mr. - university of hawaii for current form). the permittee shall comply with all applicable laws,...

LINDA LINGLE GOVERNOR OF HA.WAJI

Ref:3586-06.wcp

Mr. Rodney K. Diamond HCR #3 Box 14073 Keaau, ill 96749

Dear Mr. Diamond:

....

STATE. OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES

COMMISSION ON WATER RESOURCE MANAGEMENT P.O.BOX621

HONOLULU, HAWAII 96809

Well Construction Permit Oh Well (Well No. 3586-06)

PETER T. YOUNG c:Ho\JRI'ERSON

MEREDITH J. CHING CLAYTON W. DELACRUZ

JAMES A. FRAZIER CHIYOME L. FUKINO, M.D. STEPHANIE A. WHALEN

DEAN A. NAKANO ACTtNO DEPUTY DeRECTOR

June 8, 2005

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

Special Conditions

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.

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.

IMPORT ANT - 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 Lenore Y. Nakama of the Commission staff at 587-0218 or toll-free at 974-4000 (Hawaii), 274-3141 (Kauai), 984-2400 (Maui), or 1-800-468-4644 (Lanai & Molokai), extension 70218.

Sincerely,

W.fih 1't

PeterT. Young Chairperson

Enclosures

c: Shelley and Jeffi'ey Hecht (with applicable comments- DOH SDWB & CWB) USGS HawaiiDWS

/

r ,..,...-- 0 0

WELL CONSTRUCTION PERMIT

Oh Well, Well No. 3586-06 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 ofOh Well (Well No. 3586-06) at TMK 1-5-030:171, Hawaii, subject to the Hawaii Well Construction & Pump Installation Standards (HWCPIS -February 2004) which include but are not limited to the f6llowing conditions:

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

II.

12.

13.

14.

15.

The Chaill!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 sta:f( shall be allowed to inspect installation activities in accordance with §13-168-15, Hawaii Administrative Rules.

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

The well construction permit shall be for construction and testing of the well only. The permittee shall coordinate with the Chairperson and conduct a puJ11ling test in accordance with the HWCPIS (the latest rump test worksheet can be obtained by contacting Commission staff or at www.hawali.gov/dlnr/twrmlfonm.htm). The ~ttee shal sul:imit to the Chairperson the test results as a basis for suppating an application to install a permanent pulq). No permanent pulq) may be mstalled until a pUiql installation permit is approved and issued by the Chairperson. No withdrawal of water shall be m8de for purposes other than testing without a Certificate of Pump Installation Completion. The permitted pump capacity described on the pump installation permit may be reduced in the event that the pump test does not support the capacity.

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

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

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

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

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

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

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

The work proposed in the well construction permit application shall be completed within two (2) years from the date of permit approval, unless otherwise specified. The p~t 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 Chatrperson no later than the date the pemut exptres.

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

The permittee, its successors, and assigns shall indemnifY, defend, and hold the State of Hawaii harmless from and against any loss, liability, claim, or demand for property damage, personal injUJ¥. 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/puJ11l 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.

. w.h.f-7 1't

Date of Approval: June 2, 2005 Expiration Date: June 2, 2007

PETER T. YOUNG, Chairperson

Commission on Water Resource Management

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

Driller's Signature: ____________ C-57 License#: BC-23379 Date: __ _

Printed Name: Rodney K. Diamond Firm or Title: _______ _

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

Attachment c: USGS

Hawaii Department of Water Supply Shelly and Jeffrey Hecht

I

LINDA LINGLE GOVERNOR OIF HAWAII

Ref:3586-06.pip

Mr. Rodney K. Diamond HCR#3 Box 14073 Keaau, ID 96749 .

Dear Mr. Diamond:

0 Q

STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES

COMMISSION ON WATER RESOURCE MANAGEMENT P.O. BOX621


Pump Installation Permit Oh Well (Well No. 3586-06)

PETERT. YOUNG


JAMES A. FRAZIER CHIYOME L. FUKINO, M.D.

LAWRENCE H. MilKE, M.D., J.D. STEPHANIE A. WHALEN

DEAN A. NAKANO ACTING DEPUTY DIRECTOR

June 8, 2005

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

Special Conditions

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

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

The permittee is responsible for all conditions of the permit. This includes ensuring the submission of a completed Well Completion 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 Lenore Y. Nakama of the Commission staff at 587-0218 or toll-free at 974-4000 (Hawaii), 274-3141 (Kauai), 984-2400 (Maui), or 1..;800-468-4644 (Lanai & Molokai), extension 70218.

Sincerely,

W.f7h 1't

Peter T. Young Chairperson

Enclosure

c: Shelley and Jeffrey Hecht (with applicable comments- DOH SDWB & CWB) USGS DWS

/

·- 0 PUMP INSTALLATION PERMI"a Oh Well, Well No. 3586-06 W

Note: This permit shall be prominently displaved 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 Oh Well (Well No. 3586-06) at TMK 1-5-030:171, Hawaii, 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

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

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

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

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

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

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

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

9. The pump installation permit application and any related staff submittal approved by the Commission are incorporated into this 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.

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.

11. 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:

June 2, 2005 June 2, 2007

PETER T. YOUNG, Chairperson Commission on Water Resource Management

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

Installer's Signature: --------- C-57, C-57a, or A License#: BC-23379 Date:------

Printed Name: ~&~o~d2n~ey~~~D~i~a~m~o~n~d~ _________________ FirmorTitle: _______________________ __

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

Attachments

/

r

'

Results

0 0

06-02-05

•

OZ: 54pm From-DOH/Sah Driell Water Branch 8085864351 t"""'\ T -1 37

.....,; P.003/014 F-561

u v./oo-v

RECEIV~D SAfE Df"\!'""''1-· ,. -· ~-' r .. ,, .•. , ... ,, .. '1-.. """'I

I wi\1 , ..... .'J~·""i:l,.:. ~ ... ; .. ?·,:·---~ LINCA LINGLE PETER T. YOIJN6

COV~/1101'{ IJI" HAW ,I.' MAY ... 4 2005

C-I'IA.Ir:l?CA!:ON

TO:

FROM:

SUBJECT:

STATE OF HAWAII DePARTMeNT OF LAND AND NATURAL. ReSOLRCES

COMMISSION ON WAlER RESOURCE MANAGEMENT P.O.BOX621

HONOLULU, HAW AU 9600s

April29,2005

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

Harold Yee, Wastewater Branch William Wong, safe Drinking Water Branch Alec Wong, Clean Water Branch

PeterT. Young, Chai~person 1i Commission on Water Resource Management

Well Construction/Pump Installation Permit Application Oh Well (Well No. 3586-06

MEREDITH J. CHING CL.AYTON W. 0~ CRUZ

JAMES A FRAZIER CHIYOI'IE L FUKJNO, M.D. STEPHANIE A, WHALEN

DEAN A. NAKANO A¢1m's Ot:f'uTT DIU::;;TOR

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 bv returning this cover memo fonn by June 2. 2005. 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 pem1it application, request additional information, or request addit100al review time, please contact Lenore Y. Nakama of the Commission staff at 587-0218.

LYN:ss Attachment(s)

RESPONSE:

[ J

[I

[ l

[ l

[ l

X ( l

Thl~ well qwUfie!l as a source which will serve as a source of potable waier to a public water system (defined as seJ'\IitiS 25 or more people 31 lell$1 EiO days per year oc hal; 15 or moru service ccnnactiollli) and must racaiva Dilactor of Health approv~t prl<lr to liS use to comply with Hawaii Admlnlstratl11e Rulee CHAR), Title 11. Chaptar20, R1.1lee Reletlngto PotebleWalerSystems, §11·20-29.

Thio; wall c:loeo not qualify as a source serving a public water S)IStem (serves less Ulan 25 people or lllOI'a people at IOlsEit 60 days per ye.,.r or 15 6111Vice connections) and if the well wafer iS used for drinking, the prival& owner should test for bacteriological and chenucel preieflce before Initiating sum uliB and routnaly men iter the water qualitv thereafter. However, if future planned use frQm till$ source oncreases 10 meet t~e p1,1blic ~tar s~em dafimtion than Diractor of Health approval is requireo;ll!!!gr to lmplement;;UIQtl,

If the well Is used to supply both ~blf;l and non-pOtable purposes in :~ !li~la s~m. tlla USEir Shall elirrinate cross-coMections and ~ckflow connections by pl'lySicahy separa~ng potable and !lO!l·potable $)'Stems by ;~~n ~r !iJIIP Qf ;!Ill 'GIPprove0 b:ilckflow preo,enter, and by Clearly labeling all non-polabla spigots witn warning Signs to ptevGtlt inadvertent consumptiOn of non-poiQbfe water. 6addlovv prevention deviCes sl'lOI.IIO be I'QI,I!Inely Inspected and tested.

lt does not appear that this well will be usro fur consumptive pu~ses 3ild 1$ nQt !!ubjeC! Ill Safe Drinking W:llter Regulation$.

For thll apoliean\'s Information. a sa urea of p066ibla walilswa1ar rontamiRation (]is ll iS not located near the I)I'Op0$$d well site (lnformation attached}.

An NPOeS petmill~ reql,llreQ. ji,98/'#6 4'~(1~~ ~ othE!I" rBIE:vanl OOH ruleslregl,lla~ons. information. or mcommendatiorn; ars attaehe.ll#M..,..A/J" ~~P'Y'~a.P~ ~~ .. In the event tl'lat tne locaUon of the well change!i but is still within the parCel desCI'itled ~~-th';!ppiieatiiln. cur division con&itfars the ~ comments to still be applieolble, ?lid we do not need to review the new location.

[ 1 No eommems/obl~ .!Z.

contact Person: ~ Phone; ----'-'---586-4258

Signed: &.J2 {/Jt>, IY ZJ

Date: JUN -2 2005

JUH-02-2005 03: 24Pt'1 FAX:8085864351 ID: DLHR CWR~1 PAGE: 003 R=96~;

06-0Z-05

-02:54pm From-DOH/Sah Dren11 'Nater Branch 9085864351 T-137 P.004/014 F-561

8~3586-06 Hawaii

The Department of Health, Safe Drinking Water Branch has the following additional comments for the Well Construction I Pump Installation Permit Application for the Oh Well (Well No. 8-3586-06 Hawaii):

UndergrOWld Injection Control (UIC) Comments:

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

6/2/05

JUN-02-2005 03:25PM FRX:8085864351 ID:DLNR CWRM PRGE: 004 R=96:·:

' 0 0

LINDA LINGLE GOVERNOR OF HAWAII

PETER T. YOUNG CHAIRPERSON


JAMES A. FRAZIER CHIYOME L. FUKINO. M.D. STEPHANIE A WHALEN

DEAN A NAKANO

STATE OF HAWAII ACTING DEPUTY DIRECTOR

TO:

FROM:

SUBJECT:

DEPARTMENT OF LAND AND NATURAL RESOURCES _ ~ COMMISSION ON WATER RESOURCE MANAGEMENT

P.o. oox'621. · HONOLULU, HAWAII·-96809

April 29, 2005

Harry M. Yada, Acting Administrator Land Division

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

Well Construction/Pump Installation Permit Application Oh Well <Well No. 3586-06


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 June 2. 2005. 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 Lenore Y. Nakama of the Commission staff at 587-0218.

LYN:ss Attachment( s)

RESPONSE:

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

bdx 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 (.11

......

fxk - .I Othercomments: Original source of private title was issued pt:ior t'o

statehood in 1959.

Contact Person: ----'GI..:LC:Ia...t.r~y'--'-MI!.Ioa;u;r-~.t....~i~tl.._------- Phone: §87 CH~l

Date: __ MA_Y_1 _7 _,..200 __ --_5

---J

-~ ..... ---

r J

0 0 LINDA LINGLE

GOVERNOR OF HAWAII PETER T. YOUNG

CHAIRPERSON

!1 .. ~ .... , ~)

MEREDITH J. CHING CLAYTON W DELACRUZ

JAMES A FRAZIER CHIYOME L FUKINO, M.D. STEPHANIE A WHALEN

\_,· ·-· DEAN A NAKANO

STATE OF HAWAII ACTING DEPUTY DIRECTOR

Mr. Chris Yuen, Director County of Hawaii Planning Department 101 Pauahi Street Hila, HI 96720

Dear Mr. Yuen:

DEPARTMENT OF LAND AND NATURAL RESOURCES COMMISSION ON WATER RESOURCE MANAGEMENT

P.O. BOX621 HONOLULU, HAWAII 96809

April29, 2005

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

Oh Well (Well No. 3586-06


We would appreciate your comments on the captioned application with regard to the SMA permitting requirements specific to your division. Please respond bYc returning this cover memo form bv June 2, 2005. If we do not receive comments or a request or additional review time by this date, we will assume you have no comments.


Sincerely,

W.f7h 1'a.

DEAN A. NAKANO Acting Deputy Director 070083 .

LYN:ss

RESPONSE: C~)

This well project [ 1 requires ['1-] does not require a SMA. If a SMA is required it [ 1 h~ [·}has ncWtieen [ 1 approved and [ 1 is [ 1 is not currently active. ~-~

:;.:~.~ - ·~

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

No objections

Other comments:

[ 1

[ 1

[ 1 .. Contact Person: c'5\-hev- .:1-w, ~ Signed: __ ..;;.~..;;.__· _ ___;_~ _ __;._ ___ .c~~_~_ .. _____ _

Phone: (to? ) t:t fo I ~ S i$~ Date: :r/~/~..r

}

-.. . , ' )


0 0 PETER T. YOUNG

CHAIRPERSON


JAMES A. FRAZIER CHIYOME L. FUKINO, M.D. STEPHANIE A. WHALEN

STATE OF HAWAII DEAN A. NAKANO

ACTING DEPlfTY DIRECTOR

TO:

FROM:

SUBJECT:

DEPARTMENT OF LAND AND NATURAL RESOURCES COMMISSION ON WATER RESOURCE MANAGEMENT

P.O. BOX621 HONOLULU, HAWAII 96809

April 29, 2005

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

Harold Yee, Wastewater Branch William Wong, Safe Drinking Water Branch Alec Wong, Clean Water Branch

Peter T. Young, Chairperson ~ Commission on Water Resource Management



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 June 2. 2005. If we do not receive comments or a request for additional review time by this date, we will assume that you have no comments.



RESPONSE:

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 servinQ 25 or more people at least 60 days per year or has 15 or more service connections) and must receive Director of Health approvaiQ'lgor to 1ts use to comply with Hawaii Administrative Rules (HAR), Title 11, Chapter 20. Rules Relating to Potable Water Systems. §11-2 - 9.

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 wafer is used for drinking, tfie J?rivate owner should test for bacteriological and chemical presence before initiating such use and routinelY. monitor the water guahtv thereafter. However, if future planned use from this source 1ncreases to meet the public water system defimtion then Director of Hearth approval is required m:l2!: to Implementation. c:::.::>

I I If the well is used to supply both potable and non-potable purposes in a single system, the user shall eliminat~-conne~ and backflow connections by physically separating potable and non-potable systems by an air Elap or an approved batkflow preveoter, and by cle~rly labeling all non~pota~le spigots with warning signs to prevent inadvertent consumption of non-potable water. Backflo~vention · "J dev1ces should be routinely Inspected and tested. _ ::.-< r1

I I

[ l

It does not appear that this well will be used for consumptive purposes and is not subject to Safe Drinking Water.Regulations. c.c ·) 1

[ l

[ l I I

For the applicant's information, a source of possible wastewater contamination [)Is [] is not located near the proposed well site (information attached). . :t:>

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 diliiSiOn consider&.tt!Jl comments to still be applicable, and we do not need to review the new location.

Jf No comments/objection~ N 0 P;f:-UJ rt(,J'

Contact Pers9"<.~~ Phone:

Slgned: __ \._~---~...:.....-r+----....;;;.... _____ _ Date:

~ay-05-2005 03:07pm From-DEPT OF HEA~ ENVIRONMENTAL MNGMT ......,.

8085864352 T-026 P.002/00Z F-521

TO:

FROM:

SUBJECt:

~'f/"05 MAY -4

STATE OF HAWAII OEPARTMENi OF lAND AND NATURAl.. RESOURCES

COMMISSION ON WATER RESOURCE MANAGEMENT P.O.B0X521

HONOLULU. HAWAII 96a09

April29,2005



PeterT. Young, Chairperson 1 Commission on Water Resource Management

Well Construction/Pump Installation Pennit Application Oh Well (Well No. 3586·06

i>ETER T. YOUNG ctlot.,U\Pe~ON

M!Ofi£01TH J, CHING CLAYTON W. oeLA CRUZ

.IAMI=S A. FRAZIER C~I1"0ME L. FUI<iNO, M.D.

A 8 :4 3 STEPHANI!! A. WHAl-EN

DeAN A. NAI<ANO ACTINO Dt:t'lln' ctft:(i'((IR


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 fonn by June 21 2005. 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 Lenore Y. Nakama of the Commission staff at 587-0218.


RESPONSE:

[ 1

[ J

[ 1

I J

I J

! I

d\F [I

Thkl well guallfl6s Iii 1.1 aourte wl1k:h will z;eiVO as a souroa of poli:lble water to Iii publir; watef s~stem (defined as serving 25 or more people at klacn 60 days ~r year or has 1$ or more satviee connectiotls) and must tuoei~e DireciOO" of Hoatth ;~PP.rova_l Rill~~; 10 ots uselo c:oml)ly with Hawaii Administrative Rules (I'IAR), Title 11, Chapter 20, Ftul~ Rslatin!) 10 Potable Watar Syslt!ltlls, §11-20-20,

Ttli5 W<OII do&s not qulil!ify as a source <;erving a putlllc wstar &)llitem (set~~a.ele&s than 26 people or mora people at least eo d~i~YS per year Of 15aervice connectioru;) and If the well watet Is used fQr drinking, the ptlv11te owner ,.hould 1est for bacteriOIO{Iieal and c:llemlcal pres8nce before initiating iUCh use and rou1inely monitor the water quahtv tnereetter. However, It fulllre Pianned use from this source Increases to meet thtlllullllc water SyStem definrtion then Olrector of Heafth approv~l ie required dl: 10 lmplem!HllatiOn.

If the wall is uied to &upp~both PQtaPie am~ oon-potlible purposeli In a single system, the user shalllflllmlnate cross..-connaction5 atld baekflow c:onnectiOOII by !Cally ~~epa rating potable and nol'l-potable ey&tems by an air gap or an approved backflow prevent..-. and b}' clearly labefing all non-pota Ia 8PIQots with warnii'IO slens to prevent ina<llfenent consumplklti of non-potable water. BaCkflow prevention devices sllOUid be roLJflnely lnipilded and testecl.

It doe:s not ap~ear that !his well will be used for con:sumplive purposes and i:i nOI WllJ&Ct to Sam Dril'll<lng Waa Regulations.

For the applicant's informati011, a sou.-ce of PQ&&ible wastewater contamination []I• [] It AOt locatfj(j near the propcaeo well site (informatiOn attaened).

An NPOES permit Is requi~.

Olher reklvant DOH ruiaSJregulatiOI'Ir;;, information, or recommendlltions are attached.

In tne event ttrat the localicrn or the well d"lanaes but ii !iliij within 1he ~real doserlbed Qfl thi& appl~tlon, o~r divi&ion conslilers the comment& to :st~l be applcablc, and we do nOt nood to review tha new location.

[ ] No comtnenta/cbjectlons

COntact P~ k( U/ 1/JtJN(;, Phone:

&g>ed: ~~ Date:

r•1RY-05-2005 02:56PM FR><: 8085864352 I D: DU~R CWRM PRGE:006 R=97\

May-05-2005 03:07pm From-DEPT OF HE~p~ ENVIRONMENTAL MNGMT -- ""' 8085864352 T-026 P.OOl/002 F-521

The Department of Health, Clean Water Branch has the following comments:

1. For Well-Drilling Activities

Any discharge to State waters of treated process wastewater 6ffluent a:;.socli.ted with well drilling activities is regulated by Hawaii Administrative Rules, Title 11. Chapter 55, Appendix I, effective September 22, 1997. Treated process wastewater effluent covered by this general permit includes well drilling slurries, lubricating fluids wastewaters, and well purge wastewaters. This general- permit does not cover well pump testing. The applicable Notice of Intent Forms and filing 1ee shall be submitted at least thirty (30) days before the start of discharge to the-Department of Health, Clean Water Branch at 919 Ala Moana Boulevard, Room 301, Honolulu, Hawaii 96814--4920 or P.O. Box 3378, Honolulu. Hawaii 96801-3378. Inquiries may be directed to the Clean Water Branch at (808) 586-4309 or by fax at (808) 586~4352.

2. For Well Pump Testing

The discharger shall take all measures necessary to prevent the discharge of pollutants from entering State waters. Such measures shall include, if ne:cessary, containment of the 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 imp!emented to pr~vent th~ disch~rge from dis~urbi~g the clarity ?f the receiving water. If the discharge is entenng a storm dram, the discharger must obtam wntten permisSIOn from the owner of that storm drain prior to discharge. Furthermore, best management practices shall be implemented to prevent the discharge from collecting sediments and other pollutants prior to entering the storm drain .

. JS/cr

t1A'r'-05-2005 02:56PM FAX: 8085864352 ID: DLNR CWRt·l PAGE:005 R=97%


TO:

FROM:

SUBJECT:

0 0


COMMISSION ON WATER RESOURCE MANAGEMENT P.O .. BOX621


April 29, 2005

Samuel J. Lemmo, Administrator Office of Conservation and Coastal Lands

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


z en !to ~c:l"'l ~::o-o )>~ or-o "T!::O..., :J:I"'lr-

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JAMES A FRAZIER CHIYOME L. FUKINO, M.D. STEPHANIE A WHALEN

DEAN A NAKANO ACTING DEPUTY DIRECTOR

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We would appreciate your comments on the captioned application with regard to the programs, plans, and objectives specific to your division. Please respond by return in~ this cover memo form by June 2, 2005. If we do not receive comments or a request for aditional review time by this date, we will assume you have no comments.



[ 1 Other relevant OCCL rules/regulations, information, or recommendations are attached.

[ 1 No objections

[ 1 Other comments:

Contact Person: ]) QlNN ft.e(Yfc::t: Phone: 6e>7-0t:Jeo

Signed~ /J~ Date: fuy 1h "U:7D5

--------------------·- ·--·-··-.

[ 1

0 0

,

,, -~·· .. . .... ~'

''· \

'. "


Mr. Rodney K. Diamond HCR #3 Box 14073 Keaau,HI96749

Dear Mr. Diamond:

0 0




April 29, 2005



JAMES A. FRAZIER CHIYOME L. FUKINO, M.D.

LAWRENCE H. MilKE, M.D., J.D. STEPHANIE A. WHALEN


3586-06.rev

Well Construction/Pump Installation Permit Application for Well No. 3586-06

We acknowledge receipt, on April 11, 2005, of your completed Well Construction/Pump Installation permit application and filing fee for the Oh Well (Well No. 3586-06). You can expect your application to be processed within ninety (90) days from this date.

For your information, the attached table (Permit Process 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. Until then, all aspects of the permits are the responsibility of the contractor. 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 Lenore Y. Nakama of the Commission staff at 587-0218 or toll-free at 974-4000 (Hawaii), extension 70218.

LYN:ss Attachment

c: Shelly and Jeffrey Hecht

Sincerely,

W.f'tf-7 1't

DEAN A. NAKANO Acting Deputy Director

0 0 LINDA LINGLE

GOVERNOR OF HAWAH PETER T. YOUNG

CHAIRPERSON

TO:

FROM:

SUBJECT:




April 29, 2005



Peter T. Young, Chairperson~ Commission on Water Resource Management



JAMES A. FRAZIER CHIYOME l. FUKINO, M.D. STEPHANIE A WHALEN



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 June 2, 2005. 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 informati()n, or request additional review time, please contact Lenore Y. Nakama of the Commission staff at 587-0218.


RESPONSE: [ 1

[ l

[ l

[ l

[ l

[ l

[ l [ l

[ l

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 ofl-teaHh approval Rl12!: to 118 use to comply with Hawaii Administrative Rules (HAR), TiUe 11, Chapter 20, Rules Relating to Potable Water Systems, §11-2o: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 chem1cal 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 defimtion then Director of Health approval is required prior to Implementation.

If the well is used to supply both DOiable 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 non-potable 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 [)Is [] 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 HAWAtl

TO:

FROM:

SUBJECT:

0 0




Apri129, 2005

Harry M. Yada, Acting Administrator Land Division

Dean A Nakano, Acting Deputy Director 1 Commission on Water Resource Management




JAMES A FRAZIER CHIYOME L. FUKINO, M.D. STEPHANIE A. WHALEN



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 June 2. 2005. If we do not receive commentS or a request for additional review time by this date, we will assume you have no comments.



RESPONSE:

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

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

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

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

[ ] No objections

[ ) Other comments:

Contact Person: ________________ _ Phone: ---------

Signed: ______________________________ _ Date: ______ _


TO:

FROM:

SUBJECT:

0 0



HONOU,JLU, HAWAII 96809

April 29, 2005

Melanie Chinen, Administrator Historic Preservation

Dean A Nakano, Acting Deputy Director 1 Commission on Water Resource Management





JAMES A FRAZIER CHIYOME l. FUKINO, M.D. STEPHANIE A WHALEN


We would appreciate your comments on the captioned application with regard to the programs, plans, and objectives specific to your division. Please respond by return in~ this cover memo form by June 27 2005. If we do not receive comments or a request for aditional review time by this date, we w1ll 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 Lenore Y. Nakama 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.


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: ______ _


TO:

FROM:

SUBJECT:

0 0




April 29, 2005

Samuel J. Lemmo, Administrator Office of Conservation and Coastal Lands

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




MEREDITH J. CHING CLAYTON W. OELA CRUZ

JAMES A. FRAZIER CHIYOME L. FUKINO, M 0 STEPHANIE A. WHALEN


We would appreciate your comments on the captioned application with regard to the programs, plans, and objectives specific to your division. Please res ond b returnin this cover memo form by June 27 2005. If we do not receive comments or a request or a 1t1onal review time by this date, we w1ll assume you have no comments.


LYN:ss Attachment(s}

RESPONSE:

[ ] This well project [ 1 requires [ 1 does not require a COUP. If a COUP is required it [ ] has [ ] has not been approved and [ 1 is [ 1 is not currently active.

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

[ ] No objections

[ ] Other comments:

Contact Person: _______________ _ Phone: ______ _

Signed: __________________ _ Date: ______ _


Mr. Chris Yuen, Director County of Hawaii Planning Department 1 01 Pauahi Street Hilo, HI 96720

Dear Mr. Yuen:

0 0




April29, 2005

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

Oh Well (Well No. 3586-06



JAMES A. FRAZIER CHIYOME L. FUKINO, M.D STEPHANIE A. WHALEN



We would appreciate your comments on the captioned application with regard to the SMA permitting requirements specific to your division. Please res ond b return in this cover memo form by June 2. 2005. If we do not receive comments or a request or ad 1t1ona rev1ew t1me y this date, we will assume you have no comments.


LYN:ss

RESPONSE:

Sincerely,

w.f7f1 1't

DEAN A NAKANO Acting Deputy Director

[ 1 This well project [ 1 requires [ 1 does not require a SMA. If a SMA is required it [ 1 has [ 1 has not been approved and [ 1 is [ 1 is not currently active.

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

[ 1 No objections

[ 1 Other comments:

Contact Person: _______________ _ Phone: _______ _

Signed: __________________ _ Date: ________ _

BOC Document Display

Bureau of Conveyances

Document Description I Order I

Document No: L3237903 (5 pages)

Fee: $5.00

Recorded: 2005-03-08

Class: DEED

Grantor(s): USHIMURA NAGAYO

Grantee(s):

TMK:

HECHT JEFFREY J

HECHT SHELLEY R

3-1-5-030-171

Description: CT 737431 NOTED ON CT 340420 LOT 1297 BLK 9 MAP 64 APP 1053

Copyright© 2005 State of Hawaii Bureau of Conveyances

http:/1132.160.239 .151/boc/showit.php?DocNo=L323 7903

0 Page 1 of 1

4/22/2005

0

After Recadatlon. Return by Mail ( ) Pickup ( ) to:

Mr. & Mrs. Jeff Hecht HCR 3 Box 10003 Keaau, Hawaii 96749

Affects: Tax Map Key (3) 1-5-030-171

0

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I ., [~ . - , . ~·, , , J \L ·- ; ,

4~~. HPP ' I

TG: 2005-04345 TGE: AS--302...()233 Ms. Debra A. Perreira Total pages: SIX

Hawaiian Paradise Park, lot 1297, Block 9, Map 64, Application No. 1053 Transfer Certificate ofTltle No. 340,420

WARRANTY DEED

THIS WARRANTY DE=.ED. made this __ day of---------2005, by:

NAGAYO USHIMURA, wife of Keeichi Ushimura, whose address is 5-17-7 Kasumigaseki-Higashi Kawagoe-8hi Saitama, Japan 35D-1103 (hereinafter referred to as "GRANTOR"), in favor of

JEFFREY JOSEPH HECHT and SHELLEY RENE HECHT, husband and wife, whose address Is HCR 3 Box 10003, Keaau, Hawaii 96749 (hereinafter referred to as .. GRANTEE");

WITNES§ETH:

That for TEN AND N0/100 DOLLARS ($10.00}, and other valuable consideration paid by the Grantee, the receipt of which is hereby acknowledged, the Grantor does hereby grant, bargain, sell and oonvey unto Grantee, as Tenant$ by the Entirety, In fee simple, all of that certain real property described in Exhibit "A• attached hereto and made a part hereof.

1

SC::t6-996£80Bl cis r : c:n so 90 .Jclij

• 0 STATEOFHA~ DEPARTMENT OF LAND 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 Commission on Water Resource Management, P.O. Box 621, Honolulu, Hawaii 96809. Application must be accompanied by 6 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 587-4225. For further Information and updates to this appDcatlon form, visit http:flwww.hawaD.govfdlnr/cwrm.

... Conslrud New Well 0 Modify Existing Well 0 Abandon/Seal Well

PROPOSED USE

0 16. Municipal

JG. 17. Domestic

0 18

than 25 individuals

Number or units to be served: l

OTHER LEGAL REQUIREMENTS If required, items 22. and 23. must be obtained before

For Official Use Only:

5

0(''

Flowmeter Open Pipe

0 Weir 0 Orifice

A 9' Q 6

·-·'

0 Other (explain)

WCPI App. Form 10/05104

/

/

0

PROPOSED WELL SECTION (Rease attach schematic if different trom diagram provided below)

Hole Diameter: l 'Z-- ln.

Elevation at top of casing S5::L.. ft., msl* -\. f.-{- __ :~ Minimum of 2' Radius & 4" Thick Concrete Pad (to contain benchmark _L_f-- surveyed to nearest 0.01 ft.)

r.:.-s· ~?.b\ r Ground Elevation: W ft .. msr

----------- fi'~' ::~:: .}.:. ''"""' ,,,.,.,., Please refer to the

Cement Grout: bl!) ft. ~·.; • .. HAW All WELL CONSTRUCTION AND (min. 70% of distance from t ~~ / PUMP INSTALLA !ION ST ANDARQS ground elevation to top of .: : ;. · ~ to ensun: that your a.'l-buill is in compliance with water surface or 500 ft., .· ::: _!.: .• •.:. · 1 dard apphcab e stan s. whichever Is less.) ;{~ :·.~:.: :=============;~--< ~·=: •..

Grouting method:

0 Positive displacement

Annular space between hole and casing (1.5" for positive displacement, 3" for other methods):

.... ,. :: ;:

~-~~{ u Solid Casing: (2: 90% x (Ground Elev.-Water Level Elav))

Total Length: J3 6 ft.

ilfOther ;~._:: ::·::

V .. ~:·. :·.~:: Nominal Diameter: __ ~PL.. ______ in.

Wall Thickness: ---'"..,S~Ch~_'-l::JOeb~---ln. Bottom Elevation: __ -_-:.,C>=------- ft., msl*

~ln. ...... . .. Rock or Gravel Packing:

Material: 1<:>.

0 Crushed Basalt

Total Depth

qo ft. Open Casing: jltPerforated

Total Length: f 0 0 Screen

ft.

ZD ._ ~~ I; ~r~ .... -;::===========;- ..lZ. ~ _~..,r~..,-v 0 Rounded Gravel ,_ h~

Nominal Diameter: __ __.lt..O.. ______ in .

-·~ I

Wall Thickness: ___ .:;;gaOh~L....!lfl?u.~--in. Estimated Water Level

Elevation: Bottom Elevation: - I 6 ft., msl"

___ .L __ ft. msl" note: Neither bentonite nor mud should be used in

saturated zone during drilling

Open Hole:

Length: --.--,RA'"'/A,..,_ ______ ft. !v Diameter: _____________ in.

- --- ----- ---------------- L- Bottom Elevation: _________ ft., 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 Completion/Well Abandonment reports and referenced to a benchmark which has been established by a surveyor licensed by the Stale.

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

Bottom Elevation of Well Limit= (water Elevation- 41 • Waler Le~d EleYalion )

Example: Estimated+ 2ft. Water Level Elev. -Bottom Elevation of Wen limit= ( 2. 41 ~ 121

) = ·18.5 ft.

Solid Casing Material: Carbon Steel: compliant with (check one or more): 0 ANSIIAWWA 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 TypeS 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): (schedule 40 0 Schedule 80 0 Schedule 120 Thermoset Plastic: (check one)

Open Casing Material:

0 Filament Wound Resin Pipe conforming to ASTM 02996

0 Centrifugally Cast Resin Pipe conforming to ASTM D2997

0 Reinforced Plastic Mortar Pressure Pipe conforming to ASTM 03517

0 Glass Fiber Reinforced Resin Pressure Pipe conforming to AWWA C950

0 PTFE Fluorocarbon Tubing conforming to ASTM 03296

0 FEP Fluorocarbon Tubing conforming to ASTM D3296

Carbon Steel: compliant with (check one or more): 0 ANSI/AWWA 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 TypeS 0 Grade 6 0 Other

Stainless Steal: (check one): 0 ASTM A409 (production wells) 0 ASTM A312 (monitor wells)

ABS Plastic conforming to ASTM F480 and ASTM D1527: (check one) 0 Schedule 40 0 Schedule 80

PVC Plastic conforming to ASTM F480 and (ASTM 01785 or ASTM 02241 ): (check one): )l Schedule 40 0 Schedule 80 0 Schedule 120 Thermoset Plastic: (check one) 0 Filament Wound Resin Pipe conforming to ASTM 02996

0 Centrifugally Cast Resin Pipe conforming to ASTM 02997

0 Reinforced Plastic Mortar Pressure Pipe conforming to ASTM D3517

0 Glass Fiber Reinforced Resin Pressure Pipe conforming to AWWA C950

0 PTFE Fluorocarbon Tubing conforming to ASTM 03296

0 FEP Fluorocarbon Tubing conforming to ASTM 03296

WCPI App. Form 10/05104

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MEMORANDUM FOR THE RECORD

FROM: Lenore Nakama SUBJECT: WCPIA for 3586-06

4/6/05 Called Rod Diamond and left message that he needs to submit the new information that is required in our updated application form (launched 2/18/05 with the CWRM approval of new standard conditions). Basically, the only additional info are:

• 8 copies of a photo of proposed well site • 8 copies of a schematic diagram showing well site, access road,

infrastructure • Proposed surveyor's name license # • Identification and signature f proposed pump installation contractor (for

combined well & pump appli ations)

Rod said that he would prefer to ju transfer the info from the old form to the new form and submit a new application n the new form.

Search Results

0 0 Page 1 of 1

Copyright @4/6/2005 by Hawaii Information Service

Assessed Values reflect tax year 2004. Oahu and Maul Assessed Values reflect tax year 2005

• PUBLIC RECORD DATA Tax key Subdiv I Condo Tnr Address Owner /Lessee Bd.s .Bths Land area Liv area Last Sale lrui

r 3-1-5-30-171 Hawaiian F USHIMURA,NAGAYO/ETAL 1.00 ac 0 12/18/1989 DEE Paradise Park

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

http://webre1.hawaiiinformation.com/re4/HIS/Search/search_PUB.asp?NOCACHE=11128... 4/6/2005

Department of Commerce & Con. sumer Affairs - State of Hawaii - PVL ~ENSE CLAS. .. Page 1 of 1 0 .··

Department of Commerce and Consumer Affairs l'rof!·\;Jorl.tl dnd Vo<atH:lnallin·:niiVJ t),v, ,,on

11 roft.~ssional and \' ot·ation411 l.it.·t.~nsing Search

LICENSE CLASS SCF~EEN

Please click a link listed below to display the other screen.

There were 2 specific license classes pn this licensee!

***** LICENSE CLASS FOR THIS I ICENSEE ***** LIC: CT -23379 RODNEY K PIAMOND

CLASS CODE CLASS TYPE EFFECT VE RESTRICTED B GENERAL BUILDING 10/12/( I C57 WELL 06/30/( 4

<-Back New Search-~

STATUS

EMPLOYEES LISTII EMPLOYERS LIST IIINSURAJ.CEL_BONDII LICENSE CLASS

Copyright 2002 Professional and Vocatio 1al Licensing Division

Hawaii State homepage II DCCAII Professional and Vc cational LicensinG Division

http://pahoehoe.ehawaii.gov/pvl/app? _f=n& _ a=LC&licno=23 3 79 &lictp=CT &off=O&nm=R. .. 4/6/2005

Well Background Check Well Construction Pump Installation

Approved Well No. Wei/Name Applicant Driller Pumplnst. Type Issued Signed WCR1 Accept Issued Signed WCR2 Accept

3686-06 Polu Puka Rick Carey BC-23379 BOTH

11/18/2002 3688-05 Love David Love BC-23379 BC-23379 BOTH 11/27/2002 7/29/2004 3/24/2005 3/24/2005

4/12/2004 3500-02 Nichols Greg Nichols BC-23379 BOTH 4/19/2004 7/13/2004

4/14/2004 3687-10 Fenn Isaac J. Fenn BC-23379 BC-23379 BOTH 4/23/2004 9/13/2004 3/24/2005 3/24/2005

6/4/2004 3688-07 Webb Charles Webb BC-23379 BC-23379 BOTH 6/9/2004 7/19/2004 3/24/2005 3/24/2005

8/27/2004 3586-04 Dennis Ardis Dennis BC-23379 BOTH 9/23/2004 10/29/2004

8/31/2004 3687-13 Camp Richard & Teresta Camp BC-23379 BC-23379 BOTH 9/21/2004 11/1/2004 3/24/2005 3/24/2005

10/21/2004 3787-05 Bartlett Michael Bartlett BC-23379 BC-23379 BOTH 10/26/2004 10/29/2004 3/24/2005 3/24/2005 0 12/23/2004 3686-04 Connie Connie Bouchard BC-23379 BC-23379 BOTH 1/7/2005 1/27/2005 3/24/2005 3/24/2005

1/3/2005 3786-01 Gapp John Gapp BC-23379 BC-23379 BOTH 1/6/2005 1/15/2005 3/2412005 3/24/2005

1/3/2005 3687-16 Duley Robert Duley BC-23379 BOTH 1/7/2005 211/2005

1/3/2005 3388-01 Hendershot Carolyn Hendershot BC-23379 BOTH 1/6/2005

2/21/2005 3688-10 Wallace William & Marietta Wallace BC-23379 BOTH 2123/2005 2126/2005

317/2005 3686-05 Gibson Judith Gibson BC-23379 BOTH 3/7/2005 3/9/2005

317/2005 3587-08 Oliver Patty Oliver BC-23379 BOTH 3/7/2005 3/9/2005

3/7/2005 3587-07 Hendershot 2 Carolyn Hendershot BC-23379 BOTH

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.RTMENT OF LAND AND NATURAL REsor&s DOCUMENT NO · .. UAC OR ATTACHED WORKSHEET DATE: March 28. 2005

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

s 05 326 c 1026 0752 (1) $25.00 Shelley R. Hect

" " " " " II (2) $25.00 McCloskey and Company

" " " " " " (3) $25.00 TNWRE, Inc.

" " " " " II (4) $25.00 Tracey Runnels Well Service, Inc.

(5)

(6)

(7)

(8)

(9)

(10)

TOTAL $ 25.00

REMARKS: LINE (1) OH Well tmk: 1-5-030:171 LINE (2) Tom's Well, tmk: 4-9-14:24 LINE (3 CB No. 2 Well, tmk: 3-8-7:89 LINE (4) VIP Sanitation Well, tmk: 9-1-13:09 LINE (5) LINE (6) LINE (7) LINE (8) LINE (9) LINE (10)

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o " State of .. aii 0 IForOffkiaiUaeOpty:

~• COMMISSION ON WATER RESOURCE MANAGEMENT Department of Land and Natural Resources APPLICATION FOR PERMIT r/t Well Construction and/or J'Pump Installation

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.. suucaons: Pl888e pnrr In Ink or tp ancs send completed appiCation with aaactunents m the Commission I ill It H 2 8 9 , 5 .1 on Walar Raaowca Maragemert, P .0. Box 621, Honokllu. Hawaii 96808. Applcalon nut be aa:omparied by Ul;\!1 t.,p,R A • '1 5 ooples and a non-~&fundabla ftlng fee d $25.00 payable to the Dept of Land and Nab.ral Reaoi.IC88. The Comnisslon may not accept lncompleaa applcaliona. For 888islanee, call Ule Regulation Branch at 517~225. Forfi.rtherlnbn1811onand ..,ctallas totliaapplcalonfonn, Wllthtlp:l/www.atate.N.usldlnrlcwmt. 1 .... ,. ", ,,. , ~t -·

;p r .( ~-. ·~ , ' "• _ , _ ... APPLICANT INFORMATION: (FII ow au three, If applcable, and place a check next to the primary conact) ~i . :. · · r ~ • • · i ·;

1~·~ Jt "":.~::,:., ~liX t:i~uJZ~£rtKo;;:;d'u~t.7fr;.1;9 .· . ._,..,.;,., q?J, '1'i1z ~ Fu E~t------------------------------------

(b) 11-- LAND CMNER: <= Cortact Person:

Mall!liAddresa: ~ <

P~: --------------

Fu E-mail:----~----------------(c) 1- CONTRACTOR: f?c/l Q/r:,.aut,al Cortact Person: ~l?a........,.,;\._"----:--

Malllll Add181e: 'fkrt *3 /3c't IWX11 ~ v 14( q61t.('l Fu ?o1: "" 4f/'Zt} E-mail: --------

WELL & PUMP INFORMATION: (Please fill In the diagram on the back of tis form.)

Phone: 9~7 8'/oo

Lie#: B2.2J37q (circle one: C-57, C-57a, or A)

2. WELL NAME: OM uiLli Island: 5-UAI I Address '{ -1-k IA..H- rJ..fJP Tax Map Key: L- r -0'0 : t7 1

Zone Sec Plat Parcel

& ~,

Allach: (a) portion of a 7 .5-Mioota Series USGS topograptic map (scala 1:24,000) with wei location labeled and Include the name of the q\811 nap (b) a property tax map, &hawilll wall kx:allon 18ferenced m astablshed property boundaries

3. PROPOSED WORK: ~Construct New Wei tt( instal New P\111)*

(ch8clc all that apply) 0 Modify Exlslilll Well* 0 Modify Punp*

0 AbandorVSeal*

•state wau No.: (If unknown, please caU Commlsslonat587.0225)

4. CONSTRUCTION: ~ Oriled 0 Dug 0 Shaft 0 Tunnel

Is this well part of a battery of wells? DYes ONo (Please describe) 5. PROPOSED PUMPING RATE: ~ gallons per minute

6. PROPOSED USE: (checlc all that apply)

0 Muriclpal (lncludllll to181s, slor8s, ale.) 0 lndi.atrial

}f( Domestic (lndhAdual, nonconmen:lal water syatem)

Does this well serve 25 or more people at le&St 60 days per year or haw 15 or more s8nilce connections? 0 Yes.__ No

0 hlgatlon (crop) No. of Aava:

0 MlllafY 0 Other (elCplaln): 7. (a) PROPOSED AMOUNT OF WITHDRAWAL: .JZ_<)O gallons per day

(b) METHOD OF FLOW MEASUREMENT: Jt FlcJwmetar 0 Open-pipe 0 Weir 0 Orifice 0 Other(alCplaln)

OTHER IMPORT ANT INFORMATION:

8. LEGAL REQUIREMENTS: If required, these permits llJIII1 be obtained before the Commission can legaUy issue a permit. Conaervdon Dlatrtct Use Permit (COUP) To Gnd out If a COUP Is necessary, call DLNR Land 01\'lslon at 587 .Q414

)( Not Raq~l8d If req~rad. date approvad ------Environmental Impact StldiNnent (EIB)or Environmental Aa .... ment(EA) To deWmlne lfanEIS orEA Is necessary, call OEQC at 586-4185

ji(. Not Raq~rad If requil9d, data pWIJshed In OEQC bulleUn ------8peclai•Nig8lll8fltAIH Permit (SIIAP) To determine If an SMAP Is nec:assary. on Oahu. cal 527-5374; on Hawaii, call961-8288; for Maul

county, call27o-7235; on Kaual, call241~77.

~Not Required If reqtirad, dale approvad ------9. ARCHEOLOGICAL REQUIREMENTS:

To lnd out If an archeological work Is req~red: on Oahu, call Elaine Jourdana at 692-8027; on Hawaii, call MaryAme Malg18t at 327-3690, for Ma~ courty, eel Cathy Daghar at 892-8023, on Kaual, cal Nency McMaton at 742-7033.

'J Not Raq~rad If req~rad, please allach lettaf tom DLNR Hstorlc Preservation

10. REMARKS, EXPLANATIONS:

NOTE: Sigri!ll below lndicataa the slptories tmersland and swaar thet the l~rmaton pro*Md on ttia applcalon Ia accuralll and trw ID the beat of their knowledge. F&lther, the slgnabtea underaland that approval d tlia applcation allachas the foltowlng standard condlllons: 1) the propaeed work Ia to be COfl1)1e18d wlttin Mo (2) )'IIIli'S of the approval data; 2) the contractor ahallslbmt to the Commiaaion a wall completloriabandonmelt report wlttin 80 days aflar the complallon dale of the permltlad work; 3) molthly walar \118 dala ahel be slblrittad to the ComrnJsaion; 4) such approval stall not constitute a delamination of comtlatlw water righls and shall not guaranlae the PlmP capacity or fiture \118 ~ to the pannlttad punp capacity. 5) In the ewnt thet the applcatlon Is not COfl1)1allltd corractly, any permit maybe 8\llp&nded unUI the ham Ia brought In to complance, and any work done wtila the pennit lsln suspension may res&jt In tines of~ to $1000/gay. .:Sfl~

{If mora pea Is needed, please allach additional sheet)

Wall Ownor Landowner Jel¥ flcc#I_ ;AI:!ft eon- ~ J ~eM J (pktlaglbly) --~ ~. . . n .._jpri,._Y) I

SignatLnt SignatLnt ~ tJOQ SignaiLnt ~ e/ Date Date . JtJ Date l'j=i."h ~ t2C For offiCial use only

Latitude Aquifer System No. -~-=--------Longitude State Well No. - -·

\Jv0~L,~~A ~orm 7117103 -,t ~-- [; ·• o') \l. t~ \ "'-.fv..o ~ ~:· \_\ ~ (;,.,, 'v,~J. 1)\) , ·, . , A •. A \ .

~· ,: ·\ , I.AJ • ~..-- . '\l -.ro " \ fl'-'l,..1r\, , N

0 0

10. PROPOSED WELL SECTION (Please attach schamatlc lfdltreiBIIt trom di8(118m provided below)

Hole Dlamelar: I L ln.

Elewtion at top of casil.a BL ft., ms1" MlrimLm of X Radiw & 4• Thick Co11C1'8te Pad (to carDin benctmark

Total Depth

cto ft.

Cemert Grout (min. 70% of dl.-:slance-.-=...-· ground ele\etion 1o lop of water aurfaoe or 500 ft., whichever Is less.)

Amular apace between hole and casii"Q (nin.3.):

.s ln.

Rock or Gnlwl Packing:

Zt:? ft. Matarial: ~Basal o Rounded Grnal

Estimated Walar Level

Elewtion:

'f 1G ft.msr

~-~-----lll:iol sww)llld 1o naarast 0.01 I.) · Gromd Elevation: ~ ft., mar

Please raitrlo the HAWAII WELL CONSTRUCTION AND PUMP INSJ!I I 6 DON STANDARPS 1o enaura that )O&r a.bwlls In complance

Mth applcabla alandards.

.__-1 Sold Casiru: («!: 90% x (Groum Elev.-Watar Level Elev))

Total Lef11th: 9z) ft.

Nominal Olamatar: b ln.

Wal Thickness:. __ _...;;j~~~~~~f-'0£..-___ ln.

Bollom Elewlion: Q I., mar

Open Casii"Q: ~ Petforaaad o Scraen

Total Lef11th: I 0 ft. Nominal Diameter: --~6~ _____ 1n.

Wal Thickness: Sen ctb ln.

Bollom Elewlion: - /Q I., mar nole: Neither benlollitfl nor mud 6hould be used In

NafJWAIRrl ""'"" rlurinn rlrlllinn

Open Hole:

~------~~r---------ft. Oiametar. ~ ln. Boaom Elewlion: I., mar

* The approximate elevation nut be refarenced to mean sea lewl (msl) at the lime of applcalion fiii"Q. Flral elewllona of well componanta &hal be Slbmilted In the Wei Con1Jiellon/Well Abandonment report& and refarenced lo a berdlrnark wHch has been eslablahad by a SlniB)Or lcenaed by the Slata.

For non-sal water Basal Wells -bottom elevation of wei shoWd not be deeper then 1/4 of aqtifer thickness or, Bottom Elevation of Wei Umlt • (Water Elevation- 41 1 Water ~val Elayallon)

Exa1J111e: EaUITIIIed +2ft. Water Level Elev. -... Botlom Elevation of Well Llnit • ( 2-~) .. -18.5 ft.

Solid Casing Material; Carbon StMI: compUart with (check one or m018): o ANSVAWWA C200 o API Spec. 5L o ASTM A53 o ASTM A 139

And c:ompllart with (check one or mo18): o ASTM A242 o Type E o Type S o Grade 8 o Other Stalnleu StHI: (check one): o ASTM A409 (production wells) o ASTM A312 (moritor wells)

ABS Plastic c:ontbrmifll to ASTM F480 and ASTM 01527: (check one) 0 Schedwa 40 o Schadwa 80

PVC Plaaticconformlflllo ASTM F480and (ASTM 01785orASTM02241t, (checkonet, )I(_Schedwa 40 o Schadwa 80 o Schadwa 120 ThermoMt Plastic: (check one) o Fllamert Wound Resin Pipe c:onformlfll to ASTM 02996

Open Casing Material:

o Certrifugally Cast Resin Pipe conforrri!11 to ASTM 02997 o Reinforced Plastic Mortar Pressure Pipe c:onformlfll to ASTM 03517 o Glass Fiber Reinforced Resin Pressure Pipe conrormlfll to AWWA C950 D PTFE Fluorocarbon TLblng c:onbrmlfll toASTM 03296 o FEP Fluorocarbon TLbif11 c:onformlfll to ASTM 03296

C•rbon StMI: compUart with (checkoneorm018): o ANSIIAWWAC200 o APISpec.5L o ASTMA53 o ASTMA139 And c:ompllart with (check one or mot8): o ASTM A242 o Twa E o Type S o Grade B o Other

Stalnleaa StHI: (check one): o ASTM A409 (production web) o ASTM A312 (moritor wells) ABS Plastic oonforrri'll to ASTM F480 and ASTM 01527: (check one) o Schedule 40 o Schadwa 80 PVC Plastic conformlf11 to ASTM F480 and (ASTM 01785 or ASTM 02241 ~ (check one): )(Schadwa 40 o Schadwa 80 0 Schadwa 120 ThennoMt Plutic: (check one) o Fllamert Wound Resin Pipe conformlflllo ASTM 02996

o Certrifugally Cast Resin Pipe c:onlormlfll to ASTM 02997

o Reinforced Plastic Mortar Pressure Pipe conformlfll to ASTM 03517 o Glass FlberRelnfoR:ed Resin Pressure Pipe c:orlormlfll toAWWA C950 0 PTFE Fluorocarbon Tlbif11 c:onformilll to ASTM 03296 o FEP Fluorocarbon TLbillJ conforming to ASTM 03296

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DfPA.TMIIOfr 01' THI t.U: COMMISSoiON ..

TAXA noN MAPS !URfAU I fAT! 01' KAWAII

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mr. - university of hawaii for current form). the permittee shall comply with all applicable laws,...

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