachment(s)
RESPONSE:
[ ] This well project [ ] requires [ ] does not require a CDUP. Ifa CDUP is required it [ ] has [ ] has not been approved and [ ] is [] is not currently active.
[ ]
[ ]
[ ]
Other relevant OCCL rules/regulations, infonnation, or recommendations are attached.
No objections ~ ~~OJ.U!-L It-~ C~ cc:t( fA' ~~,,--bg) ~~lQ t
Phone: ~\-Q?;"(J\-
Date: fldJ{~
e o
~ ..
LINDA LINGLE GOVERNOR OF HAWAII
TO:
FROM:
SUBJECT:
o c RfCEf\M:JrtIIIH. THIELEN LAND DI,rC"""RPERSON
~1&:'1ruJ CHING JA~'1RAZIER NEAL S. FUJIWARA 111 f't'p 2. aCHIYOME L FUKINO, M.D.
~r;1 N AY~ ~~AKI, P.E. CEJiI'M~!:1M.D., J.D.
D·- , .. ~ KEN C. KAWAHARA, P.E. STATE OF HAWAII tr I, Of .I t-, • DEPUTY DIRECTOR
DEPARTMENT OF LAND AND NATURAL RESOURCES HATUf?Al m?§,ND & COMMISSION ON WATER RESOURCE MANAGEMENT S TATf 'OF H9~RCtS
P.o. BOX 621 h n'A.1 t HONOLULU, HAWAII 96609
September 24, 2007
Russell Tsuji, Administrator Land Division
Ken C. Kawahara, P.E., Deputy Director '11 Commission on Water Resource Management
Well ConstructionlPump Installation Permit Application Chai Well (Well No. 4958-02) TMK 7-2-010:010
Transmitted for your review and comment is a copy of the captioned Well ConstructionlPump 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 October 25,2007. Ifwe 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 of the Commission staffat 587-0255.
Rl:ss Attachment(s)
RESPONSE: ~ _ S [ ] A. ~~ter lease/pennit is required ofthis applicant and an application for such will "ested ~ur ~,~
dIVISIOn. ~~ :;.- --. I"'"
~~ r •. "~ ~ [XX A water lease/pennit is not required of this applicant. '~~~ ';c$ ~~
~.r~.::t(
[ ]
[ ]
[ ]
[x1x
A water lease/pennit has been obtained by the applicant through lease no. ___ -':'~"'"·~x"""~;;------4~ .......... --~ Other relevant Land Division rules/regulations, infonnation, or recommendations ar.ed.;
No objections -, \oM'
Other comments: Original source of private titi~"is land Corrmission Award 7715:10 issued between 1845 and 1855.
Contact Person: ____ --l.1G"'a""r~y--J,:.Mk:lau.r-Lt ..... j .... nL--------- Phone: 587-0421 --->!.""-!....-'==
Signed:------'~'---=--+--~-=---=---:-=--==-)---- OCT L 9 20J7 Date: _______ _
( )
('
o ..
o o
Results
Well Depth Theoretical Thickness of Aquifer 82 1/4 Aquifer Thickness 20.5 Depth of Well below Se.a Level -5 okay Section 2.2
Well Casing Minimum Wall Thickness
Material pvc plastic Minimum Thickness per standards no requirement / Wall Thickness Provided 0.25 to~maJl ,,\lV Section2:4{b} .....
Minimum Length of Solid Casing 90% of ground to top of aquifer 34·2 f- '- ----Length of sotiacasing Provided ·1:;'1'~";;·'7:.:j '·<.{5 not enopal) casina ::::> SeCtion 2.4 C
Casing Material SclJedule 40 lin Section 2;4j:f (forpvc only- check for 200' limit) <. .. okay S.ection 2,416
Annular Space Depth of Grouting
Calculated Depth of Grouting 26.6 Depth of Grouting provided 28 okay Section 2,6(e)
Minimum Annular Space required 2 Thickness of Annular Space 3 okay Section .2~6(p)
---------------------,--.~ .. ------------------------
CQSION ON WATER RESOURCE MANAGEMEN-P ROUTE SLIP FOR NEW APPLICATIONS
FROM: RYAN DATE: 27-Aug-07 ----------------
CHING, F. NAKAMA, L. FUJII, N. NAKANO, D. GOODING, K.-- -3-0HYE, M.
1 HARDY, R. ~ SAKODA, E. __ HIGA, D. ~ SWANSON, S.
~ 2 HOAGBIN, S. UYENO, D.
--ICE, C. -- YODA, K. 4 IMATA, R. == --YOSHINAGA, M.-
~K~:U~;1:r {»C (.~ WELL NUMBER ~OJ':l ~. ~ 1,...- WELL NAME Chai
.-\ ! ~ ~
SUSPENSE DATE:
Approval -1-Signature -3-lnformation
3-Sep-07
PLEASE:
See Me -1-Review & Comment --Take Action
Type Draft acknow leiter -2-Type Final, label file folder, update People.db -4-File
Xerox copies
-----------------------------------------o WELL CONSTRUCTION o PUMP INSTALLATION
ATTACHMENTS FOR APPLICATION PROCESSING - Both applicant & staff generated 1 TRANS. LETTER ..,/
2 PERMIT PROCESS TABLE =::2 3CWRMMAP ~ 4 APPL. FORM (11 COPIES) -~
5 USGS MAPS (11 COPIES) i> 6 TAX MAPS (11 COPIES)
7 PARCEL OWNER VERIF. ~/ MLS PRINTOUT 8 CONTRACTOR VERIF. ......:!.-..,L DCCA tl~bI5E SCREEN PRINTOUT
~OTH
9 ALL INFO FILLED IN \.0~ I~/ . J ~ 10 BACKGROUND CHECK ~ ,,\.VV"' .IVV ~ 11 $25 FEE DEPOSIT SLIP . ~ti\.~ :;. ~ c.op:. ~ (c,.~ 12DHP/CDUP/SMApre.screen (SMA map printout hltp:llgis.hicentral.com/website/parcelzoninglviewer.htm.,or GRID'S SMA/CD MAP)
--(LUC map printout hltp:llluc.state.hLus/luc_maps.htm., or INGRID'S SMNCD MAP) FOLDER: -/" .
1LI MADE NEW FILE FOLDER, ATTACHED o FILE FOLDER ALREADY MADE, IN FILE CABINET
INCOMPLETE ACTION DATES:
DATE ACTION
saltwater fishponds. New driller. Not sure of location or aquifer.
tj[l1[ol L&t ~!:'& ~ bAh';' to S?<--J 4~ 0$4 S I!~ +-L2 s.e V\..lW ~y'Vk ~ V\A (,.I
LINDA LINGLE GOVERNOR OF HAWAII
Mr. Derrick Moreira
o o
STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES
COMMISSION ON WATER RESOURCE MANAGEMENT P.O. BOX 621
HONOLULU, HAWAII 96809
September 24, 2007
Derrick's Drilling and Pump Service P.O. Box 2187 Keeau, HI 96749
Dear Mr. Moreira:
LAURA H. THIELEN CHAIRPERSON
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.
KEN C. KAWAHARA, P.E. DEPUTY DIRECTOR
Well ConstructionlPump Installation Permit Application for Well No. 4958-02
We acknowledge receipt, on September 6,2007, of your completed Well ConstructionlPump Installation permit application and filing fee for the Chai Well (Well No. 4958-02). 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 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.
Rl:ss Attachment
c: Kona Village Investors KSBE
Sincerely,
Wf7H 1't
KEN C. KAWAHARA, P.E. Deputy Director
o o LINDA LINGLE LAURA H. THIELEN
GOVERNOR OF HAWAII CHAIRPERSON
TO:
FROM:
STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES
COMMISSION ON WATER RESOURCE MANAGEMENT P.O. BOX 621
HONOLULU, HAWAII 96809
September 24,2007
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
Laura H. Thielen, Chairperson 1 Commission on Water Resource Management
MEREDITH J. CHING JAMES A. FRAZIER NEAL S. FUJIWARA
CHIYDME L. FUKINO, M.D. DONNA FAY K. KIYOSAKI, P.E. LAWRENCE H. MilKE, M.D., J.D.
KEN C. KAWAHARA, P.E. DEPUTY QIRECTOR
SUBJECT: Well ConstructionlPump Installation Permit Application Chai Well (Well No. 4958-02)
Transmitted for your review and comment is a copy of the captioned Well ConstructionlPump 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 returninj this cover memo form by October 25, 2007. Ifwe do not receive comments or a request for additiona 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 permit application, request additional information, or request additional review time, please contact Ryan Imata of the Commission staff at 587-0255.
RI:ss Attachment(s)
RESPONSE:
[ I
[ I
[ I
[ I
[ I
[ I
[ I [ I
[ I
This well qualifies as a source which will serve as a source of potable water to a public water system (defined as serving 25 or more people at least 60 days per year or has 15 or more service connections) and must receive Director of Health approval prior to its use to comply with Hawaii Administrative Rules (HAR), Title II, Chapter 20, Rules Relating to Potable Water Systems, §11-20-29.
This well does not qualify as a source serving a public water system (serves less than 25 people or more people at least 60 days per year or 15 service connections) and if the well water is used for drinking, the private owner should test for bacteriological and chemical presence before initiating such use and routinely monitor the water quality thereafter. However, if future planned use from this source increases to meet the public water system definition then Director of Health approval is required prior to implementation.
If the well is used to supply both potable and non-potable purposes in a single system, the user shall eliminate cross-connections and backflow connections by physically separating potable and non-potable systems by an air gap or an approved backflow preventer, and by clearly labeling all nonpotable spigots with warning signs to prevent inadvertent consumption of non-potable water. Backflow prevention devices should be routinely inspected and tested.
It does not appear that this well will be used for consumptive purposes and is not subject to Safe Drinking Water Regulations.
For the applicant's information, a source of possible wastewater contamination ( lis ( I is not located near the proposed well site (information attached).
An NPDES permit is required.
Other relevant DOH rules/regulations, information, or recommendations are attached.
In the event that the location of the well changes but is still within the parcel described on this application, our division considers the 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 HAWAII
TO:
FROM:
SUBJECT:
o o
STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES
COMMISSION ON WATER RESOURCE MANAGEMENT P.O. BOX 621
HONOLULU, HAWAII 96809
September 24, 2007
Russell Tsuji, Administrator Land Division
Ken C. Kawahara, P.E., Deputy Director 1 Commission on Water Resource Management
Well Construction/Pump Installation Permit Application Chai Well (Well No. 4958-02) TMK 7-2-010:010
LAURA H. THIELEN CHAIRPERSON
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.
KEN C. KAWAHARA, P.E. DEPUTY DIRECTOR
Transmitted for your review and comment is a copy of the captioned Well ConstructionlPump 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 October 25,2007. Ifwe 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 of the 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.
[ ] 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 HAWAII
TO:
FROM:
SUBJECT:
o o
STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES
COMMISSION ON WATER RESOURCE MANAGEMENT P.O. BOX 621
HONOLULU, HAWAII 96809
September 24, 2007
Melanie Chinen, Administrator Historic Preservation
Ken C. Kawahara, P .E., Deputy Director 1i1 Commission on Water Resource Management
Well Construction/Pump Installation Permit Application Chai Well (Well No. 4958-02) TMK: 7-2-010:010
LAURA H. THIELEN CHAIRPERSON
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.
KEN C. KAWAHARA, P.E. OEPUTY DIRECTOR
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 October 25, 2007. Ifwe do not receive comments or a request for additional review time by this date, we win 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 pennit will not disturb historic sites.
[ ] We do not concur that the work described under this pennit will not disturb historic sites. We require the following for our concurrence:
Contact Person: _________________ _ Phone: -------
Signed: ___________________ _ Date: _______ _
LINDA LINGLE GOVERNOR OF HAWAII
TO:
FROM:
SUBJECT:
o o
STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES
COMMISSION ON WATER RESOURCE MANAGEMENT P.O. BOX 621
HONOLULU, HAWAII 96809
September 24, 2007
Mr. Anthony Ching, Executive Officer Land Use Commission
Laura H. Thielen, Chairperson 11 Commission on Water Resource Management
WELL CONSTRUCTION PERMIT APPLlCA TION Well No. 4958-02, Hawaii
LAURA H. THIELEN CHAIRPERSON
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.
KEN C. KAWAHARA, P.E. DEPUTY DIRECTOR
We would appreciate your review of the proposed well that is described in the attached application that appears to be in the conservation district. Specifically, we request that you confirm inform us of the current state land use designation for the location of the well in the TMK parcel, or portion thereof. Please respond by returning this cover memo along with your review comments by October 25,2007, which is the legal deadline for objections.
If you have any questions, require additional information, or would like to request an extension of the review period for this application, please contact Ryan Imata at 587-0255.
RI:ss Attachment( s)
Response:
( ) Is in the conservation district ( ) Is not in the conservation district ( ) Only comments attached
Contactperson: _________________ _
Si~ed: ___________________________________ _
Phone: -----------Date: ----------
-------_._. --,~ .. , ..
LINDA LINGLE GOVERNOR OF HAWAII
TO:
FROM:
SUBJECT:
o C)
STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES
COMMISSION ON WATER RESOURCE MANAGEMENT P.O. BOX 621
HONOLULU, HAWAII 96809
September 24, 2007
Samuel J. Lemmo, Administrator Office of Conservation and Coastal Lands
Ken C. Kawahara, P .E., Deputy Director '11 Commission on Water Resource Management
Well Construction/Pump Installation Permit Application Chai Well (Well No. 4958-02)
LAURA H. THIELEN CHAIRPERSON
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.
KEN C. KAWAHARA P.E. DEPUTY DIRECTOR
Transmitted for your review and comment is a copy of the captioned Well ConstructionlPump Installation permit application.
It appears that the subject well project is in conservation land. 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 October 25, 2007. Ifwe 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 of the Commission staff at 587-0255.
RI:ss Attachment(s)
RESPONSE:
[ ] This well project [ ] requires [ ] does not require a CDUP. Ifa CDUP is required it [ ] has [ ] has not been approved and [ ] is [] is not currently active.
[ ] Other relevant OCCL rules/regulations, information, or recommendations are attached.
[ ] No objections
[ ] Other comments:
Contact Person: _________________ _ Phone: -------
Signed: ___________________ _ Date: _______ _
LINDA LINGLE GOVERNOR OF HAWAII
Mr. Chris Yuen, Director Planning Department County of Hawaii 101 Pauahi Street Hilo, HI 96720
Dear Mr. Yuen:
o o
STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES
COMMISSION ON WATER RESOURCE MANAGEMENT P.O. BOX 621
HONOLULU, HAWAII 96809
September 24, 2007
Special Management Area Use Permit Requirements for Well ConstructionlPump Installation Permit Application
Chai Well (Well No. 4958-02)
LAURA H. THIELEN CHAIRPERSON
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.
KEN C. KAWAHARA, P.E. DEPUTY DIRECTOR
Transmitted for your review and comment is a copy of the captioned Well ConstructionlPump Installation permit application.
We would appreciate your comments on the captioned application with regard to the SMA permitting requirements specific to your division. Please respond by returning this cover memo form bJi October 25, 2007. If we do not receive comments or a request for additional review time by this date, we wil 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 of the Commission staff at 587-0255.
RI:ss
RESPONSE:
Sincere~l . ..£.
Wf7T7 ~
LAURA H. THIELEN Chairperson
[ ] This well project [ ] requires [ ] does not require a SMA. If a SMA is required it [ ] has [ ] has not been approved and [ ] is [ ] is not currently active.
[ ] Other relevant rules/regulations, information, or recommendations are attached.
[ ] No objections
[ ] Other comments:
Contact Person: __________________ _ Phone: _____________ _
Signed: ____________________ _ Date: ________ _
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GENERAL LICENSEE
L1C ID: CT-28001 Active/Inactive: ACTIVE
NAME: DERRICK'S WELL DRILLING & PUMP SERVICES LLC
TRADE NAME:
STATUS: CURRENT, VALID & IN GOOD STANDING
ENTITY: ORGANIZATION (LIMITED LIABILITY COMPANY) BUSINESS CODE:
ORIG L1C DATE: 06/19/2007 EXPIRE DATE: 09/30/2008
CLASS PREFIX: C SPECIAL PRIVILEGE:
RESTRICTION: EDUCATION CODE:
BUSINESS ADDR: 15-2005 29TH AVE KEAAU HI 96749
MAILING ADDR: POBOX 2187 KEAAU HI 96749
Click here to enter search criteria for prior
http://pvl.ehawaii.gov/pvlsearch/app?_a=d&_ f=n&lictp=CT &licno=2800 l&off=&nm=DE... 9/19/2007
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Search Results o o Page 1 of 1
Copyright (99/19/2007 by Hawaii Information Service
Assessed Values reflect tax year 2007.
Search criteria: TMK Taxkey 3-7-2-10-10
• PUBLIC RECORD DATA Taxkey Subdiv /Condo Tnr Address Owner /Lessee Bds Bths Land area Liy area Last Sale lnm Pri.
r;e3-7-2-10-10 l B P BISHOP 81.39 ac 32,124 3/16/2007 Al $85,0( ESTATE TRUSTEES /ETAl KONA VILLAGE INVESTORS llC
This information has been supplied by third parties and has not been independently verified by Hawaii Information Service and is therefore not uaranteed.
http://webre2.hawaiiinformation.comlREsearchIHIS/Searchisearch_PUB.asp?NOCACHE... 9/19/2007
QRTMENT OF LAND AND NATURAL RESQS DOCUMENT NO.: UA OR ATIACHED WORKSHE T DA E: August 9, 2007 C E T
SRC/ COST F YR APP D OSJ CTR PROJECT PH ACT AMOUNT NAME/DESCRIPTION (WANG INPUT)
S 08 326 C 1026 0752 (1 ) $25.00 Derrick;s Well Drilling & Pump Services, LLC
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9) i
(10)
TOTAL $ 25.00
REMARKS: LINE (1) ChaiWell LINE (2) LINE (3 LINE (4) LINE (5) LINE (6) LINE (7) LINE (8) LINE (9) LINE (10)
---------_._-------------
c o IlrricrsWllllrillil1
lid ' •• 1 Slrvlcl., Ill. P.O. Box 2187 Kea'au, HI 96749
Office: (808) 982-7627 • Fax: (808) 982-7698 • Cell: 557-5309 • Email: [email protected]
Commission on Water Resource Management P.O. Box 621 Honolulu, HI 96809
Mr. Ryan Imata,
September 4, 2007 :0 "C~ V)C -:;,::;:-
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Enclosed you will find the permit for the Chai Well with the proper USGS topography map attached. I apologize for using the old version of the well permit application; I am having this issue resolved as soon as possible.
Thank You for your time and understanding.
Sincerely,
D~~ Derrick Moreira
Enc: 10 copies of revised WCPI_A1
..
STATEOFH~ a DEPARTMENT dJlII!IlkD AND NATURAL RESOURCES COMMISSION ON WATER RESOURCE MANAGEMENT APPLICATION FOR A WELL CONSTRUCTION I PUMP INSTALLATION PERMIT
Instructions: Please print in ink or type and send completed application with attachments to the ConvniRdiW Water Resource Management, P.O. Box 621. Honolulu. Hawaii 96809. Application must be accompanied by 6 copies
For Official Use Only:
and a non-refundable filing fee of $25.00 payable to the Dept. of Land and Natural Resources. The .' . . .,..- " Comm~ion ~y not accept ~~. F~~~. cal ~ Regulation Branch at 587-0225. ej ,r.\\i~\QH~H ~~~T,~.~ further Information and updates to this application form. visit hUp:llwww.hawan.govldlndcwrm. Rf::~ :.;;' ' .. \ ,'.:' ,J .• ' ...
WELL LOCATION INFORMATION 1. STATE WEll NO. (If already assigned) 2. WEll NAME
ChaiWell 3. ISlAND
Hawaii 4.TMK
7 2 - 10
The following be attached before this appIicaIion is accepted as compIele (check oIf if attached): o Portion of7.5-Minute Series USGS topographic map (scale 1:24.000) with wei location labeled and include the name of the quad map o Property tax map, showing wei location referenced to established property boundaries o Photogfaph of the proposed well site
A sc:hematic . . the wei •• acx:ess road and well infrastruc:Iunt if
5. WELL OPERATOR'S NAMEfCOMPANY WeI Operator's Contact 6. lANDOWNER'S NAMEICOMPANY
Kona ViII Investors Mel Yanos KSBE Well Operator's Mailing Address P.O. Box 1299 Kailua-Kona, HI 96745
Well Operator's Phone Well Operator's Fax
808-325-5555
landowne(s Mailing Address 567 South King Street, Suite #200 Honolulu, HI 96813
Landowner's Phone landowne(s Fax
808-534-3843 808-534-3937
10
7. Have you consulted with the HisIDric Preservation Division of the Department of land and Natural Resources regarding potential impads of well construdion activities 00 historic siteS? o Yes (please attach 181 No attach a short desai' of'
PROPOSED WELL CONSTRUCTION 8. Proposed Worlt
181 Construct New WeD o Modify Existing WeD o AbandonlSeal Well
9. Construction Type 181 Drilled o Dug o Shaft o Tunnel
10. Is this well part of a battery of wells? 0 Yes to No
PROPOSED PUMP INSTALLATION 11. Proposed Work 12. Proposed Pumping Rate, 181 Instal New Pump gpm (gallons per minute) o Replace Pump 1400
13. Proposed Amount ofWMldl3Wal, Hons per day) 2,016,000
14. MeIhod offtowmeasurement 181 Flowmeter o Open Pipe o Weir o Orifice o Other (explain)
15. Proposed Surveyor name and license number (a surveyor is required for all Well Construction Pennits and may be raqui .... for some Pump Installation Pennlts)
PROPOSED USE o 16. Municipal (water systems serving greater than 25 individuals or 15 rvice
and no. of acres
Site Photo
OTHER LEGAL REQUIREMENTS If required, ilems 22. and 23. must be obtained befote the Commission can legally issue 8 permit: 22. Conservation District Use Permit (COUP) o Required. COUP ## date approved 181 Not uired attach documentation from 0CCl ---23. Special Management Area Permit (SMAP) o Required, SMA" date approved __ ---,-181 Not uiled attach docIanentation from . ColI --:-
Additional remarks, explanations. etc. (attach additional sheet f more space is needed) #7 • Proposed weB located on vehicle access roadway. No impact to historic Sites..
NOTE: Signing below indicates that the signatories undenIt.and and swear Ihat the infonnation provided is accurate and true to the best of their knowledge. Further, the signatories undeIstand that upon penni approval: 1) the proposed work is to be completed within two (2) years of the approval date; 2) the contractor shall submit to the Commission a well compIetionIaban report within 60 days after the completion date of the pennilled work; 3) in the event that the application is not completed c:orrectIy, any pennit may be suspended untif the Ism is brought in to compliance, and any work done while the
rmit is in ion result in fines of to $5000/1 . 24. WELL DRILLER (IIust be filed out if application is for WeI Construction)
Derrick's Well Drilling & Pump Svc C-=-.c::2:;.,800~1_~ __ _ Licensee business name C-57 Ucense No.
0~ ~ DerrickMoreira 8-~7 Signature Print Date
P.O. Box 2187 Keaau, HI 96749 Address
982-7627 Phone
982-7698 Fax E-mail
25. PUMP INSTALLER (IIuIt be tilled out if appIicaIion is for Pump IlIslallalioo)
Derrick's Well Orifling & Pump Svc --,::C-:-:2=800~1_~ __ _ licensee business name C-57 License No.
D ~ ~ Derrick Moreira Signature Print
P.O. Box 2187 Keaau, HI 96749 Address
982-7627 Phone
982-7698 Fax E-mail
8-~7 Date
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72010010
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Printed on Friday. July 27,2007. at 8;51;42 PM
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c o PROPOSED WELL SECTION (Please attach schematic if different from diagram provided below)
Ground Elevation: 40 ft., msI*
Grouting method
o Positive displacement
181 Other
Total Depth
45 ft
Cement Grout: 28 ft. (min. 70% of distance from ground elevation to top of water surface or 500 ft., whichever is less.)
Annular space between
and casing (1.5" for positive displacement, 3" for other methods)
Rock or Gravel Packing ~ft Material: 181 Crushed Basalt
o Rounded Gravel
- Minimum of 2' Radius & 4- Thick Concrete Pad (to contain benchmark ---...... surveyed to nearest 0.01 ft.)
Please refer to the HAWAll WELL CONSTRUcnON AND PUMP INSTALLATION STANDARDS
to ensure that your as-built is in compliance with applicable standards.
---I Solid Casing: (~ 90% x (Ground EIev.-Water Level Elev»
Total Length: .§ft. Nominal ~iameter: 12in. Wall Thickness: PVC Schedule 4Oin. Bottom EIevation:-O- ft., msr
Open Casing: 0 Perforated 0 Screen
Total Length: ~ft. Nominal Diameter: 12 in. Wall Thickness: PVC Schedule 40 in. Bottom Elevation-10 ft., ms\*
note: Neither bentonite nor mud should be used in saturated zone dudng drilling
Estimated Water Level Elevation: ~ ft. ms\*
Open Hole:
Length: n/a ft. Diameter: ____________ in.
* The approximate elevation must be referenced to mean sea level (msI) at the time of application fil~. Final elevations of well components shall be submtted In the WeD CompletionlWell Abandonment reports and referenced to a benchmark which has been estabflShed by a surveyor licensed by the State.
Bottom Elevation:
For non-saIt water Basal Wells - bottom elevation of wei should not be deeper than 114 of aqUfer thickness or, Bottom Elevation of Well Limit = (Water Elevation _ 41 " Wm J.e.,r I!lr..mm )
Example: Esimaled + 2 ft. Water Lew! Elev. -+ BcItom ElevatiOn efWeB Linit = (2 - ~) = -18.5 ft.
Solid Casing Material: Carbon Sleel: compliant with (check one or more): 0 ANSIIAWNA C200 0 API Spec. 5L 0 ASTM A53 0 ASTM A 139
And compliant with (check one or more): 0 ASTM A242 or A606 0 Type E 0 Type S 0 Grade B 0 Other
Stainless Steel: (check one): 0 ASTM A409 (production wens) 0 ASTM A312 (monitor weDs)
ABS Plastic confonning to ASTM F480 and ASTM 01527: (check one) 0 Schedule 40 0 Schedule 80
ft., msl*
PVC Plastic conforming to ASTM F480 and (ASTM 01785 or ASTM 02241): (check one): 181 Schedule 40 0 Schedule 80 0 Schedule 120
Thennoset Plastic: (check one) 0 Filament Wound Resin Pipe conforming to ASTM 02996
o Centrifugally Cast Resin Pipe confonning to ASTM 02997
o Reinforced Plastic Mortar Pressure Pipe conforming to ASTM 03517
o Glass Fiber Reinforced Resin Pressure Pipe conforming to AWNA C950
o PTFE Fluorocarbon Tubing conforming to ASTM 03296
o FEP Fluorocarbon Tubing confonning to ASTM 03296
Open Casing Material: Carbon Steel: comp6ant with (check one or more): 0 ANSIIAWNA C200 0 API Spec. 5L 0 ASTM A53 0 ASTM A 139
And compliant with (check one or more): 0 ASTM A242 or A606 0 Type E 0 Type S 0 Grade B 0 Other
Stainless Steel: (check one): 0 ASTM A409 (produc::tion wellS) 0 ASTM A312 (monitor wellS)
ABS Plastic oonfonning to ASTM F480 and ASTM 01527: (check one) 0 Schedule 40 0 Schedule 80
PVC Plastic conforming to ASTM F480 and (ASTM 01785 or ASTM 02241): (check one): 181 Schedule 40 0 Schedule 80 0 Schedule 120
Thennoset Plastic: (check one) 0 Filament Wound Resin Pipe conforming to ASTM 02996
o Centrifugally Cast Resin Pipe confonning to ASlM 02997
o Reinforced Plastic Mortar Pressure Pipe oonfonning to ASTM 03517
o Glass Fiber Reinforced Resin Pressure Pipe conforming to AWVIIA C950
o PTFE Fluorocarbon Tubing conforming to ASTM D3296
o FEP Fluorocarbon Tubing conforming to ASTM 03296
WCPI App. Form 10105/04
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