STATE OF HAWAII DEPARTMENT OF LAND AND ...0522-01. wcr2.acc We received your Well Completion Report...

LINDA LINGLE GOVERNOR OF HAWAII

Mr. Michael Sober 91-458 Komohana Street Kapolei, HI 96707

Dear Mr. Sober:

o

STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES

COMMISSION ON WATER RESOURCE MANAGEMENT P.O. BOX 621

HONOLULU, HAWAII 96809

January 7, 2010

Certificate of Pump Installation Completion for Waipouli 2004 Well No. 0522-01 (TMK (4) 4-4-003:073)

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, P.E. DEPUTY DIRECTOR

0522-01.ccpi

We are pleased to inform you that the Pump Installation work permitted for the Waipouli 2004 (Well No. 0522-01) is complete and acceptable and welcome you as a new member to the community of well owners and ground water users in Hawaii. This certificate of pump installation completion allows you to commence pumping your well for reasonable & beneficial water use.

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

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

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

3. In the event that the well operator and/or landowner changes, the Commission shall be notified prior to the change.

4. In the event the benchmark in the concrete base of the well is altered in any way, an updated version of the Well Elevation page of the Well Completion Report Part I shall be submitted to the Commission. If a licensed surveyor had estimated the original benchmark elevation then a licensed surveyor must establish the new benchmark elevation. The Well Elevation portion of the Well Completion Report Part I can be obtained by contacting Commission staff or at www.hawaii.gov/dlnr/cwrmlforms.htm.

Mr. Michael Sober

o January 7, 2010

5. Your approved pump has a capacity of 30 gpm at a head of 180 ft. In the future, pump replacements of equal or lesser capacity will not require an additional permit from the Commission, but will require the submission of a Well Completion Report Part II by the licensed pump installer. If the pump replaceme~t is greater than the existing pump, you will need to apply for a new pump installation permit.

6. The landowner shall cause the well operator to maintain the installed meter or other appropriate means for measuring and reporting withdrawals and water levels, and appropriate devices or means for measuring chlorides and temperature. These data shall be measured monthly and reported to the Commission on a annual basis, on forms provided by the Chairperson (attached), in accordance with § 13-168-7, HAR. Blank water use report forms are also available at www. hawaii. gov / dlnr/ cwrmlresources ~ermits.htm

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

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

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

If you have any questions, please contact Charley Ice of the Commission staff at 587-0218 or toll-free at 274-3141 (Kauai), extension 70218.

CI:ss Encl: Water Use Report Form

c: Kauai Department of Water Valley Well Drilling, LLC

Sincerely,


Ms. Tracie Sober

o




January 7,2010

Valley Well Drilling, LLC 91-458 Komohana Street Kapolei, HI 96707

Dear Ms. Sober:

Well Completion Report Part II for Well No. 0522-01


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

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

KEN C. KAWAHARA, PE. DEPUTY DIRECTOR

0522-01. wcr2.acc

We received your Well Completion Report Pa.rt II for the Waipouli 2004 (Well No. 0522-01) on December 18, 2009 and acknowledge that it is complete.

This completes your obligations under the pump installation permit. A certificate of pump installation completion will be issued to the well operator/landowner and you will receive a copy. The certificate transfers responsibility of all aspects of well usage and maintenance from you to the well operator/landowner.

If you have any questions, please contact Charley Ice of the Commission staff at 587-0218.

Sincerely,

N C. KA AHARA, P.E. D puty Dire or

CI:ss

MEMO and ROUT~SLlP (ver. 7/14/2009) 12/21/09

L:...=--=-~~;.;.:~~.:.=.=--:..:....:::..:..:.....:..:...:=-=----=";O;,;:;:;5,::;;2,::;;2,,,;-O~1~~(s::.:u~rv:...:e~y -=to:.....:r..:.eg~u:::la:.:t=io.:..:..n ..:..:.m.:.:e::..:.m=o~) _.-l 'N~p~ 20 04 ~'""' (initial) ! 't.tIf-tt1(;.J ?0..1fl1A. - V\<> P r

2. Pum Tests Check s ecial condition of PIP? Yes~ -. England ~itial) Yes No If no, describe deficiency

Step-Drawdown Test:

followed WCPI Stds analysis attached

Aquifer Pump Test:

followed WCPI Stds T & S analysis attached

Potential Well Interference: Potential Stream Impacts:

Additional Testing or Data Required:

Pump Test Comments Attached:

Proposed Pump Capacity is OK,:

0 0 ~m no test required 0 0

0 0 ~pm no test required 0 0

stream names:

! j

3. Pump Installation Check Mitch Ohye _____ (initial) ... R Terres __ (il"litial) X!! No If no, describe deficiency /

data complete /D followed Special Cond & Elev. 0

well database updated 0

~

o o o

4. (£;arl~yan ~ (initial) take action based on above analysis ..... ATTACHMENTS FOR ACCEPTANCE:

1WCR2 ACCEPTANCE LETTER

2PUMP INST. COMPLETION CERTIFICATE 7 3METER INSTALL. REPORT (IF NECCESSSRY) __ +/_ 4WUR FORM(if necessary) ·7 sUSGS MAP UPDATED 6PARCEl CHECK 1WELL DATAaASE INPUT CHECK 8PUMP TEST WORKSHEET 9PUMP As-Built CHECK PRINT

1" To be sent to driller

J To be sent to landowner/operator

} Staff internal checks

5. ROY+ (initial) check(Entered WCR 2/PICC accept date into database)

6. Susan Hoagbin ~ __ (initial) finalize

7. Ken ~nature 8. Faith Ching (initial) enter into WUR database

9. <£harle~yan File

,I

c State of Hawaii COMMISSION ON WATER RESOURCE MANAGEMENT Department of Land and Natural Resources

WELL COMPLETION REPORT - PART II Installation

Instructions: Please print in ink or type and send completed report (with attachments, if applicable) to the Commission on Water Resource Management, P.O. Box 621, Honolulu, Hawaii 96809. The Commission may not accept incomplete reports. This form shall be submitted within 60 days of the completion of work. For assistance, please consult the Hawaii Well Construction and Pump Installation Standards or call the Regulation Branch at 587-0225. For updates to this form or additional information, please visit our website at http://www.hawaii.gov/dlnr/cwrm/

1. State Well No.: 06[7. -01 Well Name: ~aipCV1\\ LCG1 2. Address: (.;, IV, K \~Gn ~fL1 \ \ KG '\'1 K1r~ll Tax Map Key:

Island: \<1Vf\ , 4 -i -00') '. 0 13

3. Pump Installation Company: ~U\ \ q Xi c \\ Dr \ , \ \ nJ I LLC

4. Date Pump Installed: _ ..... I1-!::::...,.-·I?.:...,.....:·O::..."'J-'--____ _ month/day/year

5. PERMANENT PUMP INFORMATION

Pump Type, Make, Serial No.: ll\ (\11111 b ~ 1. S ~Z.Q .. II ~ G -SO \ CG i \ Rated Capacity: __ ~~LO=-· _______ gpm at head of: _-I.i.:.J..~Ol.l...-______ ft.

Motor Type, H.P., Voltage, rpm: 1- '.q Iv 0 H 1:- 1l.-30 ~ Fr"lrkl i 11 ytj) Yfrn Pump type (check one):

o Deep Well Turbine

ta. Submersible

o Centrifugal

6. Method of flow measurement:

o Rotary

o Rotary-Displacement

o Rotary-Gear

~ Flowmeter wI totalizer Manufacturer frcc, ') \ iJ\t1

o Other, explain and attach schematic

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

8. Attach the rating curve for the installed pump.

o Propeller

o Reciprocating

o Impulse

Model no. Yl~O r~ I Size ----'1_1_12-. __ _

9. Attach photograph of well clearly showing the benchmark on the concrete pad, the well head, and the method of flow measurement.

10. Well Owner Company __________ Contact ---.l.'M,--,-\~\i-!...::::(,-· ->!.~-=-~ ~:...(~\:.../ ____ _

Address ----4-q .!...i-_i\!....::S~~ ~\<~::..L\'pl.....!:C!....!.:· hL..l5.!..:."'I...!........>S!..Lt..:..,.· ..!...~::...l.1-\-V~:...!.\ t~, \!........J...I\\!...!.:\:.-'\=lOlP~1 ____ _

Phone Iv ~ L - \ 1101 Fax ---IIlk2...u~1..1<....-~ \LJ1k~~~ ____ _ Company __ -=-________ Contact ___________ _

Address __ ~~a-"-\ ~~"__"\..L\~'.c\\-{~-(~\\L-::.(Vi.!....:..!..n~-cc.!-V __________ _ 11. Land Owner

Phone __________ _ Fax ___________ _

12. Remarks

Pump Installation Contractor (print) Iftic\f Sch;v C-57/C-57a1A Lic. No. -....:.......!-l....l.....L....-----l1

Signature Date __ ~\ L::::....·..J..v:::..·...:,U_"'1 ____ -I1

WCR2 Form 02126107 Page 1 of 2

c 7 . AS-BUILT PUMP SECTION (Please attach as-built if different from diagram provided below)

Bench mark elevation surveyed to nearest 0.01 ft. = 1 ~ft. mean sea level

l.....----------'

Elevation of top of chase tube 1;20 ~ ft. mean sea level

Pump intake depth = IlttO ft. (referenced to bench mark)

Chase tube depth = \Jk ft. (referenced to bench mark)

If airline installed, bottom of airline elevation =

ft. mean sea level


o o PERFORMANCE CURVES 25GPM MODEL 255

FLOW RANGE: 18 -32 GPM OUTLET SIZE: 11/2.' NPT NOMINAL DRA. 4"

-. I-ill ill L.l.. -.....-0 « ill :r:

1600 ~----------~------------~--~--------------~

1500

1400

1300

1200

1100

1000

900

800

700

600

500

400

300

200

100

0 0

.......... 1255100"5205 (10 HP) I " ..... . -...t

, ....

" , .. ,

·125550-26 (5 HP) I

- .... - -.... .- -- ....

5 10 15

CAPACITY (GPM)

OPERATING RANGE: 18 to 32 GPM CAPACmE5 BELOW 16 GPM SEE MODEL 165

20 25

~~ OS'2~~ol ~tqeDL\ ~4

l~:~r

30


Ms. Tracie Sober

c




November 30, 2009

Valley Well Drilling, LLC 91-458 Komohana Street Kapolei, HI 96707

Dear Ms. Sober:

Extension of Pump Installation Permit Waipouli Well 2004 (Well No. 0522-01)


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

Thank you for your emailed request for an extension, dated November 19,2009. We understand that the work is underway and met some delays. You have indicated that a short period is all that is necessary to complete the work.

By this letter, your request is approved. Your permit is extended to June 16,2010. All other conditions remain the same. Please keep a copy of this letter with your permit.

If you have any questions, please contact Charley Ice of our staff at (808) 587-0218, or toll free from Kauai at 274-3141, extension 70218.

CI:ss

Charley,

nTracie Sobern <[email protected]>

11/19/2009 11:42 AM

To <Charley. F [email protected]>

cc

bcc

Subject extension for pump permit#0522-01

Can we please request an extension for up to one year for our pump permit on well# 0522-01? We are the well, land owners, and well/pump contractor. Thanks, Tracie Sober Valley Well Drilling, LLC 91-458 Komohana Street Kapolei, Hi 96707 (808)682-1767


Ms. Tracie Sober

.''''''




April 10, 2007

Valley Well Drilling, LLC 91-235A Oihana St. Kapolei, HI 96707

Dear Ms. Sober:

Extension of Pump Installation Permit for Well No. 0522-01

PETER T. YOUNG CHAIRPERSON

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

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

STEPHANIE A. WHALEN

Ref: 0522-01.ext

This is in response to your March 8, 2007 email, requesting an extension of the pump installation permit for the Waipouli 2004 Well (Well No. 0522-01). Our records show that this permit is currently set to expire on June 16,2007.

Your request is hereby approved. The pump installation permit has been extended to June 16,2009. /

LN:ss

If you have any questions, please contact Lenore Nakama at 587-0218.

Sincerely,

w:rH W.ROYHARDY Hydrologic Program Manager

/

03/08/2007 12:05 8085821758 VWD HI PAGE 01/02

1§ Valley Well Drilling , LLI

To: Lenore Nakama

587..Q219

Company:DLNR-CWRM

He: Waipouli Well #0522-01

~~~A.

o . 'L _ de fld'M.,

i) v7f 1lI~ - - ----

~efP'e, up:";"" bate; 3/8/2007

cc:

o Urgent o For Review D Please Comment D Pleasa Reply D Please Recycle

• Comments:

Lenore,

Can we please request an extension for the pump installation permit 011 the Waipouli Well # 0522-017

Thank you,

Tracie Sober

..:...J.

~s:: ~

r..l1t;-:,..

~ c~.~! ~:;.

(:~~~ 1 '/::~'; CXl

;!";. -~~ ." .. ~ .-

- '. rs (". :- ~ ['c"'\ -:.:.----:c -I

(,..,) ':f!~;~ ..t:-

91-235A Oihana Street Kapolei, HI 96707 Phone: (808)662-1767 Fax: (808}682-1768

" " ',1 11 :/ '-,T1 ;:J

MAR-08-2007 11:59AM FAX: 8086821768 ID:DLNR CWRM PAGE: 001 R=95%

Lenore,

"Tracie Sober" <[email protected]>

01/30/200604:34 PM

To "'Lenore'" <Lenore.Y.Nakama@hawaiLgov>

cc

bcc

Subject Waipouli Well # 0522-01

Chloride = 18mg/L and 72degrees F on 11/12/04 @ 1200 Initial water was on 11/12/04 but reported as on 12/1/4 for water level to stabilize from 96'bgs to 68' bgs. Thanks, Tracie

/

"'--wlPUMP INSTALLATION PERMIT

Waipouli Well. Well No. 0522-01

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

In accordance with Department of Land and Natural Resources, Commission on Water Resource Management's Administrative Rules, Section 13-168, entitled ''Water Use, Wells, and Stream Diversion Works", this document permits the pump installation for Waipouli Well (Well No. 0522-01) at TMK 4-4-03:73, Kauai, subject to the Hawaii Well Construction & Pump Installation Standards (HWCPIS - February 2004) which include but are not limited to the following conditions:

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

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

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

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

The pump installation permit shall be for installation of a 50 gpm rated capacity, or less, pump in the well. This permanent capacity may be reduced in the event that the pump test data does not support the capacity.

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

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

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

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

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

The work proposed in the pump installation permit application shall be completed within two (2) 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.

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 ppplicant, assigns, officers, employees, contractors, and agents under this permit or relating to or connected with the granting of this e9l'fl1it.

Special conditions in the attached cover transmittal letter are incorporated herein by reference. 1

::

Date of Approval: June 16, 2005 June 16,2007

PETER T. YOUNG, Chairperson cf::J

Commission on Water Resource Management" Expiration Date: . t"

- 0 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 #: 21358 Date: ___ _

Printed Name: --!.:.M!!!ik.!::e::....S=ob=.;e::!r _________ _ Firm or Title: Valley Well Drilling, LLC

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

Attachments


PETER T YOUNG CHAIRPERSON




July 12, 2005

MEREDITH J. CHING CLAYTON W. DELA CRUZ

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

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

DEAN A. NAKANO ACTING DEPUTY DIRECTOR

0522-01. wccc

Mike Sober Valley Well Drilling, LLC 91-235A Oihana St. Kapolei, HI 96707

Dear Mr. Sober:

Certificate of Well Construction Completion for Well No. 0522-01

We are pleased to inform you that the Well Construction work permitted for the Waipouli Well (Well No. 0522-01) is complete and acceptable and welcome you as a new member to the community of well owners and groundwater users in Hawaii.

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

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

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

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

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

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

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

If you have any questions, please contact Lenore Y. Nakama of the Commission staff at 587-0218.

LYN:ss

c: Honolulu Board of Water Supply

Sincerelrl

WfJn 1't

DEAN A. NAKANO Acting Deputy Director

('


Mr. Mike Sober Valley Well Drilling, LLC 9l-235A Oihana St. Kapolei, HI 96707

Dear Mr. Sober:

-




July 12, 2005

Well Completion Report Part I for Well No. 0522-01




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

DEAN A. NAKANO ACTING OEPUTY DIRECTOR

0522-01.wcrl

We received your Well Completion Report Part I for the Waipouli Well (Well No. 0522-01) on May 19,2005 and acknowledge that it was completed on June 16,2005.

The as-built well section shows 55 ft. of grout, which is not compliant with Section 2.6(c) ofthe Hawaii Well Construction and Pump Installation Standards (HWCPIS), which states:

"To prevent surface contamination, the annular space of all cased non-artesian wells must be sealed with grout from the ground surface to a minimum depth of500feet or 70% of the vertical distance between the ground surface and the top of the aquifer selected for exploration, long-term monitoring, or development, whichever depth is less. "

However, in this case, we have determined that the grouted length should be adequate to prevent surface contamination; therefore, we are granting an after-the-fact administrative variance from the HWCPIS. In the future, please do not forget to seek a variance prior to the construction work. Failure to do so may result in fines of up to $5,000 per day or required well modification.

This completes your obligation under the well construction permit. A certificate of well construction completion will be issued to the well operator/landowner and you will receive a copy. This certificate transfers responsibility of all aspects of well usage and maintenance from you to the well operator/landowner.

If you have any questions, please contact Lenore Y. Nakama of the Commission staff at 587-0218.

LYN:ss

Sincerely,

W.fiM 1't

DEAN A. NAKANO Acting Deputy Director

/


Ref: 0522-01.pip

Mr. Mike Sober Valley Well Drilling, LLC 91-235A Oihana St. Kapolei, HI 96707

Dear Mr. Sober:



HONOLULU, HAWAII 96B09

Pump Installation Permit WaipouU Well (Well No. 0522-01)




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

DEAN A. NAKANO ACTING DEPUTY DIRECTOR

July 12,2005

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 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.

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.

Finally, this letter is notice that we have accepted your Well Completion Report - Part I as complete as of June 16, 2005.

If you have any questions, please call Lenore Y. Nakama of the Commission staff at 587-0218.

Sincerely,

W.f7M 1't

Peter T. Young Chairperson

Enclosure

c: USGS KauaiDWS

/

- ..... ~ PUMP INSTALLATION PERMITO Waipouli Well, Well No. 0522-01

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

In accordance with Department of Land and Natural Resources, Commission on Water Resource Management's Administrative Rules, Section 13-168, entitled ''Water Use, Wells, and Stream Diversion Works", this document permits the pump installation for Waipouli Well (Well No. 0522-01) at TMK 4-4-03:73, 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

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 50 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.hawaiLgov/dlnr/cwrm.

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

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

10. The work proposed in the pump installation permit application shall be completed within two (2) years from the date of permit approval, unless otherwise specified. The permit may be extended by the Chairperson upon a showing of good cause and good-faith 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 16, 2005 June 16,2007

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 #: 21358 Date: ___ _

Printed Name: Mike Sober Firm or Title: Valley Well Drilling, Ll.C


Attachments

/

Results

06/20/2005 16:29 8086821768

,..---_~, un, 20· 2005- 5: 3 P M-. ~. -

'l'HIS 'WORK WAS PRO:PARED BY ME OR UNDER MY SuPERVISION

Signoh.rre ESAKI SURVEYING &. MAPPING. INC,

EXPIRES; APRIL 30. 2006

VWD HI PAGE 02/02

--No.7623~P. 1---

22' 05' 01.6231" N lSq' 22' OCU>453" W fl-EV" <~e2. 91

b" PVC

(ifC,OUND

;t:~,OO

EJ..EVATION

NOTES;

I. LATITUDE AND LONGITUDE: ARE NAP '27 DATUM VALUES.

2. BENCi4 MA~K U$ED. BRASS DISK AT WAILUA f.lOM~TEAOO WELL tt& (E~.-'~.73)

616q-t< ~AIPOUJ-I ROAt' ~l-J.. I<GipClGt HCmoet9c:::1d£r, S.tand $erlo!i/

. ~IFOUl..I, KAUAI, H~AII iMf<: (4)4-4-05: 16

Pr.pt::lred ~or: vCllley "' .. 11 Drillrng C'ate 0' Surve~: P"b. :26, :2005

JUN-20-2005 04:25PM FAX: 8086821768 ID:DLNP CWPM PAGE: 002 1'::='::I:y.

State of HaQii 0 For Official Use Only:

/ COMMISSION ON WATER RESOURCE MANAGEMENT Department of Land and Natural Resources

WELL COMPLETION REPORT - PART I Well Construction

Instructions: Please print in ink or type and send completed report (with attachments, if applicable) to the Commission on Water Resource Management, P.O. Box 621, Honolulu, Hawaii 96809. The Commission may not accept incomplete reports. This form shall be submitted within 60 days of the completion of work. For assistance, please consult the Hawaii Well Construction and Pump Installation Standards or call the Regulation Branch at 587-0225. For updates to this form or additional information, please visit our website at http://www.state.hi.us/dlnr/cwrm/

1. State Well No.: 0522-01 Well Name: Waj poll] j 2004

2. Address: 6169K Waipouli Rd, Kapaa Tax Map Key:

3. Drilling Company: Valley Well Drilling

A 9' i 5

" r'

Island: Kallai

4-4-03; 7I'1ft 1 ~

4. Drilling method used during contruction: lX Rotary D Percussion D Other (describe)

5. Date Well Construction (drilled,cased,grouted) completed: 4/22/05 Fill out attached Driller's Log month/day/year

In addition to the driller's log, if a geologic log was prepared, please submit with this form.

6. Was the subject well cored? DYes I»cNo

7. Initial water-level encountered 96~. below ground Date and time of measurement: 12/1/04 1200 * Wa er level rose to 68' month/day/year time

8. Step-Drawdown Test completed? IX! No D Yes Attach Step-Drawdown Test form (12117/97 SDPTD Form)

9. Constant Rate Aquifer Test completed? ~ No D Yes Attach Constant Rate Aquifer Test form (12117/97 CRPTD Form)

Parameters prior to pump test:

10. Water-level: ft. above msl Date and time of measurement: -------------------11. Chloride: \ (C' ppm Date and time of sampling:

12. Temperature: " OF Date and time of measurement: ..

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

Attach photograph of well and concrete pad showing benchmark on concrete pad.

Fill in attached surveyoilg~R. rm berx:lhlmk E:t:clAZtion 9l.~~'f('J.

month/day/year time

month/day/year time

month/day/year time

14.

15.

16. If a pump is not planned to be install~tf~tse describe (below in the remarks section) how well is secured to prevent unauthorized access (example: lockable cover, threaded coupling, etc.)

17. Remarks: A pump house is built over the well with a padlock

Licensed Driller (print) Valley Well Drilling C-57 Lic. No. _....;2=-1;.,.;:3:.,::5;,.::;8 ______ _

Signature Date 5/12/05

Bench mark elevation:

13. AS-BUILT ~L SECTION

~

(Please attach as-built if differenO diagram provided below)

Hole Diameter: IL in. Elevation at top of casi;g ~OO ft., msl*, (to nearest 0.01 ft.)

------------..~. :.' :' .. ~ . "

'.'"

Minimum of 2' Radius & 4'~ick Concrete Pad

Ground Elevation: ......... Zq~ ft., msl ..

Please refer to the ___ ft., msl* (Survey to nearest 0.01 ft.)

Cement Grout: '2~' ft. .... HAWAII WELL CONSTRUCTION AND (min. 70% of distance from -: .... ' PUMP INSTALLATION STANDARDS ground elevation to top of to ensure that your as-built is in compliance water surface or 500 ft., with applicable standards. whichever is less.) .....

Grouting method:

'Positive displacement

Annular space between ....

...... ',' .

" .: Solid Casing: (;:: 90% x (Ground Elev.-Water Level Elev)) hole and casing (1.5" for positive displacement, 3" for other methods):

Length: 12-0 ft.

Nominal Diameter: Ip in.

. ....

..... o Other

Q in. " ,',

Wall Thickness: o .2-~ in. v> ZOO Bottom Elevation: \C ft., msl

Rock or Gravel Packing: I x

cf!. I Total Depth

1..00 ft. 10

Material: ft. 0'

Ol Open Casing: o Perforated &'Screen 1\1

~Crushed Basalt Length: ___ -=W:..:::.-________ ft.

o Rounded Gravel

Water Level Elevation: t: 1.04- ft. msl*

I 1 ',-

1 t,\, I 1

.1 L, 1 :c" _1 L,;;' 1

Nominal Diameter: _-=l?~::--______ in.

Wall Thickness: O·21l in.

Bottom Elevation:_~~....:I'_=UJ~ _____ ft., msl

Open Hole:

Length: ___ ~1.::.\.L..:~..:_. _______ ft.

Diameter: _____________ in.

Bottom Elevation: _________ ft., msl

*msl = mean sea level

Solid Casing Material: Carbon Steel: compliant with (check one or more): 0 ANSIIAWNA C200 0 API Spec. 5L o ASTMA53 o ASTMA139

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

Stainless Steel: (check one): 0 ASTM A409 (production wells) o 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 D1785 or ASTM D2241): (check one): [j1"Schedule 40 0 Schedule 80 0 Schedule 120

Thermoset Plastic: (check one) o Filament Wound Resin Pipe conforming to ASTM D2996

o Centrifugally Cast Resin Pipe conforming to ASTM D2997

o Reinforced Plastic Mortar Pressure Pipe conforming to ASTM D3517

o Glass Fiber Reinforced Resin Pressure Pipe conforming to AIfllWA C950

o PTFE Fluorocarbon Tubing conforming to ASTM D3296

o FEP Fluorocarbon Tubing conforming to ASTM D3296

Open Casing Material: Carbon Steel: compliant with (check one or more): 0 ANSIIAWNA C200 0 API Spec. 5L 0 ASTM A53 0 ASTM A 139

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

Stainless Steel: (check one): 0 ASTM A409 (production 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 D1785 or ASTM D2241): (check one): !V"Schedule 40 0 Schedule 80 0 Schedule 120

Thermoset Plastic: (check one) o Filament Wound Resin Pipe conforming to ASTM 02996

o Centrifugally Cast Resin Pipe conforming to ASTM 02997

o Reinforced Plastic Mortar Pressure Pipe conforming to ASTM 03517

o Glass Fiber Reinforced Resin Pressure Pipe conforming to AWNA C950

o PTFE Fluorocarbon Tubing conforming to ASTM 03296

o FEP Fluorocarbon Tubing conforming to ASTM 03296


State of Ha9aii 0 COMMISSION ON WATER RESOURCE MANAGEMENT Department of Land and Natural Resources DRILLER'S LOG

For Official Use Only:

35 A 9' 15 Well Number: 0522-01

~~~--------------

i,

Depths (ft.) Rock description, Water level, etc. Dates Depths (ft.) Rock description, Water level, etc. Dates

0 to 10 Brown silty dry clay 12/1/4 to

10 to 45 Light brown to reddish silty clay with 12/1/4 pockets of weathered basalt

to

45 to 96 Brown clay chips with moisture-initial 12/1/4

water hit at 96 to

to Water level then came up to 68' 12/1/4 to

96 to 150 Mix of tight brown clay with basalt. 12/1/4 Soft to medium hardness to

150 to 200 Weahtered black basalt mixed with 12/1/4 clays to

to to

to to

to to

to to

to to

to to

to to

to to

to to

to to

to to

to to

Remarks:

DL Form 06/24/2004

Attach photos of completed well and concrete pad

- -

EXAMPLE

20'

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

weR1 Form 10118104 Page 4 of 5

:' o o

VALLEY WELL DRILLING 91-235 A Omana Street • Kapolei, Hawaii 96707 808-682-1767 • Fax 808-682-1768 • G 57 License ~HT965 D~ ~~\;-: 22 A 9: I 7

March 18, 2004

Hawaii DLNR CWRM P.O. Box 621 Honolulu, HI 96809

RE: Waipouli 2004 Well-#0522-01

Dear Water Commission:

; ,-' ,-. I

" ...... ~- '

We would like to take advantage of the ruling to install a permanent pump prior to the final pump installation permit issuance.

Please call if you have any questions 682-1767.

~~ ~Cso~ Land Owner, Contractor, Permittee

, .. , ('-, . , .' ',.; ~

-' o WELL CONSTRUCTION PERMIO

Waipouli 2004 Well, Well No. 0522-01 Note: This permit shall be prominently displayed at the site until the work is f,9~~\(r: ~

In accordance with Department of Land and Natural Resources, Commission on Water Resource Man'agement's Administrative Rules, Section 13-168, entitled 'Water Use, Wells, and Stream Diversion Works", this document permits the construction and testing of Waipouli 2004 Well (Well No. 0522-01) at 6167K Waipouli Road, Kauai, TMK 4-4-03:72#2, ~tljec\,~ ~~waJ:\ WeU Cfnstruction & Pump Installation Standards (February 2004) which include but are not limited to the following ~i1diti8MS~ \ ~ • I

1,

2.

3,

4,

5.

6.

7.

8.

9.

10,

11,

12.

13.

The Chairperson 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 tiKw~~jn({'li\spelt lAS&1fcifiAn activities in accordance with §13-168-15, Hawaii Administrative Rules. REsn! (C;~~ : ... ';~:>Ti T

The well construction permit shall be for construction and testing of the well only. A minimum 11/4-inch diameter monitor tube shall be permanently installed, in a manner acceptable to the Chairperson, to accurately record water levels. The permittee, well operator, and/or well owner shall coordinate with the Chairperson and conduct a pumping test in accordance with the Standards (a pump testing worksheet is attached). The permittee; well operator, and/or well owner shall submit to the Chairperson the test results as a basis for supporting an application to install a permanent pump and withdraw water for use. No permanent pump may be installed until a pump installation permit is approved and issued by the Chairperson.

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

The permittee, well operator, and/or well owner 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, well operator, and/or well owner shall stop work and contact the Department's Historic Preservation immediately.

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 following shall be submitted to the Chairperson within sixty (60) days after completion of work: a. Well completion report, (attached - Part I, Well Construction Report). b. Elevation (referenCed to mean sea level, msl) survey by a Hawaii-licensed surveyor. c. As-built sectional drawing of the well. d. Plot plan and map showing the exact location of the well. e. Complete pumping test records, induding time, pumping rate, drawdown, chloride content, and other data.

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

The well construction p'ermit application is incorporated into this permit by reference and is subject to the Hawaii Well Construction & Pump Installation Standards (February 2004; HWCPISj. If the HWCPIS are not followed and as a consequence water is wasted or contaminated, a lien on the property may result.

The permit may be revoked by the Commission if work is not started within six (6) months after the date of app'roval or if work is suspended or abandoned for six (6) months, unless otherwise specified. 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 three (3) months prior to the date the permit expires. If the commencement date is not met, the Commission may revoke the permit after giving the permittee, well operator, and/or well owner notice of the proposed action and an opportunity to be heard.

If the well is not to be used it must be properly capped. If the well is to be abandoned then the permittee, well operator, and/or well owner 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 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.

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

Jf/frlt~7 Date of Approval: March 10,2004

March 10,2006 ~ PET~R T, YOUNG, Chairperson

Expiration Date: 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 driller have signed, dated, and returned the permit to the Commission. I also understand that non-compliance with any permit condition may be grounds for revocation and fines of up to $1000 per day starting from the permit date of approval.

permitteeISSignature~~ Date: 3/18/04

Printed Name: .~ Firm or Title: __ 0Wner _____________ _

~-JiC;~""'--»'=' =--::.rf"!h'--"--=------ C-57 License #: 21358

~ber Firm or Title: Valley Well Drilling

Driller's Signature: Date: 3/18/04

Printed Name:


Attachment c: USGS

Department of Health! Safe Drinking Water, Wastewater, and Clean Water Branches Kauai Department of Water Supply

c PETER T. YOUNG

CHAIRPERSON BOARD OF LAND AND NATURAL RESOURCES


11"»".. .,..,. '1'"""' , COMMISSION ON WATER RESOURCE MANAGEMENT ~.--, :.l''':::-n

STATE OF HAWAII ...'tl!:" , ::"zs'r~,,:. DEPARTMENT OF LAND AND NATURAL m¢P~~f,

,)~. '. \ >..,; - ,0;-

HISTORIC PRESERVATION DIVISION-

March 8, 2004 KAKUHIHEWA BUILDING, ROOM 555 601 KAMOKILA BOULEVARD

KAPOLEI, HAWAII 96707

; '..' DAN DAVIDSON DEPUTY DIRECTOR· LAND

ERNEST Y.W. LAU

A 9: 1 tfPUTYDIRECTOR.WATER

AQUATIC RESOURCES BOATING AND OCEAN RECREATION

BUREAU OF CONVEYANCES COMMISSION ON WATER RESOURCE MANAGEMENT

'\ .:1 \ 'ljo'( CQNSERVATION AND COASTAL LANDS . ,CoNl'~ATION AND RESOURCES ENFORCEMENT

, ' .' !' _ ~ , ENGINEERING , ; ,~ , ,'- t t J'li FORESTRY AND WILDLIFE

, , -, HISTORIC PRESERVATION KAHOOLAWE ISLAND RESERVE COMMISSION

LAND STATE PARKS

HAWAl'I HISTORIC PRESERVATION DIVISION REVIEW

LOG NO.: 2004.0538 DOC NO.: 0403JK07

Applicant/Agency: Address:

Project:

Location: Tax Map Key:

Mike Sober 91-235A Oihana Street Kapolei, HI 96707

Chapter 6E-42 Review (State) Commission on Water Resource Management, Well Construction/Pump Installation Permit Application, Waipouli Well (Well No. 0522-01)

Kalopa Homesteads, Hamakua, Hawai'i Island (3) 4-4-003: 72 #2

l. We believe there are no historic properties present because: X a. intensive cultivation has altered the land

___ b. residential development /urbanization has altered the land ___ c. previous grubbing/grading has altered land ___ d, an acceptable archaeological assessment or inventory survey found no

historic properties ___ e. other:

2. This project has already gone through the historic preservation review process, a. mitigation has been completed b. other:

__ X_Thus, we believe that "no historic properties will be affected by this undertaking.

Signe .' '-:1'Yl . l'-~ storic Preservation Divisiorl~ a

Jeanne M. Knapp

+ ' LINDA LINGLE PETER T. YOUNG

GOVERNOR OF HAWAII CHAIRPERSON

MEREDITH J. CHING CLAYTON W. DELACRUZ

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



HONOLULU. HAWAII 96809

ERNEST YW. LAU DEPUTY DIRECTOR

March 15, 2004

Ref:0522-01.wcp

Mr. Mike Sober Valley Well Drilling 91-235A Oihana Street Kapolei, HI 96707

Dear Mr. Sober:

Well Construction Permit Waipouli 2004 Well (Well No. 0522-01)

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 your 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 is a copy 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.

This permit does not authorize work for your permanent pump installation. Approval and issuance of your pump installation permit is contingent upon completed application and information provided to and accepted by Commission staff as required in the Well Construction & Pump Installation Standards (February 2004) and any special conditions performed under this permit. However, a permanent pump may be installed prior to the permanent pump installation permit issuance in accordance with the Commission's April 15, 1998 Declaratory Ruling No. DEC-ADM98-G5, which states that:

"Permanent pump installation for capacities between 0-70 gpm and where the proposed use is for private individl.lal needs in non-ground-water management areas may be allowed prior to the final pump installation permit issuance. When required as a condition of the well construction permit, subsequent pumping tests shall validate the acceptability of the permanent pump. The permanent pump installed prior to final pump installation permit issuance is subject to removal if the testing shows that a smaller pump is required to reduce the potential of affecting neighboring wells and localized upconing at the applicant's well. "

If you qualify and wish to take advantage of this ruling, please include a written request to install the permanent pump prior to final pump installation permit issuance when you return to us your signed well construction permit.

/'

Mr. Mike Sober Page 2 March 15,2004

Please sign both permit originals and return one for our files. Also, copies of the aquifer pump test worksheet and the well completion report form are enclosed for your use.

IMPORTANT - Drilling work shall not commence until a fully Signed permit is returned to the Commission. Be advised that you may be subject to fines of up to $1000 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 274-3141 (Kauai), extension 70218.

Sincerely,

t~/.frH ,ppeter T. Young

Chairperson

Enclosures

I""'" ~ "'wI WELL CONSTRUCTION PERMI""

Waipouli 2004 Well. Well No. 0522-01 - .

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

In accordance with Department of Land and Natural Resources, Commission on Water Resource Management's Administrative Rules, Section 13-168, entitled 'Water Use, Wells, and Stream Diversion Works", this document permits the construction and testing of Waipouli 2004 Well (Well No. 0522-01) at 6167K Waipouli Road, Kauai, TMK 4-4-03:72#2, subject to the Hawaii Well Construction & Pump Installation Standards (February 2004) which include but are not limited to the following conditions:

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

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

The well construction permit shall be for construction and testing of the well only. A minimum 11/4-inch diameter monitor tube shall be permanently installed, in a manner acceptable to the Chairperson, to accurately record water levels. The permittee, well operator, and/or well owner shal coordinate with the Chairperson and conduct a pumping test in accordance with the Standards (a pump testing worksheet is attached). The permittee; well operator, and/or well owner shall submit to the Chairperson the test results as a basis for supporting an application to install a permanent pump and withdraw water for use. No permanent pump may be installed until a pump installation permit is approved and issued by the Chairperson.

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

The permittee, well operator, and/or well owner 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, well operator, and/or well owner shall stop work and contact the Department's Historic Preservation immediately.

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 following shall be submitted to the Chairperson within sixty (60) days after completion of work: a. Well completion report, (attached - Part I, Well Construction Report). b. Elevation (referenced to mean sea level, msl) survey by a Hawaii-licensed surveyor. c. As-built sectional drawing of the well. d. Plot plan and map showing the exact location of the well. e. Complete pumping test records, including time, pumping rate, drawdown, chloride content, and other data.

The pes:mitte~Lyvell op~rator, and/or well owner shall comply with all applicable laws, rules, and ordinances; non-compliance may be grounds for revocation of mlS permit.

The well construction Rermit application is incorporated into this permit by reference and is subject to the Hawaii Well Construction & Pump Installation Standards (February 2004; HWCPISj. If the HWCPIS are not followed and as a consequence water is wasted or contaminated, a lien on the property may result.

The permit may be revoked by the Commission if work is not started within six (6) months after the date of app'roval or if work is suspended or abandoned for six (6) months, unless otherwise specified. 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 three (3) months prior to the date the permit expires. If the commencement date is not met, the Commission may revoke the permit after giving the permittee, well operator, and/or well owner notice of the proposed action and an opportunity to be heard.

If the well is not to be used it must be properly capped. If the well is to be abandoned then the permittee, well operator, and/or well owner 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 injury, or aeath 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.

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

IVAf~~1 Date of Approval: March 10, 2004

March 10, 2006 -for PET~R T. YOUNG, Chairperson

Expiration Date: 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 driller have signed, dated, and returned the permit to the Commission. I also understand that non-compliance with any permit condition may be grounds for revocation and fines of up to $1000 per day starting from the permit date of approval.

Permittee's Signature:, ______________ _ Date: ______ _

Printed Name: Firm or Title: ________________ _

Driller's Signature: ______________ C-S7 License # : _____ Date: ______ _

Printed Name: Firm or Title: ________________ _


Attachment c: USGS

Department of Health! Safe Drinking WaIJ3r, Wastewater. and Clean Water Branches Kauai Department of Water Supply

Well No. Well Name Applicant

0522-01 Waipouli 2004 mike sober

o

SECTION 1: WELL LOCATION INFORMATION

Island Aquifer System Aquifer Sector

KAUAI LIHUE ANAHOLA

data

Date of Review Reviewer

Proposed Use Proposed Withdrawal System Sustainable Yield

2/4/2004

RRI

Domestic 5000

36

SECTION 2: WELL SECTION DATA (enter data in grey cells only)

Elevation at top of casing Ground Elevation Cement Grout Rock Packing Hole Diameter Total Depth

Estimated Head Calculated Aquifer Thickness

County Water Supply (YIN ?)

ft., m.s.!. ft. ft.

_ ,It "30' ft., m.s.!.

1230 ft.

Solid Casing Material Designation Length Diameter Wall Thickness

Casing Material Designation Length Diameter Wall Thickness Openings

Open Hole Length Diameter

ft. in. in.

ft. in.

----.;...'-"+~

in. sq.in.l!.f.

SECTION 3: CHECKLIST (values to check are shaded)

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

Well Casing Minimum Wall Thickness

Material County or Non-County

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 Annular Space

Depth of Grouting Calculated Depth of Grouting Depth of Grouting provided

Thickness of Annular Space

PVC

1230 ft. 307.5 ft.

200 ft.

non-county 0.375 in. 0.375 in.

153 ft. 300 ft.

Sch 80

119 ft. 125 ft.

3 in.

okay (refer to HWCPIS Section 2.2) (disregard if the well is not basal, deep monitor or salt water)

okay (refer to HWCPIS Section 2.4 c) (disregard this if this is a non-county well)

okay (refer to HWCP/S Section 2.4 d) okay (refer to HWCP/S Section 2.4 e) If the cell above reads #NIA, reference HWCP/S)

okay (refer to HWCPIS Section 2.6 c) okay (refer to HWCPIS Section 2.6 d)

Page 1

03-04-04 09:39am From-DOH/Sate Drinkinl Water Branch 8085864351 T-951 F-559

UNDALiNGlE _ .. -

TO:

FROM:

STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL ~OURCES

COMMISSION ON WATER RESOURCE MANAGEMENT P.o. BOX621

HONOLULU. HAWAII 9G8O!I

February 6. 2004

Honorable Chiyome L Fukino, M_D., DireCtor Department of Health Attention: Harold Yee, Wastewater Branch

Fax #

srEPH'ANiEA.·Wic"AIi;· ERNEST V.W \.Au

DErun 'IlI1IU:TOR

William Wong, Safe Drinking Water Branch Dr. Keith Kawaoka, Hazardous Evaluation and Emergency Response Alec Wong, Clean Water Branch

Peter T. Young, chai~rso~ C.ommission on Water Res~~~~ Management

SUBJECT: Well Construction/Pump Installation Permit Application Waipouli 2004 Well <Well No. 0522-01)

Transmitted for your review and commelJt is a copy of the captioned Well ConstructionlPump Installation pennit application.

We would appreciate your comments on the captioned application for any conflicts or inconsistencies with the programs, plans, and objectives specific to your department. Please respond by returning this cover memo form by March 10, 2004. If we do not receive comments or a request for additional review time by this aate, 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 infoJTT1ation, or request additiOnal review time, please contact Lenore Y. Nakama .of the Commission staff at 587-0218.

LYN:ss Attachment(s)

RESPONSE:

[ 1

[ )

[ J

[ J

[ 1

This weD qualifies as a source WIIiCII willsetVe;u; a &DUIC8 DfpolBbleWBlel"to IIP~WlterSy$\Cn1 (dslinsd iI& &erVillQ 25 or IhOre peepll! at !Bast 80 da.,s per YQr or NIS 15 or more senna: col'lnac:tiOO&) and mlllit l'I!C8ive DireClior Of He81111 a~ ~or to Ita ~ to comPly with Hawaii Administrative Rules (HARJ. TitIa 11. ChapIBr 20. RiJlaa Relalingto P9\e'-walet~. §11- 29.

This WIlli does not q\J3fif)' as a ~ senriI')g a public water!'YJ!1Im (8elVl!S less Vlan 25 people or more PII!lIllI! ~ lent liD dayS rer year or 15 &erVica connectiOns) anCI if tne wall WiIIIIr 15 U&8d for drinking, .=1lVB\e owner $hOUlcr test fOr batlBriDlDglcal and ~IT\ICI presence befora initiating suCh usa and m~ monitor" the wall!r g \hefe;lllIer. However. if tutu"' ~ned use from thiS SOlltee mcraaS85 to meet tile II\Iblie watet system dafinition than Diraclor of H spprovaIls requlrecl J!!!9!: to ImplemBTlliltion.

If VIe well i& u&ad 10 5UJIIIIy bDIh poIabla and oon-pOlabll! purpD8I!B In a SIngle sYStem. tile \Iset Shall eliminate crQ6&.QOlII1ec:11ons and Qaeldlow connaction& by physically &Bparaling poWbie and non'po1Ible systems by an air gap or an apprlM!d becICfIow f)feventer. and by dearlY labeling 811 non-poISbIe!SPlllots wtm warning signs fO prevent inadllartant CDI1&umpIion of J1Dn.poUible water. Baddlow p~cn davicat; should be rouIIneIy Inspected and tested.

It does not appear 1tl3l \hIS well will lie used fOr con&IImplivu purpo&85 and i& not BUbject to Safe DrInking ~ Rcvulation&.

For lI'Ie applicants I/lfolTTl8tion, a source of possible wastewater contamination l Jit; I J is not located near the proposed well SilO (lnto~ attsched).

An IIIPOES pennit i& /'8quira',t

OIhClr rdeVaIIl OOH ruleslregulati0n5, informetlon, or ll!Comrnendllllons 81e 8tt8Ched.

[ 1 No comments/objection!;

COntact f'eP.lon' p;u CO" Phone: ____________ _

Signed ~(R co~ Date; FEB I 1 ZIl4

_ ............ o LINDA LINGLE

GOVERNOR OF HAWAII PETER T. YOUNG

CHAIRPERSON

lOO~ FE: " 0 P 2: j I


JAMES A. FRAZIER CHIYOME L. FUKINO, MD STEPHANIE A WHALEN

ERNEST yw. LAU

STATE OF HAWAII DEPUTY DIRECTOR

T

TO:

FROM:

SUBJECT:

DEPARTMENT OF LAND AND NATURAL RESOURCES

,COMflllISSION ON WATER RESOURCE MANAGEMENT P.O. BOX 621


February 6, 2004

Dede Mamiya, Administrator Land Division

Ernest Y.W. Lau, Deputy Direc~ Commission on Water Resour~~r~~nagement Well Construction/Pump Installation Permit Application Waipouli 2004 Well (Well No. 0522-01)

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

c:::1 ...... ~ ;;;;00 ;:.0

c..,)

:z:, S

c:;)

en

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 March 10. 2004. 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.


RESPONSE:

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

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

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

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

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

[ ] No objections

~;o :i1 "') '";1

.'" .... "1 :J

xfx:] Other comments: original source of private title is Grant 7147 issued prior to statehood.

Contact Person: __ -,G,;i,Ca;Ur~lr-' ~Ml,,<;au:r::.:tt;.J,j..llnL...-________ _ Phone: -~5~g+7-0~42~1~'---

Signed:_-?'7~~":""';~~'--_~;;"":"-=' ___ -":::""~ _____ _ Date: MAR - 3 2004

- o FEB.1 7 2004 .~ o


PETER T YOUNG CHAIRPERSON

TO:

FROM:

SUBJECT:




February 6, 2004

Honorable Chiyome L. Fukino, MD., Director Department of Health Attention: Harold Vee, Wastewater Branch

William Wong, Safe Drinking Water Branch

MEREDITH J CHING CLAYTON W DELA CRUZ

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

ERNEST YW LAU DEPUTY DIRECTOR

Dr. Keith Kawaoka, Hazardous Evaluation and Emergency Response Alec Wong, Clean Water Branch

Peter T. Young, Chairperso~ Commission on Water Res~~}c~ Management

Well Construction/Pump Installation Permit Application Waipouli 2004 Well (Well No. 0522-01)


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 March 10. 2004. 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: [ J

[ 1

[ 1

[ 1

[ 1

[ 1

''xf

This well qualifies as a source which will serve as a source of potable water to a public water system (defined as serving 25 or more people at least 60 days per year or has 15 or more service connections) and must receive Director of Health approval prior to Its use to comply with Hawaii Administrative Rules (HAR), Title 11, Chapter 20, Rules Relating to Potable Water Systems, §11-20-29.

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. source Increases to meet the public water system definition then Director of Health approval is required prior to I~mentation. ~

~~ If the well is used to supply both potable and non-potable purposes in a single system, the user shall eliminQ{'e crl)ss-connec1l1ns and ~ backflow connections by physically separating potable and non-potable systems by an air gap or an approv~:'baC1<.flow pr_ter, and 0!t1 clearly labeling all non-potable spigots with warning signs to prevent inadvertent consumption of non-potable w~. Backfl(\\\,Qlrevention . devices should be routinely inspected and tested. ~:.::!.. ;-/; N1

It does not appear that this well will be used for consumptive purposes and is not subject to Safe Drinking WaterR~gulationP 1}

For the applicant's ;nformation, a source of possible wastewater contamination 'Mis [I is not located near th~ ~r.o~ed well • .~, (information attached). 1\ ~.'C: W .:

~l ~~; ) "-',-{ An NPDES permit is required.

Other relevant DOH rules/regulations, information, or recommendations are attached. ~::'.~--l

)« No comments/objections • ,

Contact Person: UJv1 N. '\V\fa~ Phone: __ ~~~~~~tf ____ __ "'..( II ~'11 ~

Signed:---'::l.)JJV::....-_' ___ ~~-ft~_--L. _______ _ Date:_~_I_~_~Wlf-+-_

-.. '

ENV HEALTH KAUAI tsUts'::4"'.)'OO Wa~~e.a~e~ B~anch

ut;.'lg u"'t 11.1010 .'v.v.", ..... ,.." . If * 17 04 04: 1. 7 .. 8085864300 pel

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'-, .... 11.1

B'4 fES 20 p 3: 0 3 STAlE OF HAWAA DEPARTMENT OF HEALTH

tJ.o.WQltsmt ..,...,.. u MfIfM ..."

Facsimile Request and Cover Sheet Wasteweter Branch

919 Ala Moana BlVd. Room 309 HonoIulur Hawaii 96814-4920

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

~\ \1~!tQQ4 TotatPages---.:-,l __

~ : Joe Tateyama, Kauai District Health OffiO!

.e! Lori Kajlwara, Planning/Design Section email: [email protected]

Subjec;t: Request for Information

File # if applicable: _4-.:....:l;....o..!t...;::t':.--_

Record Date:

Submit Date: Plan Approval Date:

Inspec:tion Date: Syan "Approval for Use" 0iIte:

Ph (808)241 .. 3323 F.ax(808)241-356&

[ ] aerobic unit

\,,(tJ'T I

~qql"UC7"") Other: i= 3!fY1'C C S''fsniMS IH'V!!.Ofra-2 ~ ussr '''> iUtUZ..Oc.U.l"'~G

).. A'~~ f1e'5.¢l~C@> IN fl.PC?.), c.sssfQQ~ Ql~r Avo. ~y $sLY9U,NP' !l,)6 "~M'If4' .

Please fax site/ plot plan if available. Thank you.

.. 'l-

,. ~19-Z004 01:50pm From-DEPT OF HEALTH ENVIRONMENTAL UNCUT -- ,. ; .. 808586435Z T-066 P.OOZ/DDZ F-D76

~) LINDA LIffOLE -"'-

TO:

FROM:

SUaJECT:

, -, JlWES A FRA2lER ~ MEREDITH J CHING

CLAYTON W. DELA CRUZ

i I I . • (\: ~ I ~IYOME L. FUI<INO. M.D

STATE OF HAWAII DIOPARTMENT OF lAND AND NAluRAl RESOURCES

COMMISSION ON WATER RESOURCE MANAGEMENT I'.O.IIOX 1121

HONOI-ULU. HAWAII \lII8D9

February 6, 2004

Honorable Chiyome L. Fukino, M.D .• Director Department of Health Attention; Harold Yee, Wastewater Branch

./ -' TEPHANIE A WHAlEN

Rrlt:6T Y.W L.AU ~l't'DICtG1OR

William Wong. Safe Drinking Water Branch Dr. Keith Kawaoka, Hazardous Evaluation and Emergency Response Alec Wong, Clean Water Branch

Peter T. Young, Chairperso~ Commission on Water Res~~~~ Management

Well ConstructionlPump Installation Permit Application WaiPQuli 2004 Well (Well No. 0522-01)

Transmitted for your review and comment is a copy of the captioned Well ConstrUctionIPump 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 March 10. 2004. If we do not receive comments or a request tor additional review time by this date. we will assume that you have no comments.

Please find the attached m~ 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: II

[ 1

[ I

[ I

[ )

x

This well guaiifil5 III II .ource WIlicn WlH lIIMlilli illOII'Ge 01 potaDle Willer 10 II public watet svtotem (detineCJ as servin!! 2$ or mora people at lOUt 00 C1IIYlI per year or Ile$ 11j or more SIInrica ~necaons) and mm;t rec.eive DireClOt orliaaltllllPll"OYBI ~ to Itt LIR 10 comply *"" Hawaii AclminlstraWe RuIM (HAR), Tille 11, Cllapte, 20, Ruleu Relaung 10 Potable Water Systems. §11-~

Thill wull doeo nQi qulllify 1I11111Oun:e ICIVIng a public Winer s~ (5etveS 18&5 thlln 2S peojll8 0' RlDI'8 PQ9pe at lea" 80 ~yo re' '/fIar or 16 seMoe QOI1neclione) and If tile wei wafer 1& IlIied for dririlClng. 1M privaW QWl1er shOuld'lat fOr b;K;IeridloQlCal and "",,",ICII IIruenc:e before InlllatInCI sUCl't use and rou1in~ monitor tile watar quaillY thereafter. However. it future planned U&8 from Ulis SOU/CB Increases to meet tile pUbliC watet sy5fem definRion Ulen DI_ of l1011hh apprOYBlIS Mquirad I!!!!!! 10 Implementalioo.

If the we. iii u&Bd tg tupply belCh POIIIIIIII and non-potable purposes in a single SV51Bm. the user snail eliminate crou-connllClliona Inel bec:IdIow connectione IJy pnyeicahy 5epatlllnQ pofable ;II1d non-potable syslems by In eirtl1p or an app~ bllddlow flr!!V8I1Ier, lind by Cllllltly labeling ab non.potable SIJlgOlS with ~ing IIigns 10 pt8V1II'Il inadvertem oonsumpaon 01 non-polllble waler. BaCktIo.v prevention devices sllOUlCl be routinely Inspadad and eel_.

It aoee nDC appear II1IIt this well will be USed fOr COO&umplive purposes and is n01 subject to Safe Otinlting Water ReoufaliOl\&.

For the l!fJIIIicanf& infOrmation. 01 r;ollJI;C of possible waSl8wa1sr CDI1IW1lination I liS IllS not IDcalecI near Itle propo&ad wefl Site (Inrormation attacnea).

AI'! NPDE5 permit Is required.

DthHr relevarlt DOH tulesfregullliOn&, information, or rec:ommendilliomi are 8lt11cneo. No commentA/objeClionS [ 1

Contact person:~-+-l-'~=-",C/=-"_~;",,,_+-____ _ Phone:

signed: __ ....t..:iiOZ-...;;;:;......;...;;-------l-...a~_+:::;:::_----- Date:

~ .,.. ~ ~

FBb~19-Z004 01:50pm From-DEPT OF HEALTH ENVIRONMENTAL MNGMT 808586435Z T-066 P.OOI/OOZ F-076

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 effluent associated with well drilling activities is regulated by Hawaii Adrninistrative 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 fee 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 necessary, 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 implemented to prevent the discharge from disturbing the clarity of the receMng water. If the discharge is entering a storm drain, the dis~harger must obtain written 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 sto"!, drain .

. JSJcr


Mr. Mike Sober Valley Well Drilling 91-235A Oihana Street Kapolei, HI 96707

Dear Mr, Sober:




February 6, 2004


MEREDITH J. CHING CLAYTON W. OELA CRUZ

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

STEPHANIE A. WHALEN

ERNESTY.W. LAU DEPUTY OIRECTOR

0522-01 ,rev

Well Construction/Pump Installation Permit Application for Well No. 0522-01

We acknowledge receipt, on January 30, 2004, of your completed Well Construction/Pump Installation permit application and filing fee for the Waipouli 2004 Well (Well No. 0522-01). You can expect your application to be processed within ninety (90) days from this date.

For your information, the process of constructing a well is normally regulated and permitted in two (2) steps. First, a well construction permit is issued for drilling and testing purposes only. Based upon information provided by you through a Well Completion Report Part 1 (Well Construction), a pump installation permit (upon completed application) may then be issued to authorize pump work. If a pump is installed then a Well Completion Report Part 2 (Pump Installation) is required.

If you have any questions about your permit application, please contact Lenore Y. Nakama of the Commission staff at 587-0218.

LYN:ss

Sincerely,

p,/f,h i/ ERNEST Y.W. LAU

Deputy Director

/



TO:

FROM:

SUBJECT:



HONOLULU, HAWAII 96B09

February 6, 2004

Honorable Chiyome L. Fukino, M.D., Director Department of Health Attention: Harold Vee, Wastewater Branch

William Wong, Safe Drinking Water Branch


JAMES A FRAZIER CHIYOME L. FUKINO, M.D

STEPHANIE A WHALEN


Dr. Keith Kawaoka, Hazardous Evaluation and Emergency Response Alec Wong, Clean Water Branch

Peter T. Young, Chairperso~ Commission on Water Res~~~c~ 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 March 10. 2004. If we do not receive comments or a request for additional review time by this date, we will assume that you have no comments.


LYN:ss Attachment( s)

RESPONSE:

[ 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 servinQ 25 or more people at least 60 days per year or has 15 or more service connections) and must receive Director of Health approval prior to Its use to comply with Hawaii Administrative Rules (HAR), Title 11, Chapter 20, Rules Relating to Potable Water Systems, §11-20-29.

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 non-potable spigots with warning signs to prevent inadverlent 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 [l 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.

No comments/objections

Contact Person: _________________ _ Phone: ____________ _

Signed: __________________ _ Oate: _______ _


TO:

FROM:

SUBJECT:


COMMISSION ON WATER RESOURCE MANAGEMENT P,O, BOX 621


February 6, 2004

Dede Mamiya, Administrator Land Division

Ernest Y.W. Lau, Deputy Direc~ Commission on Water Resour~~r ~~nagement We" Construction/Pump Insta"ation Permit Application Waipouli 2004 We" (We" No. 0522-01)

Transmitted for your review and comment is a copy of the captioned We" Construction/Pump Insta"ation permit application.



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 March 1 0, 2004. If we do not receive comments or a request for additional review time by this date, we wi" assume you have no comments.



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. _________ _

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

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

[ ] No objections

[ ] Other comments:

Contact Person: ________________ _ Phone: ______ _

Signed: __________________ _ Oate: _______ _


TO:

FROM:

SUBJECT:


COMMISSION ON WATER RESOURCE MANAGEMENT P,O. BOX 621


February 6, 2004

Holly McEldowney, Acting Administrator Historic Preservation

Ernest Y.W. Lau, Deputy Direct~ Com.mission on Water Resource Management




MEREDITH J. CHING CLAYTON W. OELA CRUZ

JAMES A. FRAZIER CHIYOME L FUKINO, M.D

STEPHANIE A. WHALEN

ERNEST YW LAU OEPUTY DIRECTOR

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 March 10, 2004. If we do not receive comments or a request for additional review time by this date, we will assume you have no comments.



RESPONSE:

[ ] There may be areas in the vicinity of the well site that contain subsurface cultural remains such as artifacts, burials or concentrations of shells or charcoal.

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

[ 1 No objections

[ 1 Other comments:

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

Signed: __________________ _ Oate: _______ _

Search Results o o Page 1 of 1

• PUBLIC RECORD DATA ... TMK # 4-4-4-3-73-2 6167-K WAIPOULI ROAD, Apt 0002 Owner: SOBER, MICHAEL D & TRACIE A

Tax Payer: SOBER, MICHAEL D & TRACIE A Tax Bill: 91-235 A OIHANA ST, KAPOLEI, HI 96707 USA

Assessed Value Land: $159,100

Total Buildings: $0 Total: $159,100

1/22/2003 DEED

Exemption $0 $0 $0

Size 2.90 ac o sq ft

SALES

SOBER, MICHAEL D, H/W(Tenants By Entirety)

SOBER, TRACIE A, H/W(Tenants By Entirety)

Tenure: Fee Simple Annual Tax: $1,264.85

Buildings: 0 Dwellings: 0 PITT Code: 500 Zoning: Land Use: 0 Subdivision: Waipouli

Condo Name:

$255,000 Doc 03-010705

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

http://webre2.hawaiiinformation.comlresearchl AsplFunctions/Property ISearch.asp ?SRC= L... 2/4/2004

Department of Commerce & C~sumer Affairs - State of Hawaii - PVL }_~~CENSE CLAS... Page 1 of 1

~ \'.11i

Department of Commerce and Consumer Affairs Proft~ssjonal and Voeatlf>nallir:cnsmg DlviJion

Professional and Vocational Licensing Search

CLASS CODE C57

LICENSE CLASS SCREEN

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

There was 1 specific license class on this licensee!

***** LICENSE CLASS FOR THIS LICENSEE ***** LIC: CT-21358 VALLEY WELL DRILLING CLASS TYPE

WELL EFFECTIVE

03116198

<-Back New Search->

RESTRICTED STATUS

EMPLOYEES LIST I I EMPLOYERS LIST II INSURANCE/BONDI I LICENSE CLASS

Copyright 2002 Professional and Vocational Licensing Division

Hawaii State homepage II DCCAII Professional and Vocational Licensing Division

http://www.ehawaiigov.org/serv/pvl?_f=n&_a=LC&licno=21358&lictp=CT&off=O&nm=V ... 2/4/2004

Well Background Check Well Construction Pump Installation

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

4327-09 USGS Kihei B2 U.S. Geological Survey [04] C-21358 WELL

4327-08 USGS Kihei B1 U.S. Geological Survey [04] C-21358 WELL

4427-07 USGS Kihei A2 U.S. Geological Survey [04] C-21358 WELL

4427-06 USGS Kihei A 1 U.S. Geological Survey [04] C-21358 WELL

4426-10 USGS Kihei C1 U.S. Geological Survey [04] C-21358 WELL

5/18/1998 2509-07 Maili Quarry Hawaiian Cement [01] C-21358 BOTH 5/22/1998 8/611998 12115/1998 112011999 1/26/1999 12/18/2000 712612001 212712002

3/23/2000 2201-10 Kunia T41 Mon Honolulu BWS [01] C-21358 WELL 4/5/2000 4/20/2000 1 0/25/2000 1 0/25/2000

9/14/2000 0124-03 Hanamaulu 4 Kauai DWS [01] C-21358 BOTH 9/21/2000 5/2212001 8/5/2002 8/5/2002 8/28/2002 <. .. .. : ./ () 12/18/2000 2459-26 Lower Waiawa 0 Honolulu BWS [01] C-21358 WELL 12128/2000 1/25/2001 9/25/2001 9/25/2001

3/2212001 5125-04 Wailuku MW-4 Maui Dept. of Public Works C-21358 BOTH 3/28/2001 4/10/2001 8/10/2001 10/23/2001 312812001 4/10/2001 8/10/2001 10/23/2001

3/22/2001 5125-06 Wailuku MW-6 Maui Dept. of Public Works C-21358 BOTH 3/28/2001 4/10/2001 8/10/2001 10/23/2001 312812001 4/10/2001 8/10/2001 10/23/2001

3/22/2001 5125-05 Wailuku MW-5 Maui Dept. of Public Works C-21358 BOTH 3/28/2001 4/10/2001 8/10/2001 10/23/2001 312812001 4/10/2001 8/10/200110/23/2001

2/27/2002 4157-12 HME-1 Hawaiian Marine Enterprises C-21358 BOTH 4/19/2002 5/13/2002 12111/2002

7/23/2002 1906-11 HC Campbell Qu Hawaiian Cement [01] C-21358 BOTH 7/23/2002 7/26/2002 10/25/2002 121612002 12110/2002

9/23/2002 3213-08 ERDC-MW-2 U.S. Army C-21358 WELL 9/26/2002


9/23/2002 3113-03 ERDC-MW-4A U.S. Army C-21358 WELL 9/26/2002

9/23/2002 3213-09 ERDC-MW-3A U.S. Army C-21358 WELL 9/26/2002

9/23/2002 3213-11 ERDC-MW-3C U.S. Army C-21358 WELL 9/26/2002 0 9/23/2002 3113-04 ERDC-MW-4B U.S. Army C-21358 WELL 9/26/2002

9/23/2002 3113-05 ERDC-MW-4C U.S. Army C-21358 WELL 9/26/2002

9/23/2002 3213-10 ERDC-MW-3B U.S. Army C-21358 WELL 9/26/2002


312112003 3956-08 Laie Deep Monito Honolulu BWS C-21358 WELL 3/27/2003 4/10/2003

5/212003 2308-04 Perimeter Road P PVT Land Company, LTD C-21358 BOTH 5/8/2003 5/19/2003

6/27/2003 2345-01 Kawai Nui Test State DLNR C-21358 WELL 7/1/2003 9/17/2003

7/16/2003 3407-38 Paradise Producti Paradise Shrimp Farm C-21358 BOTH 7/18/2003 121212003 11/24/2003 121212003 12/11/2003

MOllday, February 02, 2004 Page I of2

Approved Well No. Well Name Applicant Driller Type

10/17/2003 3412-04 Hawaii Fish Co. 1 Hawaii Fish Co C-21358 BOTH

Monday, February 02, 2004

Well Construction Issued Signed WCR1 Accept

11/5/2003

Pump Installation Issued Signed WCR2 Accept

o

o

Page2of2

02/04/2004 14:40 808682i""::'fg8 VWD HI PAGE 02/02

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"-State of Hawa i i 6 r: rl"~ QffikiM Use Only: COMMISSION ON WATER RESOURCE MANAGEMENt· ._-> .. , ... '

Department of Land and Natural Resources APPLICATION FOR PERMIT .ltl Well Construction and/or IX Pump Installation

. ,.

04 J/,N 30 A B: 59 Instructions: Please print in ink or type and send completed application with attachments to the Co~~~iqrt :;;.;" , ;.:, I ' 'J ~"_ on Water Resource Management, P.O. Box 621, Honolulu, Hawaii 96809. Application must be accompa~t'I,'oy') :/.:'.1 !i .. , i ,_i. 5 copies and a non-refundable filing fee of $25.00 payable to the Dept. of Land and Natural Resour~S!J~1 ~ :.~,', ;,',\.;;·.EN r Commission may not accept incomplete applications. For assistance, call the Regulation Branch at 58'7'-0225. For further information and updates to this application form, visit http://www.state.hi.us/dlnr/cwrm.

APPLICANT INFORMATION: (Fill out all three, if applicable, and place a check next to the primary contact)

1. (a) Xl WELL OWNER::Mike Sober Contact Person: Mike Sober Phone: 682-1767 Mailing Address: 91-235A Oihana Street Kapolei, HI 96707 Fax: 682-1768 E-mail: -'.vwdh==i@""l""'a .... v,,,.,,a.......,,.ne=t==---____________ _

(b) 0 LAND OWNER: same as well owner Mailing Address:

Contact Person: _______ _ Phone: _______ _

Fax: E-mail: _____________________ _

(c) 0 CONTRACTOR: Valley Well Drilling

Mailing Address: 91 2358 oi bana street Fax: 682-1768

Contact Person: Mike Sober

Kapolei, HI 96707 Phone: 682-1767

Lic#: 21358 E-mail: [email protected] (circle one: @, C-57a, or A)

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

2. WELL NAME: Waipouli Well 2004 Island: Kauai

Address 6167K Waipouli Rd., Kapaa Tax Map Key: 4 4 03 : 73#2 Zone Sec --'P=:':la-:t- Parcel

Attach: (a) portion of a 7 .5-Minute Series USGS topographic map (scale 1 :24,000) with well location labeled and include the name of the quad map (b) a property tax map, showi ng well location referenced to established property boundaries

3. PROPOSED WORK: IXI Construct New Well ~ Install New Pump· (check all that apply) o Modify Existing Well· o ModifyPump·

o Abandon/Seal·

·State Well No.: (if unknown, please call Commission at 587-0225)

4. CONSTRUCTION: ~ Drilled 0 Dug o Shaft 0 Tunnel

Is this well part of a battery of wells? DYes IRINo (Please describe)

5. PROPOSED PUMPI NG RATE: _--=5:..,::0'--_____ gallons per minute

6. PROPOSED USE: 0 Municipal (including hotels, stores, etc.) 0 Industrial (check all that apply) Kl Domestic (individual, noncommercial water system)

Does this well serve 25 or more people at least 60 days per year or have 15 or more service connections? 0 Yes Xl No

o Irrigation (crop) No. of Acres:

o Military o Other (explain):

7. (a) PROPOSED AMOUNT OF WITHDRAWAL: ____ 2_0_00 _______ gallons per day

(b) METHOD OF FLOW MEASUREMENT: Jtl Flowmeter 0 Open-pipe 0 Weir o Orifice o Other(explain)

OTHER IMPORTANT INFORMATION:

8. LEGAL REQ UI REM E NTS: If required, these permits tml§1 be obtained before the Commission can legally issue a permit. Conservation District Use Permit (COUP) To find out if a COUP is necessary, call DLNR Land Division at 587-0414 ~ Not Required If required, date approved _____ _

Environmental Impact Statement (EIS) or Environmental Assessment (EA) To determine if an E IS or EA is necessary, call OEOC at 586-4185

~ Not Required If required, date published in OEOC bulletin _____ _

Special Management Area Permit (SMAP) To determine if an SMAP is necessary: on Oahu, call 527-5374; on Hawaii, call 961-8288; for Maui county, call 270-7235; on Kauai, call 241-6677.

¥J Not Required If required, date approved _____ _

9. ARCHEOLOGICAL REQUIREMENTS: To find out if an archeological work is required: on Oahu, call Elaine Jourdane at 692-8027; on Hawaii, call MaryAnne Maigret at 327-3690, for Maui county, call Cathy Dagher at 692-8023, on Kauai, call Nancy McMahon at 742-7033.

,. Not Req ui red If required, please attach letter from DLNR Historic Preservation

10. REMARKS, EXPLANATIONS:

(if more space is needed, please attach additional sheet) NOTE: Signing below indicates the signatories understand and swear that the information provided on this application is accurate and true to the best oftheir knowledge. Further, the signatories understand that approval of this application attaches the following standard conditions: 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) monthly water use data shall be submitted to the Commission; 4) such approval shall not constitute a determination of correlative water rights and shall not guarantee the pump capacity or future use up to the permitted pump capacity; 5) in the event that the application is not completed correctly, any permit may be suspended until the item is brought into compliance, and any work done while the permit is in suspension may result in fines of up to $1 OOO/day.

/

Well Owner Mike Sober Landowner Mike Sober Contractor Valley Well Drilliin~

(P''''''''''b'Y~ (p,"' •• 'b'y) ~ Sig nat ure Sig nat ure . ____

Date \ lZk 7 () L{ Date 0

For official use only Latitude _______ Aquifer System No.

Longitude State Well No.

(print legibly)

Signature

Date

10, PROPOSED WELL SECTION (Please attach schematic if differen t from diagram provided below)

Hole Oiameter: \ I in.

Elevation at top of casing 2.0' ft., msl* .::::1.-+_ [ r.- Minimum of2' Radius & 4" Thick Concrete Pad (to contain benchma ~ ~ surveyed to nearest 0.01 ft.)

~b-0" ",

'.~ ...... ~~~ :,;" r Ground Elevation: WO ft., msl*

1//JIf;.\ .~:: ' ., '1/111>.' '1/111>.' ., , -A:::' Please refer to the " . ;,.:': ~'. HAWAII WELL CONSTRUCTION AND ::;. ::;.,

Cement Grout: 11..t? ft. ~.:: t ".~ PUMP INSTALLATION STANDARDS (min. 70% of distance from .:~

~:~: ~:~~ ;;;- to ensure that your as-built is in compliance ground elevation to top of .~ : .. :. Q) with applicable standards . • ''&: iIi water surface or 500 ft., : ..... ;: ' ,.

r-. .... ".::': ~ whichever is less.) ," , ~', ,'.

Q) ;."/-"- /;. ...J

~:.: ~:.: ... Solid Casing: (:?: 90% x (Ground Elev.-Water Level Elev» .$

Annular space between .: ... .:'''' <tl Total Length: ?co ~

:p." 3: ft. hole and casing (mi n.3"): :-:~. .. . - ,

NominalOiameter: '? II OD in . V}~ ~:"".!: :>

~ in. Q) () .'31-5 v .', iIi Wall Thickness: in.

;~~ ::t'. ':.~

'0 -IOD c Bottom Elevation: ft., msl* I: ~ ~

-: !2 Rock or Gravel Packing: ~ ~ x ~[

TotalOepth 216 ft. --. ~ Open Casing: o Perforated Jiil'Screen

400 ft. Material: ~

0 en Total Length: 10Q ft.

o Crushed Basalt III

o Rounded Gravel /1 Nominal Diameter: 5"OD in.

~ Wall Thickness: 0.315 in. .. Estimated Water Level Bottom Elevation: -200 ft., msl*

Elevation: ~---' note: Neither bentonite nor mud should be used in -''-- -30 ft. msl* .... atllmtp.rl mnp. rlllrinn rlrillinn

-

* 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 CompletionlWell Abandonment reports and referenced to a benchmark which has been established by a surveyor licensed by the State.

Open Hole:

Length:

Oiameter:

Bottom Elevation:

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 x Water L4vel Elevation)

Example: Estimated + 2 ft. Water Level Elev. --. Bottom Elevation of Well Limit = ( 2 _ 41 ~ (2) = -18.5 ft.

Solid Casing Material:

~dA

Carbon Steel: compliant with (check one or more): 0 ANS VAWWA C200 0 API Spec. 5L 0 ASTM A53 0 ASTM A 139

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

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

ABS Plastic conformi ng to ASTM F480 and ASTM 01527: (check one) 0 Schedule 40 0 Schedule 80

ft.

in.

ft., msl*

PVC Plastic conforming to ASTM F480 and (ASTM 01785 or ASTM 02241): (check one): o Schedule 40 MI Schedule 80 0 Schedule 120




o Glass Fiber Reinforced Resin Pressure Pipe conforming to AWWA C950



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

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

o ASTMA139

o Other

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

ABS Plastic conformi ng 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): 0 Schedule 40 ~ Schedule 80 0 Schedule 120




o Glass Fiber Reinforced Resin Pressure Pipe conforming to AWWA C950



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\ 183.40

'- 1/2" PIPE

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LOT 111-(,

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eARJt6EI AG.5TORA6E

L.IMITEI:' L.IMlTE!:) COMMON G-OMMON

I • •

1..1 MI TEe::> COMMON eLeMeNT

(9.000,A.CRES) . eJ..eMeNT : eLeMeNT : ~ (2.'i02 AC~$) : (~.506 AC~S) .

1 3.43

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________ .ll~5~3 ______ _

120o r7' - 530.00 P;\R('EL 148

11 .04

IllAlAlPOULI ~gTAT~~u

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DOCUMENT NO· OARTMENT OF LAND AND NATURAL RESO":;ES

UAC OR ATTACHED WORKSHEET DATE· 1/30104 .. SRCI COST

F YR APP D OBJ CTR PROJECT PH ACT AMOUNT NAMEIDESCRIPTION (WANG INPUT)

S 04 326 C 1026 0752 (1 ) $25.00 Michael D. Sober

(2)

(3)

(4)

(5)

(6)

(7)

(8)

(9)

(10)

TOTAL $ 25.00

REMARKS: LINE (1) Waiopuli Well 2004, tmk: 4-4-03:73 #2 LINE (2) LINE (3 LINE (4) LINE (5) LINE (6) LINE (7) LINE (8) LINE (9) LINE (10)

STATE OF HAWAII DEPARTMENT OF LAND AND ...0522-01. wcr2.acc We received your Well Completion Report...

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Transcript of STATE OF HAWAII DEPARTMENT OF LAND AND ...0522-01. wcr2.acc We received your Well Completion Report...