47
'0;;\ '. -::(, < Ott " ;',/; -', \ NATIONAL , .... Well ) !1224-0.4) \ \ : - f\r; \, ·f \! Point

W~IFE - University of Hawaii · ... (CWB) has the following comments: 1. For Well-Drilling Activities Any discharge to State waters of treated process wastewater effluent associated

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'0;;\ '. -::(,

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< Ott " ~r ;',/;

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NATIONAL W~IFE , ....

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~Kalihiwai-Gerow Well ) !1224-0.4) \ \ : -

f\r; \, ·f \!

Point

12-16-2009 08:20am

Fax to: Company:

Fax No.:

From-DEPT OF HEALTH ENVIRONMENTAL MNGMT 8085864352 T-780 P.001/003 F-095 r -. '" ,-v, f "", - - I \ C L.> . , . ~. ~

FAX TRANSMITTAL State of Hawaii Department of Health Environmental Management Division

Clean Water Branch - Engineering Section Phone No.: (808) 586-4309

Fax No.: (808) 586-4352

Date: \t.. l& O~ Fax from: Joanna L. Seta cf Mr. Ryan Imata cMi: Charl~Y i£s>! Ms. Denise Mills

Commission On Water Resource Management Deparunent of Land and Natural Resources 587-0219 Total Pages, incl. cover: 2+ 1

~-kl~~~ SUbject: Well Constructioll/Pump Installati()n Permit Application(s)

WeUNo(s). ,Zz..4·- 01

The Department of Health. Clean Water Branch (CWB) has the following comments:

1. 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 CHAR), Title II, Chapter 55. Appendix I~ effective October 22~ 2007. and compiled JWle 15,2009. Treated process wastewater effluent covered by this general permit includes well drilling slurries, lubricating fluids wastewater, and well purge wastewater. This general permit does not cover well pump testing. The applicable Notice of Intent (NOl) Founs and filing fee shall be submitted at least 30 calendar days before the start of discharge to the:

Department of Health Clean Water Branch 919 Ala Moana BOulevard. Room 301 Honolulu, Hawaii 96814-4920

The CWB-NOI Fanus are available online at http://www.hawaii.govlhealthfenvironmental/water/cleanwater/fonns/genl-index.html. Inquiries may be directed to the CWB at (808) 586-4309 or by fax (808) 586-4352 ..

2. For Well Pmnp Testing

The discharger shall take all measures necessary to prevent the discharge of pollutants from entering State waters. Such measures shall include, ifnecessary~ containment 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 irnplemented 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 storm drain prior to discharge. Furthermore, best management practices shall be implem.ented to prevent the discharge from collecting sediments and other pollutants prior to entering the stonn drain.

12-16-2009 08:20am From-DEPT OF HEALTH#~NVIRONMENTAL ~~GMT

" Mr. Ryan !mata / Mr. Charley Ice / Ms. Denise Mills Commission On Water Resource Management

8085864352 T-780 P.002/003 F-095

~

FAX TRANSMITTAL Page 2

3. For Construction Activities Disturbing One (1) or More Acres of Tota! Land Area

By HAR, Title 11, Chapter 55, Appendix C, effective October 22, 2007, and compiled June 15, 2009. an NPD ES permit or Notice of General Permit Coverage is required before the start of the construction activities that result in the disturbance of one (1) or mOre acres of total land area, including clearing, grading, and excavation. The total1and area includes a contiguous area where multiple separate and distinct construction activities may be taking place at different times on different schedules under a larger common plan of development or sale. An NOI (see Comment No.1, above) shall be submitted 30 calendar days before the start of construction activities.

12-16-2009 08:21am From-DEPT OF HEALTH}NViRONMENTAL MNGMT 8085864352 T-780 P.003/003 F-095

zeeg NOV 18 10:011 t\'\':') •

I-INCA liNGLE C:OvJ::~NC)R Qf "ioWAN

TO:

STATE OF HAWAII DEPARTMENT OF LANO AND NA'rURAL REsouRCES

COMMISSION ON WATER RESOURCE MANAGEMENT po. BOX 621

HONOLuLU, HAWAII ~509

November 12,2009

Honorable Chiyome L. Fukino, M.D., Director Department of Health Attention: Tomas See, Chief, Wastewater Branch

~tUart Yamada, Chief, Safe Drinking Water Branch "Alec Wong, Chief, Clean Water Branch

I-AUAA H. THIELEN . \~'1' ( ~~fII!~Ft~DIi Qji

WILlIM'I D. BAI.fOUR. JR. SUMNeFl ERDMAN NEAl S. FUJIWARA

CHIYOME L ~UKIND. M.D. DONNA FAY K KIYOSAJ<I. p.e. LAWRENCE H. MilKE. M.D J.D.

KEN C KAWAHARA. P.E. ce''UTV ~iC:TQA

Dr. Keith Kawaoka, Office of Hazard Ey. luation and mergency Response

FROM: W SUBJECT)"

Laura H. Thielen, Chairperson Commission on Water Resource Management

Well Construction/Pump Installation Penn It Appl' Kalihiwai-Gero)Y Well (Well No. 1224-04)

~.

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 November 29, 2009. lfwe do not receive comments or a request for additional review time by this date, we will assume that you haw 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 contact Charley Ice of the Commission staff at 587-0218.

Cbs Attachment(s)

RESPONSE:

[ I

I J

( 1

r 1

[ J

.£ [ J

[ 1

This well qualifics as a ~oute. whiol> will ~(!M as a sautce OfpOI~bl~ w~ler 1ll iI public water .y.l~rn (tktined as serving 25 or rnQr~ IJ'IOplc at le~,r 60 days per vear or has IS Ot IWrto ;;<>rViQ¢ wnn;Qrions) and m .... r te~.iv~ Director of Heallh 3pprDv~ll!.~ to its uac [0 comply with Hawaii AdlT\inj~lT~tivc Rules (BAR), ritl. II, Cb~pt..,r 20. Rules Rtlatillj; to l'OI .. bl. Water Systems. §11-20.29.

This well docs D01 qualify as a ;UI.I,"8 .emnl! a pllbli~ wa[C( S)lSlom t~.rv~~ less rhan 25 pCOpl. or more pcople Il[ leas[ 60 ¢I)~ por year or IS seNic\> connec[ioos) alld ifrh. ",.11 w~ler is U5~ for drinking, 11 ... prlv:ue Qwn;r should [CS[ for b~~t¢nQlogiOlll and cilelllit,,1 pr.~enoc before u\ilialing ~uoh usc !IlIQ fOulin.ly monitorth~ wirer quality th"teafltlr. rlowevcr, iffu!l\rc planned u'" from this so~rce ij\tte.,~.~ tQ meOl the puhlic .. &Iok .y~tem defmition th~n Direotor of Health appcovl!.ll~ ""<\UI~Q erin' to implementation.

If Ih~ well is used 10 supply both J?<1tablll "".:! non-potable purposes i .... ,ingle .y$l",m. rhe usc .. ~hllll ,,11111inill~ ~oss-conncction" "lid bilokflow ~Dnncctioos by physically s.p"r"tmg PQl~ble ~ud nOI\-potabl ... S}Stdltl~ p~ ;m air pp DC a~ ~pp .. ov.<I b~Gldlow prevC>lU:t, 1l.I<1 by ol"arly labeling /lllllQIl­potable spigots with ",amins .il!!'; 10 prewnt inadvctl611t cOnSump~ioll af non-potable willtl". B.ckflow l'r~v~mioo dcvic •• .bolll.:! b. rolilincly in;pactad ~nd tcsted.

It does nOt app..,:lr thal!h,. woll will be uicd for consumptiw p~rposcs and is not .ubJ"ot to S~t" Drinking WU<l: R..sul>llions.

Fonh" i'ppli"~nr~ informll\lon. a source of pos!ibl. w,,<,owiUer ~()ntaminatio!l ! Ii, II i. nnt I"~~ted Mat lh .. prepa,.d well sirc (illftmnl1t1en art~Qhcd).

All NPDES pennil is ~qllictd .

Oi~r relevant DOH i1Jle"'teg~l~lianN. infQnnalion. Of t~com.nend~tiom nrc attached.

11~ th¢ ¢V¢L)t fhAllhc localion of th~ wen .;hangc~ but IS still within thd parceJ 4~~c!Tlhc!:L1 00.' Thl~ xpph,",o.tl0n. Ollr divia;o ... ~6m.u~Qrll; th- Dommont.::l lo:.till b~ appllcablo, aM we £10 not nee.:! \Q noVlew the new loo~tlen. .

}Ie "amm~m~/obj~"tiona

Contact Person: _-,CTh~=aMMgJ~~.....:la!oC.L..W\?""'-='-'--_~ ___ _ Phone: ,(;<0'4;1):;'

Date: l Z ' 'lPo()~ Signed:_-+--I~~~~_

LINDA LINGLE OOVBRNOR 01' HAWAII

o o

STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES

STATE HISTORIC PRESERVATION DIVISlON 601 KAMOKILABOULEVARD, ROOM 555

KAPOLEI, HA WAH 96707

December 8, 2009

LAURA H. THIELEN ClIAIRI'tiRBON

DO.\IU} ""1.J\ND AIIP HA1UIW.RBSO\JI\CI!8 COMMIBSJOH ON W!t.TRR. RHSOUI«.'l!: MANAOPMHNT

IWSSI!LL Y. TSUJI PIRST DI!I'UfY

KEN C. KAWAHARA 00fUJY DIRG!TOR - WATER

AQUATIC RJ;(()UtCIl$ IlOATlHOAIlbOCllAHRECRPATlOII

IlURBAU OF CONVIIYAKCI!S COMMJl8ION ON WA11!R IIP.SOURCI! MAHAOIlMllIU

CONSERVAllON AllDOOASTAL LAIIIJS COIO!ERVATION AND RI!SOURCI!S ENFIlRCPMI'Jff

ENOlIIBElIINO FORI!S1lIV lIND WILDLIFE 1l1S1'ORICPRF.8ERVATION

IWIOO ..... WE ts ..... 1IJ) RE8liRYR CCJMNlSSION LAND

IITA11!PARKS

MEMORANDUM Log No: 2009.4582 Doc No: 0912NM12

TO:

FROM:

Ken C. Kawahara, Deputy Director Commi~sion on Water Resource Management ~

Nancy A. McMahon, Deputy Administrator ~ rJ/1, ~ and Deputy State Historic Preservation Officer ro,'(j State Historic Preservation Division

Chapter 6E-42 Historic Preservation Review- .... ~g Well Installation Permit Application for Well 1224-04 (Gerow) .. ~::J:

SUbject:

Kilauea, Hanalei, Kaua'i Island, Hawai'i ! 553 ~.; (1)';0 _T_MK __ : (.>-,4-,,-) _5-_2_-0_1_3_: _O_l1 __________________ ---:=~-i-!.g~~

:3':°fTI - x-Thank you for the opportunity to review this permit application which we received on November I ~o~ 2009. The project is for new well pump. :I ~~o

We determine that no historic properties will be affected by this project because:

~ Intensive cultivation has altered the land ~ Residential development/urbanization has altered the land o Previous grubbing/grading has altered the land o An accepted archaeological inventory survey (AIS) found no historic properties o SHPD previously reviewed this project and mitigation has been completed o Other

Please call me at (808) 692~80] 5 if you have any questions or concerns regarding this letter.

CtI :c~ Col) mJ"l"l W %:::0

-4

,-

· " - o o LINDA LINGLE

GOVERNOR OF HAWAII LAURA H. THIELEN

CHAIRPERSON

Mr. Michael Lluellen Kauai Water Well P,O. Box431 Anahola, HI 96703

Dear Mr. Lluellen:

STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES

COMMISSION ON WATER RESOURCE MANAGEMENT po. BOX 621

HONOLULU, HAWAII 96809

December 9, 2009

Pump Installation Permit Gerow Well (Well No. 1224-04)

WILLIAM D BALFOUR, JR. SUMNER ERDMAN NEAL S. FUJIWARA

CHIYOME L. FUKINO, M.D. DONNA FAY K. KIYOSAKI, P.E.

LAWRENCE H. MilKE, MD., J.D.

KEN C. KAWAHARA, P.E DEPUTY DIRECTOR

Ref: 1224-04.pip

Enclosed are two (2) originals of your approved Pump Installation Permit for the captioned welles) that authorize permanent pump installation work for your welles). As part of the Chairperson's approval, the following special conditions were added and are part of your permit under Permit Condition 14:

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.

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 copy to the Commission office 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 Charley Ice of the Commission staff at 587-0218 or toll-free at 274-3141 (Kauai), extension 70218.

Sincerely,

Enclosure

c: David Gerow USGS KauaiDWS

-. o PUMP INSTALLATION PERMIO Gerow Well, Well No. 1224-04

Note: Tllis permit sllall be prominently displayed at tile site until tile 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 Gerow Well (Well No. 1224-04) at TMK (4) 5-2-013:011 C, Kauai, subject to the Hawaii Well Construction & Pump Installation 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 (HAR).

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 49 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 sixty (60) days after completion of work (please contact staff or visit www.hawaii.gov/dlnr/cwrm/resources _permits.htm for current form).

8. The permittee, well operator, andlor 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, if relevant, any related staff submittal approved by the Commission are incorporated into this permit by reference.

10. If the HWCPIS are not followed and as a consequence water is wasted or contaminated, a lien on the property may result.

11. Any variances from the HWCPIS shall be approved by the Chairperson prior to invoking the variance.

12. 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.

13. 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.

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

Date of Approval: Expiration Date:

November 29,2009 November 29, 2011

EN, Chairperson ater 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.

Install er' s Signature: C-57, C-57a, or A License #: C-29578 Date: -------

Printed Name: Michael Lluellen Firm or Title: Kauai Water Well

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

Attachments

· -LINDA LINGLE

GOVERNOR OF HAWAII

Mr, Michael Lluellen Kauai Water Well P,O. Box 431 Anahola, HI 96703

Dear Mr. Lluellen:

o o

STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES

COMMISSION ON WATER RESOURCE MANAGEMENT P.O. BOX 621

HONOLULU, HAWAII 96809

December 9,2009

Well Construction Permit Gerow Well (Well No. 1224-04)

LAURA H. THIELEN CHAIRPERSON

WILLIAM D. BALFOUR, JR. SUMNER ERDMAN NEAL S. FUJIWARA

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

KEN C. KAWAHARA, PE DEPUTY DIRECTOR

Ref: 1224-04.wcp

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 17:

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. Also, please contact the Noise Radiation and Indoor Air Quality Branch at 586-4700 to check compliance with construction noise permit requirements for this project.

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 copy to the Commission office for our files. For copies of the aquifer pump test worksheet, please call staff or visit www.state.hi.us/dlnr/cwrmlforms.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 Charley Ice of the Commission staff at 587-0218 or toll-free at 274-3141 (Kauai), extension 70218.

Enclosures

c: David Gerow (with applicable comments - DOH SDWB, CWB) USGS KauaiDWS

- o o WELL CONSTRUCTION PERMIT

Gerow Well, Well No. 1224-04 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 Gerow Well (Well No. 1224-04) at TMK (4) 5-2-013:011 C, Kauai, 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.

16.

17

The Chai~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 (HAR).

This permit shall be prominent,ly 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 a pumping test in accordance with the HWCPIS (the latest pump test worksheet can be obtained by contacting Commission staff or at www.hawaii.gov/dlnr/cwrmlresources_permits.htm). The permittee shall submit to the Chairperson the test results as a basis for supporting an application to install a permanent pump. No permanent pump may be installed 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. If it can be shown that the well does not tap basal ground water then this condition may be waived after consultation with and acceptance by Commission staff However, in no instance can the well be drilled deeper than one-half (1/2) of the theoretical thickness without Commission approval.

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' State Historic Preservation DiVIsion. Work 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 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/cwrmlresources_permits.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, if relevant, any related staff submittal approved by the Commission are incorporated into this permit by reference.

If the HWCPIS are not/ollowed 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 prorerly 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 § 3-168-I2(t), HAR, prior to any well sealing or plugging work.

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.

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 §13-168-12(t), HAR.

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

Date of Approval: November 29, 2009 Expiration Date: November 29, 2011

EN, Chairperson ater 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-29578 ~~~~~---------

Date:

Printed Name: Michael Lluellen Firm or Title: Kauai Water Well

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

Attachment

(""j 0 ~MMISSION ON WATER RESOURCE MANAGEMENT

FROM: CHARLEY DATJf!J¥irM1T IS:~:::::"::. TO: INIT. FOR: PLEASE:

KUNIMURA,I. NAKAMA,L. NAKANO, D.

ANAKALEA, P. BAUER, G. CHING, F. DANBARA, S. FUJII, N. GOODING, K.

-3-0HYE,M. SAKODA, E.

-2-SUBIA, S. 1 HARDY, R.

HIGA,D. ICE, C. IMATA, R.

WELL NUMBER 1224-04

''6(1 WELL CONSTRUCTION

SWANSON, S. UYENO, D. YODA, K. YOSHINAGA, M.

ATTACHMENTS FOR WELL CONSTRU9TION PERMIT: 1 COVER lETTER ~ 2 PERMIT (2x) ~

COMMENTS: 3 SDWB 7-;.

~oi

Gerow

Approval Signature

-3-lnformation

:~: ;r '7/ () TO BE SENT TO APPLICANT

6 HEER I

7 lD /-r-8 HP I

9 OCCl i --10 SMA , ~ 11 WELL CHECKP~INTOUT :;z: FOR OFFICE USE ONLY

~ PUMP INSTALLA~ION !

ATTACHMENTS FOR purjnP INSTALL¥"ION PERMIT: 1 COVER lETTER / ~ 2 PERMIT (2x) j __ ./_

COMMENTS: / ?

Iw'?~ . !S = /------=====--r-

':;;.;;;' TO BE SENT TO APPLICANT

6 HEER 7 lD 8 HP 9 OCCl

10 SMA 11. GLENN'S WORKSHEET FOR OFFICE USE ONLY

See Me -1-Review & Comment

Take Action Type Draft

-2-Type Final 4 File

Xerox copies

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

Data Input

Well Number Well Name Ground Elevation Cement Grout Grouting Method Hole Diameter Total Depth Water Level Public Water Supply Well? Solid Casing Material Solid Casing Specification Solid Casing Length Solid Casing Diameter Solid Casing Wall Thickness Open Casing Length

Results

Well Depth Theoretical Thickness of Aquifer 1/4 Aquifer Thickness Depth of Well below Sea Level

Well Casing Minimum Wall Thickness

Material Minimum Thickness per standards Wall Thickness Provided

Minimum Length of Solid Casing 90% of ground to top of aquifer Length of solid casing Provided

Casing Material (for pvc only - check for 200' limit)

Annular Space Depth of Grouting

Calculated Depth of Grouting Depth of Grouting provided

Minimum Annular Space required Thickness of Annular Space

yes no

steel stainless steel

1224-04 Gerow Well

positive displacement

no pvc plastic Schedule 40

pvc plastic no requirement

Schedule 40

o

300 160

14 200 4.4 Depth to water 125

plastic

165 6

0.250 35

180.4 45.1 100 too deep Section 2.2

0.25 no standard Section 2.4(b)

112.5 165 okay Section 2.4(c)

in compliance Section 2.4(d) okay Section 2.4(d)

87.5 160 okay Section 2.6(c) 1.5

4 okay Section 2.6(d)

pvc plastic abs plastic thermoset plastic other

pvc plastic Schedule 40 Schedule 80 other

positive displacement other

steel public steel non public

steel ANSIIAWWA C200 API Spec. 5L ASTMA53 ASTMA139 ASTMA606 other

#N/A

0.28

stainless steel ASTM A409 other

pvc plastic Schedule 40 Schedule 80 other

.. NO)-23-200'jll 10: 34 From: DDWSRFE WRTER BRANH 8085864351 To:808 ,587 0219 P.l/3

LINDA ~ ING~E G.OVI::"NIJ~ at:' IoIAWA.11

TO:

RECEIVED SAFE DRINKING WATER BRANC"

NOV 'j 6 2009

STATE OF HAWAII DePARTMIiNT OF LAND AND NATURAlll(~SOURCE~;

COMMISSION ON WATER RESOURCE: MANAGEMENT PO aOXIlQ1

HONOlLllU, HAWAII 96809

November 12,2009

Honorable Chiyome L. Fukino, M.D., Director Department of Health Attention: Tomas See, Chief, Wastewater Branch

'l8tuart Yamada, Chief, Safe Drinking Water Branch Alec Wong, Chief, Clean Water Branch Dr. Keith Kawaoka, Office of Hazard Ev Juation and

LAURA H THIELEN

VVlll.lAM D BALI'OUFI, J~ SUMNER EROMAN NEAL 3. FUJIWARA

CHIYOME L FUI(INO, M.O DONNA FAY K.. KIY06AK.I. P E

LAWReNCE H. MilKE. M.D , J.D.

KJ;;N C KAWAHARA, P.E.

In General: Q - '.,1'". . I

use j,..l i \

location = /<1 ,--,1 ( ,r.: k.~~,\, I

(abovt;)(~w)UIC line grd. elev. = :~'I- r', '

well dia. well depth """

, " ' I.> .:' \' .~'.

FROM: f SUBJECT:

Laura H. Thielen, Chairperson Commission on· Water Resource Management

)t:

Well Construction/Pump Installation Pennit Appli atiOll Kalihiwai-Gerow Well (Well No. J224-04) -n.... /...-1

I ,.,J( ~ ~G·l·I!1: II 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 November 29. 2009. lfwe 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 ),OlJ have any questions about this permit application. request additional infOlmation, or request additional review time, please contact Charley Ice of the Commission staffat 587-0218.

CI:ss A ttachmen!i s)

RESPONSE: I (I C ,/': '/ : . " I ( , .. I:';" ,.(

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rh" welt Quahue~ ~~ ;; ~o ... ro. whi<:b will,"lVe as 8 .ource of p<>Lablc wlt.r to. Pllbhc W~I ••• y.t .. ", (?.tln"d~' '''IVJn!l" 2S or more peopl~ iIIle<J$t 6(l ~ .. ys per ye;JT or h~~ J ~ or mOr\! ~~N)CC COMllJ;tIOI\ll) lI\d III un reGtIVO OJT~QtQf of H~alth approval n!1!!I 10 ,ts I.tS~ 10 comply w,th Hawau Admmistratlvll Rules (liM). IIII. J I. Chl!.p\er ZO, RUles Relating 10 potable W~r Systems. jll-20-29

Th .. well doc. not qualify ., .. SQu",. swvill~ a publi~ warel sy~tCItJ ($COrve~ le~s tlIan 2j p~ople or IMre people 1l11~MI 60 Qays per year [)r 15 serv"'. oon~~II[)ns) ~nd \rth~ well water IS used for drlllluna. the pnv~t" ow,"'" 5bow(l test For b.e1eno\o8''''u lIIId c-Q"mical preooncc before Init!~I",.g sl<~h u.< 3lld ,outlooly monitor rhe water quality Ihtrt:~ft~r. Rowevcr. If future planned Us" froo:n this SO\lrQI: increases to Ineertlle public watcr system definition then Director of Health approval i~ "'<\1I1J'10 l!!iru: to IIIlpl~m~lItat1"'n.

If !t,e well IS used to supply both pqlablo .nd )lo!)'PQtabk pllfl)Oses.j< s 9 • .,gl~ ~stem, tho lI!;or ~~~II oliminatc efl)~~'wnnectl(ln~ ;md bac1,;f\ow COIllle-ClIons by phYSically ~p:.tOL!ing J)<)\.bt" <IIld MI\.potabl¢ system. by an aor g;op Dr Rn "JJprov~ back flow preVenler, ~d by cieal"ly lab:tl.ng "II non­potable SpigotS with warnIng SignA 10 p~cvcnt ilJ4.(ivenent consum~holl ()f non-potable water Baekfl.)~ preventioll devices sho~Jo:l be: roubnely Inspected and tooled.

It docs lIot appear that 11I,s writ WIll be Illl'd lor cOl)slJ!!J.ptivc PllIllOses:md IS n01 subJ"ct 10 5~fe Dri.".kt~S W~ Res"l.t,on,

Forthe applicant's Informal.otl •• ;our"c Qt'po5siblc wastewater .:;onlamm .. hon Ili~ f I j~ I)ot Jocat0d .near th~ propo."d well sU" (lIlf()t"m .. t;,," ~t!.ch.d)

An NPDES p~nmt is rcqUlr~d

Other ,etev~nt DOH ",le.I,,,gulllho~~, mfonnatu.\n. or rccclI1Imcnd"tlons II'" Qtt~"h~()

111110" cV~I\llh"t the loo~hon "fthe well .:lIangcs but" .hll willll!) the par<;!ll de=ibed on 11m applj~:I\IQn. "ur dlYision con$ldeq th. co"'m~nts \0 ~tlll be applicable. and we do not n~cd 10 r<vlew the now loc~JQ!).

No comtll~n(~/obJl;:<;tlQ!lS

Contact Person: M~ MttJ:JJ~ Signed: . ./fAA ~ _ ;;.*::::-K'--__... ....

Phone:

Date~

$Bi.- 42d8 f/ IJ .., '":J I.ve.

-HIJU-23-2009" 10: 34 From: DlJWSRFE WRTFR BRRHH 8085864351 To:80P,587 0219

CWRM ARplication Source: Kalihiwai-Gerow Well (Well No. 1224-04) TMK: (4) 5-2-013: 011

§.afe Drinking Water Branch (SDWB) - Engineering Section

No comments. See attached private well information.

SOWS Underground Injection Control (Ule) Section

• Well water quality should be initially and periodically tested for it's acceptable and intended use, especially if for human consumption. Water quality should not be presumed acceptable and unchanging. Land-based activities around the well and within the well's recharge area may, over time, have an unacceptable effect on the well's water quality. Well construction materials and related equipment could also affect water quality.

CWRM Well Application Standard Comments (SDWB) Verso 418108

tiQl)-23-200~ 10:~4 From: DOWSAFE WATER BRANH B085864351 To:808 587 0219

,

WARNING! As the owner of a privately-owned well, you should N.QT assume that water from your weills Safe for consumption. It is your responsibility to make sure that your well water is safe to drink. The only way to do this is to have your well regularly tested for bacteriological and chemical contaminants.

There are no regulations controlling water quality in private walls serving individual residences as there are for public water systems (public or privately owned utilities supplying water to 25 or more people or 15 service connections). In other words, there are no enforceable limits for contaminants and no requirements for regular testing. Private wells are often found in rural areas, where many activities suoh as onsite wastewater disposal can contaminate the ground water.

U.S. ENVIRONMEfllJAL PROTECTION ACE!':ICY (EPA) RECOMMENDATIONS

The EPA recommends that private well owners test their well water each year for such contaminants as Total Coliform Bacteria, Nitrates, as well as any other conta,minants that may be of concern in your area. More frequent testing may be appropriate if you suspect a problem. EPA also suggests that you consider testing for pesticides, organic chemicals, and heavy metals before using it for the first time. Please refer to the EPA website on Private Drinking water Wells at http;/I'NWW.epa,gov/safewater/Qrivatewell§/faq.html

OTHER CONTAMINANTS

Water testing can be very expensive. It is important that you spend time to identify what other potential contaminants may be of concern. Please refer to the EPA website on Private Drinking Water Wens at http://vyww.epa.gQv/sa1ewS\ttrJprivatewells/whatyoucando.lJtml for more helpful information. Ba aware of what and how you use and dispose of household and garden chemicals. Also determine the location of nearby septic tanks or cesspools, and agriGultural or industrial activities in tl'le area. General Information on known chemical contamination of ground water in Hawaii can also be found at the DOH website www.hawaij,gQv/health/environmentallwater/sd'£l{blconmaps/pdfLconmap§Q5.Q.Qf

LABORATORIES

Local commercial laboratories can be found in the yellow pages of the telephone book under "Laboratories, Analytical. ~ Whenever possiDle, utilize a laboratory that is certified or approved for me specific drinking water tests and carefully follOW their instructions for collecting, storing, and transporting the samples. Just be sure to ask the lab to use EPA approved methods for drinking water analysis. A list of labs certified or approved by the Department of Health can be found at www.hawaiLgovlhealth/environmental/ylaterlsdwb/sdwb/pdftTestjng%20babs.Odf.As lab certification status changes constantly, confirm their status when you contact the Ia.b. Please note that the list is limited to currently regulated contaminants ill public water systems.

RESYLTS

Once the lab provides you with the test results. you will be in a better position to determine jf your well water is safe to drink or what contaminant you need to treat for. Generally, you should compare the results with Federal (www,epa.gov/safewater/mcl.btml) and State (www.hawaij,gov/health/environmeotal/waterlsdwb/sdwb/pdVState'%20MCLpdf) drinking water standards, Where your test results are greater than the State or Federal ma><imum contaminant fevels, your well water should be considered as unsafe for consumption.

P.]/3

LINDA LINGLE GOVERNOR OF HAWAII

TO:

FROM: f SUBJECT:

o o

STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES

COMMISSION ON WATER RESOURCE MANAGEMENT PO BOX621

HONOLULU, HAWAII 96809

November 12,2009

Honorable Chiyome L. Fukino, M.D., Director Department pf Health Attention: JTomas See, Chief, Wastewater Branch

Stuart Yamada, Chief, Safe Drinking Water Branch Alec Wong, Chief, Clean Water Branch Dr. Keith Kawaoka, Office of Hazard Ev. luation and

Laura H. Thielen, Chairperson Commission on Water Resource Management

Well Construction/Pump Installation Permit Appli Kalihiwai-Gerow Well (Well No. 1224-04)

LAURA H. THIELEN CHAIRPERSON

WILLIAM D. BALFOUR, JR. 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

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 November 29,2009. Ifwe 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 Charley Ice of the Commission staff at 587-0218.

CI:ss Attachment(s)

RESPONSE:

[ 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.

)( [ I

For the applicant's information, a source of possible wastewater contamination ~s [ 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. One-Stop database screen

[ I In the event that the location ofthe 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

C t t P Lori Vatter, on ac~[~:m~_

signed:LJ\A1r)_~-=." _~--=---.:,-----_,,--=-----__ • _on __ ~ __ ----"-_ .::r.~. on Kauai 241-3323

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HllV3H jO IN3rilbVd30

tic Tank - Permit # 20588 / File # 3704

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Pe""it ID, 20588 IWS Type,

Legacy Fileii', 3704 Island,

eHawaii ID, N/ A

VarianceID'rl-----.

Status,

~===c==~,=,==~==-,~,===;

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I Pro ject Info rmatio n 1------------------------------------. Engineer:

,------------------------~'I GW L Eas.ie M Miller ~ t;~

TMK: 1452013011 •

Street Address: 14526 KUAWA RD, (UNIT C)

street Address 2:

Suite / Apt.:

City: I~~=IL=A=U=EA====~------------~I.HI Zip Code,

I Payment Information 1

Assigned To, l:r ... ~~_~":'!!J_"e __________ _ v'

Source, WWB

Description,~1 __________________________ ~I

I Review Information

Submit Date, 13/1/2000

Reviewed, 13/14/2000 H,m.!M plan Approved, 13/14/2000 Hu.].jM No Final Approval Lt.-: Hu.].jM Inspection Date, 17/26/2000

Final Approval: 17/16/2001 1'1·111. Te""ination Date, I,m.!.

Payment Type: c===-~

Check Date: Check Number: ~I ==============~

Payor: 1

Amount: L:IO:.-_____ ----l

"·IHfii,,@n, ."MII,". 'mB.UBI" -Added By, phsieh 2/26{2007 10:52 AM Last Modified:

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TMK/Street Search "J Find TMK/Street

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Cesspool Cards ~ Find Cesspool

CWDA Zones jJ Find CWDA Zone

Search ' .. ~ Bookmarks· r Settings· t2I Mail • G Address Book • _ Calendar • ~ Notepad •

BPA Complaints • WWTP , Variance tiLand Use • Sludge e Reports ~ My P .... file

E3 General IiJ IWS System .. Q Documents ! ji;l BPA 'B Notes

Site Information

I Property Owner

First Name: IOAVID/CAROLL

Last Name, GEROW

Street Address,

Street Address 2: ~===============~

Suite! Apt#:

City:

State,

Zip Code:

Email Address:

Use Project Address,

Added By, phsieh 2/26/2007 10:52 AM Last Modified,

I Dwelling Information I Lot Size (sq ft.),

CPR Lot,

Dwelling Type, .. Existing IWS,

# of Existing IWS,

Other Wastewater Bldgs,

Total Bedrooms, ~~-;--=--==-= __ ~J Designed Flow Rate (gpd), ~ll:2:5:0=====:::, __ .... _ .. __ .. _ .. ___ , Building Type,

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cesspool Cards ,J Find Cesspool Card

CWDA Zones jJ Find CWDA Zone

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BPA Enforcement I Complaints • WWTP 'variance ~LandUSe • Sludge e Reports

Eid General : ~ Site Info g Documents :il BPA : {3 Notes

IWS System Information

ISeptic Tank Informationl---------------------------------------,

Septic Tank uQuid Volume: LI ______ -'I gallons

ti" Inspection Port(s) tn grade: [CJ Manhole openings brought tn grade: [CJ Remarks:

Manufacturer:

Disposal Type: Trench

I Soil Profile Information 1----------------------------------, Percolation Rate: ~ Minimum Soil Absorption: 210 SQ. ft./bd

Total Min. Soil Absorp. Required: 840 sq. ft.

Total Soil Absorp. Pro .... ided: 0 sq. ft.

3' Groundwater Setback: [CJ

ISoil Absorption Informationl------------------------------------,

Soil Abso."tion Bed Soil Absorption Trenches

Length: Length: Oft

Width: Width: Oft

3' Soil Replacement: [C] # of Trenches: 0 3' Soil Replacement: [CJ

Seepage Pit

Diameter: 0 ft Depth: 0 ft

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Access Opening: 0 inches

Covel' Diameter: 0 ft

ti" Inspection Port: [CJ

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LINDA LINGLE GOVERNOR OF HAWAII lAICfi:~~'o~ LAU~!'~;E!~~~LEN

WILLIAM D. BALFOUR, JR. SUMNER ERDMAN N~ S. FUJIWARA

•• I' A ft:Hlc q l. FUKINO, M.D. l!!II!5'N~ Y K. KIYOSAKI, PE LAWRENCE H MilKE, MD, J.D.

STATE OF HAWAII: .' DEPUTY DIRECTOR WEPt Of~tlFHD ~N C. KAWAHARA, PE

DEPARTMENT OF LAND AND NATURAL RESOURC~ . L COMMISSION ON WATER RESOURCE MA~AGE. OF H IA I ..

TO:

FROM:

SUBJECT:

P.O. BOX 621 .Ie' . , HONOLULU, HAWAII 96809 .

November 12,2009

Morris Atta, Administrator

Land Division f t L Ken C. Kawahara, P.E., Deputy Director t2 ~ Commission on Water Resource Management

Well Construction/Pump Installation Permit App ication Kalihiwai-Gerow Well (Well No. 1224-04) TMK 5-2-013:011 C

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 November 29, 2009. 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 Charley Ice of the Commission staffat 587-0218.

CI:ss Attachment( s)

RESPONSE:

i :z o <

[ ] A water lease/pennit is required of this applicant and an application for such will be requested by our-t division. -0

X rxx A water lease/pennit is not required of this applicant. ~

:::0 Me:") (J')C>

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A water lease/pennit has been obtained by the applicant through lease no. _________ 0 __ .... ,

Other relevant Land Division rules/regulations, infonnation, or recommendations are attached.

No objections

Other comments: Ori~inal source of private title is Grant 2896 issued prior to statehood.

Contact Person: ------'G\3,6e-1rf-'J) ...... t -l'M'I<"6I-fr'+t,+i-HR-------- Phone: 587-0421 -"""'-"'-'------'<-'-=-'---

.L~ signed:_--I-~'---=----'------I'----'-~--=---=-~~I-------------- Date: NOV 7 2009

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• 03YI303R MOl2tYIO OMAJ

riGA rlWlt.

J OMAJ 10 JG]O e3:Jaf023R JAAUTAM

IIA.AH iO 3TATZ

LlNDA LINGLE GOVERNOR OF HAWAII

Date:

To:

Attn:

From:

Subject:

o RECEIV~Q~JJilNAALA FUKINO, M.D.

COMMISSION ON WM~f!tOROFHEALTH RESOllRCE l~t\~lp-.GEMENT

STATE OF HAWAII DEPARTMENT OF HEALTH

• NOV 19 P" I: 53

P.O. BOX 3378

HONOLULU, HAWAII 96801

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

cJwAvy let Ph 586-4294 Fax 586-4300

In reply, please refer to: EMD/WB

Lori Morikami, Planner Planning & Design Section Email: [email protected] water commission route.wpd sam as of 06-21-2007

Well Construction/Pump Installation Permit:/.Water Use Permit for

Well No" / ;).)-'-/-- olf p1;/7t"flH<-t"- (':u~ Well No. __________________ _

Well No. __________________ _

Well No. ___________________ _

Please find enclosed the application of the above subject project.

STATE MESSENGER DELIVERY

Mr. Clifford Lum Manager and Chief Engineer Board of Water Supply City and County of Honolulu 630 South Beretania Street Honolulu, Hawaii 96843

Dear Mr. Lum:

April 29, 2008

C&C of Honolulu \A:\1331-31LTR1.wpd mkam \Q:\ ... 1331-31 L TR1.wpd

Subject: Drinking Water Treatment Revolving Loan Fund (DWTRLF) Interim Loan Agreement Project No. DW331-0031 Oahu Ave and Huelani Drive 8-inch Mains

We are pleased to offer the Board of Water Supply, City and County of Honolulu (BOARD), a DWTRLF loan for $1,473,527 to finance the subject project.

Please sign and return all four sets (original and three copies) of the enclosed DWTRLF Interim Loan Agreement to our Safe Drinking Water Branch, Attention: Marvin Kam, 919 Ala Moana Blvd., Suite 308, Honolulu, Hawaii 96814. A fully executed agreement will be returned to your office by certified mail.

We intend to replace this DWTRLF Interim Loan Agreement with a Final Loan Agreement, after the BOARD complies with the conditions in sections 8.f and 12.c.

If there are any questions, please contact Marvin Kam at (808) 586-4294.

Sincerely,

THOMAS E. ARIZUMI, P.E., CHIEF Environmental Management Division

MK:cle

Enclosures: Interim Loan Agreement (Original and three copies)

c: Safe Drinking Water Branch Jennifer Nikaido, SDWB Alain Carey, SDWB

Dec, 1, 2009 1:15PM DOH-HEER OFFICE 808-586-7537 No,4163 p, 2

~~.

LINDA LINGLE (;ClV~I'(N()A of tlAWAI! REC£/VED

PARTMENT OF HEALTH

LAURA Ii. THIELEN CK/oIRJlEPtJjClN

TO:

9 NOV 18 P I: 4lt I

STATE OF HAWAII HEER OFFICE OEPARTMI;:NT OF LAND AND NA rORAL RESOURCES

COMMISSION ON WATER RESOURCE MANAGEMENT P.o. /!Ox 521

HONOLULU, HAWAII 9.609

November 12, 2009

Honorable Chiyome L. Fukino, M.D., Director Department of Health Attention: Tomas See, Chief, Wastewater Branch

Stuart Yamada, Chief, Safe Drinking Water Branch

WILLIAM D. BAlfOuR, JR. SUMNER "ROMAN NEAL S. FUJI'NARA

CtllYOME L fUKlNQ, M.O. OONNI\. FAY K KlYOSAI<!, p,e:. LAWRENCE H. MilKE, M.D., J.D.

Kf:N C. KAWAHARA, PE. DeruTV trIRE~TCR

Alec Wong, Chief, Clean Water Branch ~r. Keith Kawaoka, Office of Hazard Ey, Iuation and mergency Response

FROM: W Laura H. Thielen, Chairperson l' Commission on Water Resource Management ~

SUBJECT: Well Construction/Pump Installation Permit Appl' ation Kalihiwai-Gerow Well (Well No. 1224~04)

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

We would appreciate your comments On the captioned applicatioll for any conflicts or inconsistencies with the programs, plans, and objectives specific to your department. Please respond by returning this cover memo form by November 29.2009. 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 we·ll. If you have any questions about this permit application, request additional information, or request additional review time, please contact Charley Ice of the Commissiorl staff at 587-0218.

CI:ss Attachrnent( s)

RESPONSE: ( 1

( 1

( 1

[ )

{ 1

[ 1

( 1

[ 1

l'hi~ ",oil Ijl1lllifios <s. sour,e whioh will serve as a sou(~ "fpotsble Wllt~, to. public w~ter system (defmed III serving 25 or more people at I.ast 60 days per year or hI!.! 15 or morl! ulVioa ~nn.CJlQns) Md m.st rec:ive Direclor of Heallh approval prior to il$ u~e Ul comply with fiawRii Adminislralive Rul •• (HAll), lill" II, Ch,pter 20. Rulel Relaling 10 Potabl~ Walu Sy$lefM, §11.20.29,

This w(lil dol'S not qUlLlify 8! a Bource seMng a )lublic ,vatet syStem (SOTVOS iC5S Ih~n 25 people or more people alloall 60 days pet year or 15 servi~e cOnfleClioM) and if the \vell Willer is us~ for dnnking, Ihe privale oWller ihould tul for bacteriol02ic~1 an.:! ch.mical presence before initialing such U$I!

ami routinely monitor the water 'lualiLy 1hofeafiar. HOwever, if fuillrc pUnned IlSC from this Source increa~es to .Yleet Ihe public ",.Ier s~l.m ddinilion Ihtlll Directol· of Health approVal1S required n.Wu: to implemenlation.

If the well i~ '(ls~d (0 .s~pply bOlh I?0table Bnd nCI1·polabl~ pl.Iq)OSeS ill & si))gle .system. Ihellser shIll ~lilninale Clols-connectioJlS and bacJdl"w connectlDna by phYSically, !epatatitll! pot,ble ":"'i non·polable sY21el!ls by lin IUr gal? or an approved backtlow prevenler~ ~Qd by olearly labeling ~ll non­p(ll.bl~ $pll!(ll~ IYlth wllrmng signs to prevenIIAadvCl'tllt'l1 l:,mSl1mpltOfl ofll(ln·F')I"bl~ IYRter, l!R(>kftow prevenllon deVices shollid be fQUlmely In$pe(){cd and Icsled.

II doel not 21lpear Ihallhis well will b.l1~ed for consumplive purposes aJ1d is nOI subjecL to S~fe D(inking Wa, .. RegulIIIQDS.

For Ihe applicant's information, a SOUte" ofp,.,.,ible Wilsl~wlter cllntarninRlion lIb I ) Ii nOI localed Ileanhe proposed woll sII. (inform lilian attached).

/VI NPDES Ilennit is required.

Olber relevanl DOH f"les/t.g\lI~liQn$. inrt'nnBlion. or recommendalion~ we attached.

In Ihe evenllhBI the localion oflhe.well change. bill il .till \'Iilhin Ihe PJI\O~I desoribed oilihil applicalion, our division (;On~ideH th. COlT/men Is to still be applj~bl~, and we do nat n •• d to r~vi~w the new localion.

~ No ~mm~nt&lobjllCtioM n Contact person»k4 ~l ""',( Phone: -Sf' ···cy[?

.~ / / ~ ",,""'~ ..... . "I' If /J

LINDA LINGLE GOVERNOR OF HAWAII

Mr. Michael Lluellen Kauai Water Well P.O. Box431 Anahola, HI 96703

Dear Mr. Lluellen:

c o

STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES

COMMISSION ON WATER RESOURCE MANAGEMENT P.O. BOX 621

HONOLULU, HAWAII 96809

November 12,2009

LAURA H. THIELEN CHAIRPERSON

WILLIAM D. BALFOUR, JR. 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. OEPUTY DIRECTOR

1224-04. wcpia.acc

Well ConstructionlPump Installation Permit Application for Well No. 1224-04

We acknowledge receipt, on August 31, 2009, of your completed Well ConstructionlPump Installation permit application and filing fee for the Kalihiwai-Gerow Well (Well No. 1224-04). 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 Charley Ice of the Commission staff at 587-0218 or toll-free at 274-3141 (Kauai), extension 70218.

CI:ss Attachment

c: David Gerow

Sincerely,

o o LINDA LINGLE

GOVERNOR OF HAWAII LAURA H. THIELEN

CHAIRPERSON

TO:

STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES

COMMISSION ON WATER RESOURCE MANAGEMENT P.O. BOX 621

HONOLULU, HAWAII 96809

November 12,2009

Honorable Chiyome L. Fukino, M.D., Director Department of Health . Attention: Tomas See, Chief, Wastewater Branch

Stuart Yamada, Chief, Safe Drinking Water Branch Alec Wong, Chief, Clean Water Branch

WILLIAM D. BALFOUR, JR. 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

Dr. Keith Kawaoka, Office of Hazard Ev: luation and mergency Response

FROM: -f SUBJECT:

Laura H. Thielen, Chairperson Commission on Water Resource Management

Well Construction/Pump Installation Permit Appli

~-

KaIihiwai-Gerow Well (Well No. 1224-04)

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 November 29, 2009. Ifwe 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 Charley Ice of the Commission staffat 587-0218.

Cl:ss Attachment( s)

RESPONSE:

[ 1

[ 1

[ 1

[ 1

[ 1

[ 1

[ 1 [ 1

[ 1

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 I I, 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 [ 1 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:

c o

STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES

COMMISSION ON WATER RESOURCE MANAGEMENT po. BOX 621

HONOLULU, HAWAII 96809

November 12,2009

Morris Atta, Administrator

Land Division f f L Ken C. Kawahara, P.E., Deputy Director tl ~ Commission on Water Resource Management

Well Construction/Pump Installation Permit App ication Kalihiwai-Gerow Well (Well No. 1224-04) TMK 5-2-013:011 C

LAURA H. THIELEN CHAIRPERSON

WILLIAM D. BALFOUR, JR. 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

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 November 29, 2009. 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 Charley Ice of the Commission staff at 587-0218.

CI: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

November 12,2009

Dr. Puaalaokalani Aiu, Administrator Historic Preservation

Ken C. Kawahara, P.E., Deputy Director Commission on Water Resource Management

Well Construction/Pump Installation Permit Ap Kalihiwai-Gerow Well (Well No. 1224-04) T

LAURA H. THIELEN CHAIRPERSON

WILLIAM D. BALFOUR, JR. SUMNER ERDMAN NEAL S. FUJIWARA

CHIYOME L. FUKINO, M.D. DONNA FAY K. KIYOSAKI, PE. 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 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 November 29, 2009. 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 or request additional review time, please contact Charley Ice of the Commission staff at 587-0218. 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.

CI: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: --------

LINDA LINGLE GOVERNOR OF HAWAII

Mr. Ian Costa, Director Planning Department County of Kauai

o o

STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES

COMMISSION ON WATER RESOURCE MANAGEMENT P.O. BOX 621

HONOLULU, HAWAII 96809

November 12,2009

4444 Rice Street, Ste. A473 Lihue, Hawaii 96766

Dear Mr. Costa:

Special Management Area Use Permit Requirements for Well Construction/Pump Installation Permit Application

Kalihiwai-Gerow Well (Well No. 1224-04)

LAURA H. THIELEN CHAIRPERSON

WILLIAM D. BALFOUR, JR. SUMNER ERDMAN NEAL S. FUJIWARA

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

KEN C. KAWAHARA, PE. DEPUTY 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 SMA permitting requirements specific to your division. Please respond by returning this cover memo form by November 29,2009. 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 Charley Ice of the Commission staff at 587-0218.

CI:ss

RESPONSE:

~Sincerel~.~aL

(l; L IJRA H. T IELEN '1. . C alrperson

[ ] 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: --------

CO'U~ION ON WATER RESOURCE MANAGEMENT 0 ROUTE SLIP FOR NEW APPLICATIONS

FROM: CHARLEY DATE: 14-Aug-09 SUSPENSE DATE: -----------------INIT. TO:

'\-~ .z, ')- \\]\ c CHING, F. __ ( __ KUNIMURA, I. FUJII, N. NAKAMA, L. ...:.,......,..J. i GOODING, K. ;;;;7'.: --4- OHYE, M. \j

-1-HARDY, R. SAKODA, E.

Approval 3 Signature 4 Information

HIGA, D. SWANSON, S. -2-HOAGBIN, S. UYENO, D.

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

-3-KAWAHARA,K.==

WELL NUMBER 12-24-,.-oif

~ WELL CONSTRUCTION

WELL NAME Gerow

~ PUMP INSTALLATION

ATTACHMENTS FOR APPLICATION PROCESSING - Both applicant & staff generated 1 TRANS. LEITER

2 PERMIT PROCESS TABLE

3 CWRMMAP

4 APPL. FORM (11 COPIES)

5 USGS MAPS (11 COPIES)

6 TAX MAPS (11 COPIES)

7 PARCEL OWNER VERIF.

8 CONTRACTOR VERIF.

9 ALL INFO FILLED IN

j~

~~~ilvWJ>..L ----'- MLS PRINroUT ---L- DCCA LICENSE SCREEN PRINTOUT

21-Aug-09

PLEASE:

See Me -1-Review & Comment

Take Action Type Draft acknow letter

-2-Type Final, label file folder, update People.db -5-File

Xerox copies

WUP Number na

D WUPA

10 BACKGROUND CHECK

11 $25 FEE DEPOSIT SLIP

12 DHP/CDUP/SMA pre-screen (SMA map 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: D D

MADE NEW FILE FOLDER, ATTACHED FILE FOLDER ALREADY MADE, IN FILE CABINET

INCOMPLETE ACTION DATES:

DATE ACTION

tU O!J ft> ~VU-tJw-e P -·2 (wtll tl{(~_j~~ J '~(AM~' ~ ~(te/ ~ J

rl0...r0 -,?o~ \M ~ M~ Y.o.se., tMvJ <M~~J...Ak.

o ..... -q

STATE OF HAWAII cfJ'n"ff&'l:F JIVian~r R~ DEPARTMENT OF LAND AND NATURAL RESOURCES I [~~lwrON W TER

) COMMISSION ON WATER RESOURCE MANAGEMENT SOURCI:. MANAGEMENT APPLICATION FOR A WELL CONSTRUCTION I .. II AUG 13 AH 9:38 PUMP INSTALLATION PERMIT .

Instructions: Please print in ink or type and send completed application with attachments to the Commission on Water Resource Management, P.O. Box 621, Honolulu, Hawaii 96809. Application must be accompanied by 10 copies and a non-refundable filing fee of $25.00 payable to the Dept. of Land and Natural Resources. The Commission may not accept incomplete applications. For assistance, call the Regulation Branch at 587-0225. For further information and updates to this application form, visit http://www.hawaii.gov/dlnr/cwrm.

WELL LOCATION INFORMATION 1. STATE WELL NO. (if already assigned) ./2. WELL NAME 3. ISLAND J 4. TMK s-- .-£ - ots Ol/-€.. kAI/II , :

zone sec plat parcel

The following must be attached before this application is accepted as complete: • Portion of 7.5-Minute Series USGS tOPOgrephic map (scale 1 :24,000) with welilocelion labeled and indude the name of the quad map • Property tax map, showing well location referenced to established property boundaries • Photogreph of the proposed weD site • A schematic diagram showing the well site, acoess ~ and proposed wellinfrestructure • For dug wells, attach a grading plan with cross section profiles showing exisling and finish grades

5. WELL OPERATOR'S NAME/COMPANY I Well Operator's Contact 6. LANDOWNER'S NAME/COMPANY I Landowner's Contact o f\.U 10 <Ell=. "Y(.i){..J S A\A-tiZ g ~~)O(,S- J" ./IflA~ r J. « .) C(.,. S'"

Well Operator's Mailing Address Cj<; 7~<r

landowner'S Mailing Address

4');).~ Jc:.,.u/,lW 13 jl.O Jr.1 '-iOlJ~1\ I~l 5 ~Mt: , Well Operator's Phone I Well Operator's Fax I Well Operator's E-mail Landowner's Phone I Landowner's Fax I Landowner's E-mail r)..~ .lO(..,.} ~;)..3 ICj,.;,< 5o~.fL.

PROPOSED WELL CONSTRUCTION PROPOSED PUMP INSTALLATION 7. Proposed Work 8. Construction Type 10. Proposed Work 11. PrQPosed Pumping Rate, gpm 13. Method of flow measurement ;l1' Construct New Well A'1 Drilled ...e1lnstall New Pump (gallons per minute) . .0 Flowmeter o Modify Existing Well o Dug o Replace Pump W'f?//41 o Other (explain) o Abandon/Seal Well o Shaft

12. Proposed Amount of o Tunnel Withdrawal, gpd (gallons per day)

9. Is this well part of a battery of wells? 0 Yes 1\ No 20Cb 14. Proposed Surveyor name and license number (a surveyor Is required for all Well Construction Permits and may be required for some Pump

Installation Permits) 1?LS p~~ PROPOSED USE

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

o 16. Domestic Number of units to be served: 1 o 17. Industrial (describe)

o 18. lnigation (describe crop and no. of acres)

o 19. Military (describe)

o 20. Other (describe)

OTHER LEGAL REQUIREMENTS If required, items 21. and 22. must be obtained before the Commission can legally issue a permit: 21. Conservation District Use Permit (COUP) o Well is in Conservation District

o Required, COUP. date approved o Not Required (attach documentation from OCCL) o I have not checked with OCCL about whether or not a COUP is required. I understand that checking with OCCL prior to making this

application will expedite my review. I further understand that issues raised by this agency may delay or result in denial of the permit Issuance, or revocation ofthe permit after it is issued.

o Well is not in Conservation District .2J I have not checked if well is in or out of Conservation District. I understand that checking if the well is in a Conservation District may expedite my

review. I further understand that issues raised may delay or resuH In denial of the permit issuance, or revocation of the permit after it is issued. 22. Special Management Area Permit (SMAP) o Required, SMA. date approved ~ot Required (attach documentation from applicable County agency)

I have not checked with the county about whether or not an SMA Permit is required. I understand that checking with the County prior to making this application may expedite my review. I further understand that issues raised by this agency may delay or result in denial of the permit issuance, or revocation of the permit after it is issued.

23. State Historic Preservation Division (SHPD) of the Department of Land and Natural Resources o I have consulted with the HPD regarding potential impacts of well construction activities on historic sites. I have attached applicable documentation

from the HPD. )lJ I have not consulted with the HPD regarding potential impacts of well construction activities on historic sites. I understand that checking with the HPD

prior to making this application may expedite my review. I further understand that issues raised by this agency may delay or result in denial of the permit issuance, or revocation of the permit after it is issued. Additionally, the histo'!y of past land use Is attached.

24. Water Use Permit No. (if applicable):

Additional remarks, explanations, etc. (attach additional sheet if more space is needed)

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 permit 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 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 work done while the ~ermit is in su~nslon may result in fines of up to $5000/day. 25, WELL DRILLER (Must be Jd out if application is for Well Construction) 26. PUMP INSTALLER (Must be filled out if application is for Pump Installation)

~Ih vi Ih-Pv£ . JIIL/ / ( - Zft. S-7 fj' /LAu~ (d~ lJ f3-' / c - 2..9 FZ-Jr LicaM~ame C-57 License No. License~ ..,. C-57/C-5:alA License No.

~II:;#.J t.u~l/hJ "7-Z/-o7 (!L l/tu"ht-i fNA/!rtf/'1:-LI -OJ Signatul'e rint Date ignature Print • Date

1:J::> :box l{j I /kAf~/.j., ?c -:.ro 3 'fb~'&x 15L 11.mdlA- I Ii 16 7-tJ;> Address Address )

B08 -r;fl-f'I(-.r LLt.lItLL i0/!(jl9tJ[. ~'1 tidJ .t/6,'/-'!Ii;s-Phone Fax E-mail Phone Fax E-mail

WCPI Application Form 0512012009

o o flECEIVEO

CQMN1SSfoN Of4 WATER RE;;,OURCE "fMMGEMENT

2. AUG 3' All '0: " PROPOSED WELL SECTION (Please attach schematic if different from diagram provided below)

Hole Diameter: j "= in.

Elevation at top of casing ~ ft., mSI·l

_ r Minimum of 2' Radius & 4" Thick Concrete Pad (to contain benchma surveyed to nearest 0.01 ft.)

~ '0:H r Ground Elevation: ~O ft.,msl· 0' :'=4', ' .. "' .. ~' ,',<lII, "°llo_,

Z~\ ,,,,.- ."' .. '11M" </1&"

:.:: .. .... :/': .. Please refer to the L ~Oft. Cement Grout: ~'-: v'.

BA WAll WELL CONSTRUCTION AND (min. 70% of distance from :. ~. :: :: ground elevation to top of

.~. '.: 4.,· PllMl INI:!TA~~A TION STANDARDI:! .:: ;. ::';' water surface or 500 ft., .;.: .. t.:· to ensure that your as-built is in compliance with .... :. :~: . applicable standards . whichever is less.) ...... :

:-.::' ".::', . '. v'.

Annular space between hole :·t· :.f" if.---- Solid Casing: (:1: 90% x (Ground Elev.-Water level Elev» Grouting method: '~.:.: i~··~. and casing (1.5" for,positive

.21 Positive -.:t>"

Total length: I&;'2' ft. displacement, 3" for other ';.!'

~:~:: ± displacement methods): :.-:: '!>., Nominal Diameter: ~ In.

/ ' .' o Other

3.-ln.

:.r. •.. ...... .' . Wall Thickness: In. ",',4 .... 4

- :. ~. ~% :: :: .. ' Bottom 8evation: fl., msl· ~'.-: ./I.,'

Rock or Gravel Packing: - I-- ~:

I I Total Depth I/o ft. ----, Open Casing: ,t! Perforated o Screen 2oClft. Material: 35" o Crushed Basalt Total length: ft.

~ Nominal Diameter: ~ in. o Rounded Gravel Pog

u Wall Thickness: _y. in. Estimated Water level '1 1- Bottom Elevation: LaO ft., msl* Elevation: note: Neither bentonite nor mud should be used in i 'l.. ~ ft. msl·

-~ :--saturated zone during drilling

op~e: lengt~ ft.

Diameter: --------- in.

- Bottom Elevation: ~ .• msl*

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

For non-salt water Basal Wells - bottom elevation ofweH should not be deeper than 1/4 of aquifer thickness or,

Bottom Elevation of Well limit = (water Elevation _ 41 x Water Let E1eyatjon )

Example: Estimated + 2 ft. Water Level Elev. - Bottom Elevation of Well LImit = ( 2 - ~) = -18.5 ft.

Solid Casing Material: Carbon Steel: compliant with (check one or more): 0 ANSIIA'MNA C200 0 API Spec. 5l 0 ASTM A53 0 ASTM A 139

And compliant with (check one or more): 0 ASTM A242 (or AS06) 0 Type E 0 Type S 0 Grade B 0 Other

Stain .... Steel: (check one): 0 ASTM A409 (production wells) 0 ASTM A312 (monitor wells)

ABS Pla.tlc: conforming to ASTM F480 and ASTM 01527: (check one) 0 Schedule 40 0 Schedule 80

PVC PI •• tlc conforming to ASTM F480 and (ASTM 01785 or ASTM 02241): (check one): # Schedule 40 0 Schedule 80 0 Schedule 120

Thermo.et 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 A'MNA 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 ANSIIA'MNA C200 0 API Spec. 5l 0 ASTM A53 0 ASTM A139

And compliant with (check one or more): 0 ASTM A242 (or A606) 0 Type E 0 Type 5 0 Grade B 0 Other

Stalnle •• Steel: (check one): 0 ASTM M09 (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 PI •• tlc conforming to ASTM F480 and (ASTM 01785 or ASTM 02241): (check one): ~ Schedule 40 0 Schedule 80 0 Schedule 120

Thermoset Pla.tlc: (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 A'MNA C950

o PTFE Fluorocarbon Tubing conforming to ASTM 03296

o FEP Fluorocarbon Tubing conforming to ASTM 03296

rk

WCPI Application Form 0512012009

WOODSIDE ACRES 4530 Kuawa Road ~ TMK: 5~2-013-{)11

. (corner of Kuhio IhW Er Kuawa Ra~ Kilauea)

~.

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\

I? ... ·H c,oMMON ,6..ccess And uri LlI4 E.L.EI1E.N1

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\ ----;;;;-a;)Ifl'IOS ···----:;;"'.-'i=.-:.I,8

o /

LINDA LINGLE LAURA H. THIELEN GOVERNOR OF HAWAII CHAIRPERSON

WILLIAM D. BALFOUR, JR.

Mr. Michael Lluellen Kauai Water Well P.O. Box 431 Anahola, HI 96708

Dear Mr. Lluellen:

STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES

COMMISSION ON WATER RESOURCE MANAGEMENT P.O. BOX 621

HONOLULU, HAWAII 96809

September 23,2009

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

1224-04, wcpia, ack

Well Construction/Pump Installation Penn it Application for Well No. 1224-04

We have received your Well ConstructionlPump Installation pennit application and filing fee for the Kalihiwai-Gerow Well (Well No. 1224-04). We had sent you a notice on August 17,2009, by email, that page 2 of the application needed to be filled in, but have not received a response. The application is incomplete. Matters which must be addressed before we accept your application as complete are as follows:

1. Please complete page 2 of your application fonn.

Upon receipt of the above infonnation, we will accept your application as complete and you can then expect your application to be processed within ninety (90) days.

By this acknowledgment 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 pennitted pump capacity described on the pump installation penn it 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 detennined 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 pennit application, please contact Charley Ice of the Commission staff at 587-0218 or toll-free at 274-3141 (Kauai), extension 70218.

CI:ss Attachment

c: David Gerow

Sincerely,

1f:!.~~';; If;~~})lrector

o

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

Hole ~iameter: i if;.. in.

Elevation at top of casing ~ ft., msl* l_ r I ~ Minimum of 2' Radius & 4" Thick Conaete Pad (to contain benchmark surveyed to nearest 0.01 ft.)

0 q iXN r Ground Elevation: ~O ft., msl* ••• 'fI • . :4

1""" ~.~:~; ." .. 'I""" 1/"""\ ....

Please refer to the • ,4.' L ~Dft. Cement Grout: . '. ,' . RA WAn WELL CONSTRUCTION AND (min. 70% of distance from :. ~. :. ~. ground elevation to top of ":-,:: 4.',: PUMP INSTAUA TION STANRARDS

>:;. '.:ti to ensure that your as-built is in compliance with water surface or 500 ft., ';.: . ; . ~. .... applicable standards . whichever Is less.) ','!": ...

'to.' ..... . .. ~: : ~= • /h

;-: ,'.

Grouting method: Annular space between hole :. ~. :. ~. Solid Casing: (:2: 90% x (Ground E1ev.-Water Level Elev» '~.:.: ~~"l and casing (1.5" for,positive

.21 Positive ,.:,,-

Total Length: L~t;;' ft. displacement, 3" for other r ;':' displacement methods): ",6;

Nominal Diameter: ~ In. '",-o Other ~/

:.:',

~In. ~'-: ... ~'. :4 Wall Thickness: in. - t:t .: :: .: :: ~'.': 4.,' Bottom Elevation: fl., msl*

I Rock or Gravel Packing: - .-- I' Total Depth i/o ft. I-- Open Casing: ;11 Perforated o Saeen 200 ft. Material:

I 3!J' o Crushed Basalt Total Length: ft.

V Nominal Diameter: iP}i in. o Rounded Gravel

" Wall Thickness: in. 3. Estimaled Water Level

-~I i_ Bottom Elevation: LOO ft., msl* Elevation:

note: Neither bentonite nor mud should be used in i 'l. ~ ft. msl*

I-saturated zone during drilling

OP~ Leng . ft.

Diameter: -------- in. - Bottom Elevation: ~:.msl*

• The approximate elevation must be referenced to mean sea level (msl) at the time of application filing. Final elevations of well components shall be submitted In the Well CompietionlWell Abandonment reports and referenced to a benchmark which has been established by a surveyor licensed by the State.

For non-sail water Basal Wells - bottom elevation ofweH should not be deeper than 1/4 of aquifer thickness or,

Bottom Elevation of Well Limit = (Water Elevation _ 41 x Water Let E1eyation )

Example: Estimated + 2 ft. Water Level Bev. - Bottom Elevation of Well Limit = ( 2 - ~) = -18.5 ft.

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

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 M09 (production wells) 0 ASTM A312 (monitor wells)

ASS Plastic: confonning 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): # Schedule 40 0 Schedule 80 0 Schedule 120 Thermoset Plastic: (check one) 0 Filament Wound Resin Pipe confonning to ASTM 02996

o Centrifugally Cast Resin Pipe confonning to ASTM 02997

o Reinforced Plastic Mortar Pressure Pipe confonnlng to ASTM 03517

o Glass Fiber Reinforced Resin Pressure Pipe conforming to AWNA C950

o PTFE Fluorocarbon Tubing confonning to ASTM 03296 o FEP Fluorocarbon Tubing confonning to ASTM 03296

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

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 M09 (production wells) 0 ASTM A312 (monitor wells) ABS Plastic confonning to ASTM F480 and ASTM 01527: (check one) 0 Schedule 40 0 Schedule 80

PVC Plastic: confonning to ASTM F480 and (ASTM 01785 or ASTM 02241): (check one): ~ Schedule 40 0 Schedule 80 0 Schedule 120

Thermoset Pla'tlc: (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 confonning to AWNA C950

o PTFE Fluorocarbon Tubing confonnlng to ASTM 03296

o FEP Fluorocarbon Tubing confonnlng to ASTM 03296

WCPI Application Fonn 0512012009

.""'" . I...' "

oCRTMENT OF LAND AND NATURAL RESOuO:S D OCUM o ENTN .: UAC OR ATTACHED WORKSHEET DATE A t 13 2009 ugus ,

SRC/ COST F YR APP D OBJ CTR PROJECT PH ACT AMOUNT NAME/DESCRIPTION (WANG INPUT)

S 10 326 C 1026 0752 (1 ) $25.00 Waimea Water Services

" " " " " " (2) $25.00 David Gerow

(3)

(4)

(5)

(6)

(7)

(8)

(9)

(10)

TOTAL $ 50.00

REMARKS: LINE (1) BiQ Island Carbor Well #1 LINE (2) TMK: 5-2-013:011 LINE (3 LINE (4) LINE (5) LINE (6) LINE (7) LINE (8) LINE (9) LINE (10)

Well Background Check '~:i'

\

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

Gerow David Gerow C-29578 C-29578 BOTH

Tony Aldo Abondio Albertoni, Jr. C-29578 C-29578 BOTH

1323-02 Rosenblum Elliott Rosenblum C-29578 C-29578 BOTH

4/14/2005 1225-05 Kai Halalu 1 Miller Family Trust C-24947 C-29578 BOTH 4/27/2005 5/112006 8/10/2006 12119/2006 4/27/2005 215/2009 2118/2009 211812009

10117/2007 1122-02 Waiakalua-Hunt V. Stephen Hunt C-29578 C-29578 BOTH 213/2009 2111/2009 3/16/2009 3/16/2009 213/2009 515/2009 6/15/2009 6/15/2009

1/29/2009 1122-03 Friedman Melinda Friedman C-29578 C-29578 BOTH 2/3/2009 2111/2009 5/28/2009 7/13/2009 213/2009 811212009

2/17/2009 0521-13 Aina Wai II George Hoffberg C-29578 C-29578 BOTH 2/24/2009 2/24/2009

211712009 0521-12 AinaWai George Hoffberg C-29578 C-29578 BOTH 2/24/2009 212412009 0 3/2/2009 0323-01 Wailua-Smith Gregory Kent Smith C-29578 PUMP 3/5/2009 3/19/2009

3/512009 0919-12 Barnes James Barnes C-29578 C-29578 BOTH 3/6/2009 3/20/2009 5/28/2009 6/29/2009 3/612009 8/3/2009

3/5/2009 1222-09 Kilden Terje Haakonsen C-29578 C-29578 BOTH 3/5/2009 3/20/2009 7/14/2009 8/112009 3/6/2009 8/12/2009

3/512009 1222-08 Moorhead Aimee Moorhead C-29578 C-29578 BOTH 3/6/2009 3/19/2009 6/15/2009 8/812009 3/6/2009

3/25/2009 1122-04 Betsy Sonja Geiger C-29578 C-29578 BOTH 3/30/2009 5/2212009 ~9 3/30/2009 ~9 (?) ~ E:l,~i . d~) 4/812009 1221-12 Miranda Brandon Miranda C-29578 C-29578 BOTH 4/16/2009 4/16/2009

6/512009 1122-05 Kane David & Sandy Lear C-29578 C-29578 BOTH 6/17/2009 6/17/2009

o

Page 1 ofl

o [email protected]

08/10/2009 06:36 PM

o To Charley. F [email protected]

cc

bcc

Subject Re: Betsy Well wcr1 & signed permits

History: ~ This meSsage has been~r:Ward~d;

Charley, I don't think I sent anything on this well. I have not drilled as the project has been fianicially postponed and they are hoping to drill in the recent future.

-----Original Message-----From: [email protected] To: [email protected] Sent: Mon, Aug 10,20099:46 am Subject: Betsy Well wcrl & signed permits

I guess this works both ways! We received your wcr1 for this well (1122-04), along with signed permits, but they have fallen throught the cracks. Please do us the favor of resending? Sorry, and thanks in advance!

Chortey Ico Hydrologist

Ha\'\eii water Comm ission 1151 P unchbow 227 Kalanim oku P .O.Box621 , Honolulu 96809 (808) 587-021 8

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Search Results

o Page 1 of 1

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Assessed values and Building Details reflect tax year 2009 for all islands. Taxes reflect tax year 2009.

Search criteria: TMK Taxkey 4-5-2-13-11

PUBLIC RECORD DATA Taxkey-t

re4-5-2-13-11 [1 SubdivlCondoTnrAddressOwnerlLesseeBdsBths Land area Liv area

r "iif4-5-2-13-11-1 [j WOODSIDE ACRES

F 4530-D WOODSIDE 0 0 19.23 ac 0 KUAWA ACRES RD

F 4520 MAJOR, HENRY 3 2 KUAWA, & CELIA S/ETAL Apt A

3.63 ac 1,605

Last Sale Instr

4/3/2000 DEED ~

r~4-5-2-13-11-2 C WOODSIDE ACRES

F 4522 BARNETT, KUAWA, MICHAEL

2 2 4.01 ac 1,152 3/31/2000 DEED ~

r iif4-5-2-13-11-3 [j WOODSIDE ACRES

r .4-5-2-13-11-4 [j WOODSIDE ACRES

r.4-5-2-13-11-5 [j WOODSIDE ACRES

Apt B F/ETAL F 4526 GEROW, DAVID 3 2

KUAWA, D & CARROLL A Apt C

F 4540-E POSNER, GLEN 3 2 KUAWA, K TR/ETAL 1/2 Apt D

F 4530-DOOO KUAWA RD, Apt E

TANGEN, DOROTHYT TRUSTEE

3 2

4.50 ac 2,376 10/29/1999 DEED ~

3.90 ac 2,404 3/22/1999 DEED ~

2.25 ac 1,612 1/30/1997 DEED

This information has been supplied by third parties and has not been independently verified by Hawaii Information Service and is therefore not uaranteed.

Copyright ©8/17/2009 by Hawaii Information Service

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