NEIL ABERCROMBIE GOVERNOR OF HAWA.II Ms. Tracie Sober o o STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES COMMISSION ON WATER RESOURCE MANAGEMENT P.O. BOX 621 HONOLULU, HAWAII 96809 June 20,2011 Valley Well Drilling, LLC 91-458 Komohana Street Kapolei, HI 96707 Dear Ms. Sober: Expiration of Pump Installation Permit for Well No. 3306-23 WILLIAM J. AILA, JR. CHAIRPERSON WILLIAM D. BALFOUR, JR. SUMNER ERDMAN LORETTA J. FUDDY, A.C.S.w., M.P.H. NEAL S. FUJIWARA DONNA FAY K. KIYOSAKI, P.E. LAWRENCE H. MilKE, M.D., J.D. WILLIAM M. TAM DEPUTY DIRECTOR 3306-23.exp This is notice that your Pump Installation Permit for the Payes Well (Well No. 3301-23) expired on May 25, 2011. Based on your conversation with staff, we understand no work was done and there are no current construction plans for the well. Therefore, the permit expiration date will not be extended. You can reapply for a new permit at any time in the future should you decide to recommence this activity. Please be aware that no further work should be done on this well without a valid signed permit nor can it be pumped without valid well and pump completion certificates. Work without a valid and active permit or failure to adhere to conditions of the permit is a violation of the state water code and may be subject to fines of up to $5,000 per day. If you have any questions, please contact Charley Ice of the Commission staff at 587-0218. CI:ss c: Linda Payes Sincerely, WILLIAM M. TAM Deputy Director ------------------------------,_ ...•
Transcript
NEIL ABERCROMBIE GOVERNOR OF HAWA.II
Ms. Tracie Sober
o o
STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES
COMMISSION ON WATER RESOURCE MANAGEMENT P.O. BOX 621
HONOLULU, HAWAII 96809
June 20,2011
Valley Well Drilling, LLC 91-458 Komohana Street Kapolei, HI 96707
Dear Ms. Sober:
Expiration of Pump Installation Permit for Well No. 3306-23
WILLIAM J. AILA, JR. CHAIRPERSON
WILLIAM D. BALFOUR, JR. SUMNER ERDMAN
LORETTA J. FUDDY, A.C.S.w., M.P.H. NEAL S. FUJIWARA
DONNA FAY K. KIYOSAKI, P.E. LAWRENCE H. MilKE, M.D., J.D.
WILLIAM M. TAM DEPUTY DIRECTOR
3306-23.exp
~ This is notice that your Pump Installation Permit for the Payes Well (Well No. 3301-23)
expired on May 25, 2011.
Based on your conversation with staff, we understand no work was done and there are no current construction plans for the well. Therefore, the permit expiration date will not be extended. You can reapply for a new permit at any time in the future should you decide to recommence this activity.
Please be aware that no further work should be done on this well without a valid signed permit nor can it be pumped without valid well and pump completion certificates. Work without a valid and active permit or failure to adhere to conditions of the permit is a violation of the state water code and may be subject to fines of up to $5,000 per day.
If you have any questions, please contact Charley Ice of the Commission staff at 587-0218.
Some more of those NSLF permits have expired. Any word on status? Should we cancel? NSLF 08 (3307-23)
NSLF 09 (3307-24)
also Andrew Dillon (Kauai, 0421-05)
and the pump for Linda Payes (3306-23)
Charley leo H~rologist
Havo.eii Water Comm ission 1151 P unchboVll 227 Kalanim oku P .O.Box621, Honolulu 96809 (808) 587-0218
. ., ..
LINDA LINGLE GOVERNOR OF HAWAII
Ms. Tracie Sober
Q
STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES
COMMISSION ON WATER RESOURCE MANAGEMENT P.O. BOX 621
HONOLULU, HAWAII 96809
January 29, 2009
Valley Well Drilling, LLC 91-458 Komohana Street Kapolei, HI 96707
Dear Ms. Sober:
Extension of Pump Installation Permit for Well No. 3306-23
LAURA H. THIELEN CHAIRPERSON
MEREDITH J. CHING JAMES A. FRAZIER NEAL S. FUJIWARA
CHIYOME L FUKINO, M.D. DONNA FAY K. KIYOSAKI, P.E.
LAWRENCE H. MilKE, M.D., J.D.
KEN C. KAWAHARA, P.E. OEPUTY DIRECTOR
3306-23 pip.ext
This is in response to your e-mail message to our staff, dated January 28, 2009, . requesting an extension of the pump installation permit for the Payes Well (Well No. 3306-23), within TMK (1) 6-6-028:006 on Oahu. We understand that the construction work on the property has been put on hold because of an illness in the Payes family. By this letter, we are advising you that your request is approved. Your new completion date for the pump installation work is May 25,2011. / All other conditions of your permit remain the same.
If you have any questions, please contact Denise Mills of the Commission staff at 587-0251.
Please let the Hackerly one expire. They haven't gotten back to me. As for Payes, the well is in. They were planning on building on the property but the boyfriend recently was diagnosed with Cancer and they put the building on hold. 2 years would be great. 'I)
My responses below. For the extensions, can you give me an explanation of the reason(s) that the extensions are needed? A short e-mail reply will be sufficient. Thanks! -dm
For the Payes well, I see we accepted the well construction report on June 4, 2008. Only the pump installation permit expires on February 10, 2009. Myoversight. --dm
---- Forwarded by Denise E Milis/DLNRIStateHiUS on 01/27/200910:48 AM ---
cc 01/27/200910:46 AM Subject Permit status - Wells 0519-02, 3104-01, 3306-23
Hi Tracie,
In reviewing our record of permits issued to you, I would like to verify information on three well permits: • 0519-02, Kapaa-Sams -- Well and pump permits expired on January 23,2009. Originally
approved on January 23,2007, and signed on February 21,2007. No extensions have been requested or granted. I am preparing a permit expiration notice, but want to make sure our record is accurate before sending it. Can you tell me the status of this well?
• 3104-01, Hackerley -- Well and pump permits issued on February 10, 2007, and will expire on February 10, 2009. What is the status of this well? Still plans to construct it?
• 3306-23, Payes -- Well and pump permits expire on 5/10/2009-- Can you tell me the status of this well?
Subject Fw: CORRECTION ... Permit status - Wells 0519-02, 3104-01,3306-23
For the Payes well, I see we accepted the well construction report on June 4, 2008. Only the pump installation permit expires on February 10, 2009. Myoversight. --dm
---- Forwarded by Denise E Mills/DLNRIStateHiUS on 01/27/2009 10:48 AM ----
Subject Permit status - Wells 0519-02, 3104-01, 3306-23
In reviewing our record of permits issued to you, I would like to verify information on three well permits:
• 0519-02, Kapaa-Sams -- Well and pump permits expired on January 23,2009. Originally approved on January 23,2007, and signed on February 21,2007. No extensions have been requested or granted. I am preparing a permit expiration notice, but want to make sure our record is accurate before sending it. Can you tell me the status of this well?
• 3104-01, Hackerley -- Well and pump permits issued on February 10, 2007, and will expire on February 10, 2009. What is the status of this well? Still plans to construct it?
• 3306-23, Payes -- Well and pump permits expire on 5/10/2009-- Can you tell me the status of this well?
Thanks for the information!
--Denise
MEMO and ROUTE liP (ver. 03/0412008) Q 03/12/08
I WCR 1 Check for Well No. 3306-23 (survey to regulation memo)
1. Pump Tests Check Diane England <tZ ~initial)
Step-Drawdown Test: followed WCPI Stds analysis attached
Constant Rate Test: followed WCPI Stds analysis attached proposed pump cap o.k.
Potential Well Interference:
Potential Stream Impacts:
Additional Testing or Data Required:
Yes
0 0
0
~ o
o
o
Pump Test Comments Attached: 0
No /J) 0
0 ~o gpm no test required 0
0 p51 gpm no test required 0 0
2. Well Log Check Geology Code for Well Index:-\t\) Fm Name ,I,:' 12t2/?!JA-~¥.tlan~ 3. Construction Check Milch Ohye 1 (intt~2
If no, describe deficiency
data complete ' ". c;I:! 0 followed Special Cond & elevatiofls 0 /' 0 well database updated :EY' 0
(j~ ../
Latitude
NAD27 ~? I --' ? ')0 ---' .. / NAD83 1-1 33 0(1
Longitude
f \, '( .... , 7 ;.,.
\ "-, { () (~;J
() -, '\ '{ (>
4. ChareRY~ (initial) take action based on above analysis
ATTACHMENTS FOR PUMP INSTALLATION PERMIT (2x): ----.29.. not necessary - OnIY~ r BOTH.
1COVER LETTER } ~ 2COUNTY COMMENTS (OWS/SMA) 300H COMMENTS To be sent to driller/pump installer
5. Roy j (initia check (Entered WCR 1IWCCC accept date into database) 6. Susan agbin (initial) finalize 7. Ken (in I I signature 8. Mitch (initial) signature (Entered PIP issue date if attached/required)
9. Char~R~?ile
LINDA LINGLE GOVERNOR OF HAWAII
Ms. Tracie Sober Valley Well Drilling 91-235 Oihana St Ste A Kapolei, HI 96707
Dear Ms. Sober:
o o
STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES
COMMISSION ON WATER RESOURCE MANAGEMENT P.O. BOX 621
HONOLULU, HAWAII 96809
June 4, 2008
Well Completion Report Part I for Well No. 3306-23
LAURA H. THIELEN CHAIRPERSON
KEN C. KAWAHARA, P.E. DEPUTY DIRECTOR
MEREDITH J. CHING JAMES A. FRAZIER NEAL S. FUJIWARA
CHIYOME L. FUKINO, M.D. DONNA FAY K KIYOSAKI, P.E.
LAWRENCE H. MilKE, M.D., J.D.
We received your Well C9fl1pletion Report Part I for the Payes 2007 Well (Well No. 3306-23) on February 29, 2008 and acknowledge that it is complete.
This completes your obligation under the well construction permit. A certificates of well construction completion will be issued to the well operator/landowner and you will receive a copy. This certificate transfers responsibility of specific aspects of well usage and maintenance from you to the well operator/landowner.
If you have any questions, please contact Ryan Imata of the Commission staff at 587-0255.
Sincerely,
:i~::~:t::;;--Deputy Director
RI:ss
c: Linda Payes
/
o LINDA LINGLE LAURA H. THIELEN
GOVERNOR OF HAWAII CHAIRPERSON
STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES
COMMISSION ON WATER RESOURCE MANAGEMENT P.O. BOX 621
HONOLULU, HAWAII 96809
June 4, 2008/
MEREDITH J. CHING JAMES A. FRAZIER NEAL S. FUJIWARA
CHIYOME L. FUKINO, M.D. DONNA FAY K KIYOSAKI, P.E.
LAWRENCE H. MilKE, M.D., J.D.
KEN C. KAWAHARA, P.E. DEPUTY DIRECTOR
3306-23,cwcc
Ms. Linda Payes 933 Makaiwa St. Honolulu, ill 96816
Dear Ms. Payes:
Certificate of Well Construction Completion for Well No. 3306-23 (TMK 6-6-028:006)
We are pleased to inform you that the Well Construction work permitted for the Payes 2007 Well (Well No. 3306-23) 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. Ifthe 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(t) 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/cwrmlforms.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,OOO/day. The CommiSSIon needs your help and asks that you to do your part in utilizing this shared resource. We prefer to work with you in meeting the goal of protecting our ground water resources together.
If you have any questions, please contact Ryan Imata of the Commission staff at 587-0255.
RI:ss
c: Honolulu Board of Water Supply Valley Well Drilling
Sincerely,
:t!::w~~ Deputy Director
/
o o
o o State of Hawaii COMMISSION ON WATER RESOURCE MANAGEMENT Department of Land and Natural Resources
For Official Use On~: RECE,VED
WELL COMPLETION REPORT - PART I 08 FEB 29 A 9 · 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 fonn shall be submitted within 60 days of the completion of work. For aSSistance, please consult the Hawaii Well Construction and Pump Installation Standards or call the Regulation Branch at 587-0225. For updates to this form or additional information, please visit our website at http://www.state.hi.usldlnr/cwnn/
.. \) ""1~' 1~,1/1 T~- .. .... ,'., tIC ;:
.! -' ··l:Li :r
1. State Well No.: ?30~ ... 13 Well Name: _fl-qY1--",C--=-~---==-La=Cc...:."t _____ Island: --,O,-,q~h-,,-,I!\,--__ 2. Address: Kql!\kcmt'\bl.J\"\ Q\ <\ f1G\l' t ~01 c\ Tax Map Key: b -Ie -01. ~ : 00 ~ 3. Drilling Company: ~~ \ \(1 Wr\l Uyt" \'rIj I Llt 4.
5.
Drilling method used during construction: ~ Rotary D Percussion D Other (describe)
Date Well Construction (drilled,cased,grouted) completed: 1-C) . 0 ~ Attach Completed Driller's Log month/day/year
6. Was the subject well cored? D Yes ~ No
7. Step-Drawdown Test completed? ~ No D Yes Attach Step-Drawdown Test form (12117/97 SDPTD Fonn)
8. Constant Rate
11. After casing installation (this infonnation should be before any pump tests are perfonned with casing installed)
Chloride: .l1I..fi ppm, Temperature: 1- \ OF
rsJl No DYes
Z.S.Ol I?~
al/ elevations referenced to mean sea level, take the ground elevation (surveyed or estimated if survey not required at this time) and subtract the depth to the water level.
12. As-built section filled in completely ®
.13. Photograph of well and concrete pad showing benchmark on concrete pad attached ~
14. GPS coordinates provided in degrees, minutes, seconds ~
15. If a pump is not planned to be installed, please describe (below in the remarks section) how well is secured to prevent unauthorized access (example: lockable cover, threaded coupling, etc.)
ASS Plastic conforming to ASTM F480 and ASTM 01527: (check one) 0 Schedule 40 0 Schedule 80
PVC Plastic conforming to ASTM F480 and (ASTM 01785 or ASTM 02241): (check one): ll{ 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 AVWVA C950
o PTFE Fluorocarbon Tubing conforming to ASTM 03296
o FEP Fluorocarbon Tubing conforming to ASTM 03296
WCR1 Form 6112107 Page 2 of 5
./
I_.f.''''
o 0 State of Hawaii COMMISSION ON WATER RESOURCE MANAGEMENT Department of Land and Natural Resources DRILLER'S LOG
Well Number: -=.33=..:0:..::6;....:-2::..:3=---____ _
For Official Use Only:
08 tEB 29 A 9: 0 ~
Depths (ft.) Rock description, Water level, etc. Dates Depths (ft.) Rock description, Water level, etc. Dates
0 to 3 soft topsoil, brown gray 10/22/07 to
3 to 8 boulder, gray blue with black hard 10/22/07 to
8 to 101 red with brown decomposed rock,
10/22/07 soft water hit at 75' bgs
to
101 to 135 blue basalt, gray blue with black, 10/22/07
hard to
135 to 182 red with brown decomposed rock soft 10/22/07 to
to to
to to
to to
to to
to to
to to
to to
to to
to to
to to
to to
to to
to to
Remarks: Payes 2007 Well
DL Form 06/24/2004
Attach photos of completed well and concrete pad
o o
~ ?-~"?O~ - '2.3 fA.-,(€S t-oDl NAD83: Latitude: 11-degrees ??J min C q .0 sec Longitude: I'?l degrees -1.l.L min ~ sec
EXAMPLE PROPEFnY UN£
Lat: 19"36'45" ~ong: 154°57'18"
L..$o>
SKETCH OF WELL LOCATION (Referenced to permanent landmark, i.e. building, road, fence, etc.)
Provide Latitude and Longitude of well referenced to NAD83 to nearest second
weR1 Form 6112107 Page 4 of 5
~ <. 1\ ,
r " o PUMP INSTALLATION PERMIQ
Paves 2007 Well, Well No. 3306-23 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 Payes 2007 Well (Well No. 3306-23) at TMK 6-6-028:006, Oahu, 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 30 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 1IhiPdate of permit approval, unless otherwise specified. The permit may be extended by the Chairperson upon a showijJ.g..,of gooclCituse and goodfaith performance. A request to extend the permit shall be submitted to the Chairperson no later thanthe:ct~te the p~it expi~
.,' c::. ;' 1'\ The permittee, its successors, and assigns shall indemnify, defend, and hold the State of Hawaii harmless from and ~inst any i9ss, liability, claim, or demand for property damage, personal injury, or death arising out of any act Qr omission dgte appliOll1t, assigns, officers, employees, contractors, and agents under this permit or relating to or connected with th~ granting of this permit.;:'
'0 .,,':-;-
Special conditions in the attached cover transmittal letter are incorporated herein by reference. <' c.W 'J Wf7f1 ,'~ -;. ,
~ -Date of Approval: May 25,2007
May 25,2009 ALLAN A. SMITH, Interim Chairperson
Commission on Water Resource Management Expiration Date:
I have read the conditions and terms of this permit and understand them. I accept and agree to meet these conditions as a prerequisite and underlying condition of my ability to proceed and understand that I shall not commence work until I and the pump installer have signed, dated, and returned the permit to the Commission. I understand that this permit is not to be transferred to any other entity. I also understand that non-compliance with any permit condition may be grounds for revocation and fines of up to $5,000 per day starting from the permit date of approval.
Installer's Signature: trpvWl ~ C-57, C-57a, or A License #: 24947 Date: (.J'I~ ·Or
Printed Name: Tracie Sober 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
-
.. o _
WELL CONSTRUCTION PERMIT
Paves 2007 Well, Well No. 3306-23 Note: This permit shall be prominently displayed at the construction site until the work is completed
In accordance with Department of Land and Natural Resources, Commission on Water Resource Management's Administrative Rules, Section 13-168, entitled "Water Use, Wells, and Stream Diversion Works", this document permits the construction and testing of Payes 2007 Well (Well No. 3306-23) at TMK 6-6-028:006, Oahu, subject to the Hawaii Well Construction & Pump Installation Standards (HWCPIS - February 2004) which include but are not limited to the following conditions:
I.
2.
3.
4.
5.
6.
7.
8.
9.
10.
II.
12.
13.
14.
IS.
The Chai'1!erson of the Commission on Water Resource Management (Commission), P.O. Box 621, Honolulu, HI 96809, shall be notified, in writing, at least two (2) weeks before any work authorized by this permit commences and staffshall be allowed to inspect installation activities in accordance with §13-168-IS, Hawaii Administrative Rules.
This permit shall be prominently displayed, or made available, at the site of construction work until work is completed.
The well construction permit shall be for construction and testing of the well only. The permittee shall coordinate with the Chairperson and conduct apumping test in accordance with the HWCPIS (the latest rump test worksheet can be obtained by contacting Commission staff or at www.hawaii.gov/dlnr/cwrm/forms.htm). The permittee shal suomit to the Chairperson the test results as a basis for supporting an application to install a permanent pump. No permanent pump may be mstalled until a pump installation permit is approved and issued by the Chairperson. No withdrawal of water shall be made for purposes other than testing without a Certificate of Pump Installation Completion. The permitted pump capacity described on the pump installation permit may be reduced in the event that the pump test does not support the capacity.
In basal ground water, the depth of the well may not exceed one-fourth (1/4) of the theoretical thickness (41 times initial head) of the basal ground water unless otherwise authorized by the Chairperson.
The permittee shall incorporate mitigation measures to prevent construction debris from entering the aquatic environment, to schedule work to avoid periods of high rainfall, and to revegetate any cleared areas as soon as possible.
In the event that historically significant remains such as artifacts, burials or concentrations of shells or charcoal are encountered during construction, the permittee shall stop work and immediately contact the Department of Land and Natural Resources' State Historic Preservation DiVIsion. Work may recommence only after written concurrence by the State Histonc Preservation Division.
The proposed well construction shall not adversely affect existing or future legal uses of water in the area, including any surface water or established instream flow standards. This permit or the authorization to construct the well shall not constitute a determination of correlative water rights.
The Well Completion Report Part I shall be submitted to the Chairperson within sixty (60) days after completion of work (please contact staff or visit www.hawaii.gov/dlnr/cwrm/forms.htm for current form).
The permittee shall comply with all applicable laws, rules, and ordinances; non-compliance may be grounds for revocation of this permit.
The well construction permit application and any related staff submittal approved by the Commission are incorporated into this permit by reference. This permit is also subject to the HWCPIS. If the HWCPIS are not followed and as a consequence water is wasted or contaminated, a lien on the property may result. Any variances from the HWCPIS shall be approved by the Chairperson prior to invoking the variance.
The work proposed in the well construction permit application shall be completed within two (2) years from the date of permit approval, unless otherwise specified. The permit may be extended by the Chairperson upon a showing of good cause and good-faith performance. A request to extend the permit shall be submitted to the Chairperson no later than the date the permit expires.
If the well is not to be used it must be properly car,ped. If the well is to be abandoned during the course of the project then the permit§jtust apply for a well abandonment permit in accordance with § 3-168- 2(f) prior to any well sealing or plugging work. ::r: .~..."
The permittee, its successors, an~ assigns shall i':ldemnify, defend, and ho~d the State ofH~waii h~less from and agai~St ~ loss, li~' , claim:iJ deman.d for p~operty damage, personal mJury, or death lI!Ismg out of any act or omIssIon of the appltcant, asSIgnS, officers, employees,'~ntracto d agen,~der thIS permIt or relatmg to or connected WIth the grantmg of thIS permIt. ~, . .~ f"'o;) : . ...,
This permit shall apply to the location shown on the application only. If the well is to be relocated, the permittee shall apply for a new Wilt construciTCWpump installation permit m accordance with Hawaii Administrative Rules § 13-168-12(f). ; .'; -;
Special conditions in the attached cover transmittal letter are incorporated herein by reference. . ~ -0 \,
w. f71~-/:: CJ
1'i".;. -
Date of Approval: May 25, 2007 Expiration Date: May 25, 2009
ALLAN A. SMITH, Interim Chairperson Commission on Water Resource Management
I have read the conditions and terms of this permit and understand them. I accept and agree to meet these conditions as a prerequisite and underlying condition of my ability to proceed and understand that I shall not commence work until I have signed, dated, and returned the permit to the Commission. I understand that this permit is not to be transferred to any other entity. I also understand that non-compliance with any permit condition may be grounds for revocation and fines of up to $5,000 per day starting from the permit date of approval.
Printed Name: Tracie Sober 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.
Attachment
.. -
t
J LINDA LINGLE GOVERNOR Of HAWAII
Ref: 3306-23.wcp
Ms. Tracie Sober Valley Well Drilling, LLC 91-235A Oihana St. Kapolei, ill 96707
Dear Ms. Sober:
o
STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES
COMMISSION ON WATER RESOURCE MANAGEMENT P.O. BOX 621
HONOLULU, HAWAII 96809
Well Construction Permit Paves 2007 Well (Well No. 3306-23)
ALLAN A. SMITH INTERIM 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
June 14,2007
Enclosed are two (2) copies of your approved Well Construction Permit for the captioned well(s) that authorize well construction activities but excludes installation work for a permanent pump. As part of the Chairperson's approval, the following special conditions were added and are part of your permit under Permit Condition 13:
Special Conditions
1. Attached for your information are copies of the Department of Health's (DOH) review comments. Please note DOH's requirements related to discharge of emuent from well drilling and testing activities.
Please refer to the Permit Processes Worksheet (transmitted with your acknowledgement letter) for further information regarding the process of drilling a well and installing a pump.
No withdrawal of water shall be made other than for testing purposes until a certificate of pump installation completion has been issued by the Commission.
Please sign both permit originals and return one for our files. For copies of the aquifer pump test worksheet, please call staff or visit www.state.hi.us/dlnr/cwrmlforms.htm.
IMPORT ANT - Drilling work shall not commence until a fully signed permit is returned to the Commission. The permit shall be prominently displayed or made available at the construction site during construction. Be advised that you may be subject to fines of up to $5,000 per day for any violations of your permit conditions starting from the permit approval date.
If you have any questions, please call Lenore Nakama of the Commission staff at 587-0218.
Paves 2007 Well. Well No. 3306-23 Note: This permit shall be prominently displayed at the construction site until the work is completed
/
In accordance with Department of Land and Natural Resources, Commission on Water Resource Management's Administrative Rules, Section 13-168, entitled "Water Use, Wells, and Stream Diversion Works", this document permits the construction and testing of Payes 2007 Well (Well No. 3306-23) at TMK 6-6-028:006, Oahu, subject to the Hawaii Well Construction & Pump Installation Standards (HWCPIS - February 2004) which include but are not limited to the following conditions:
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15.
The Chai'P-erson of the Commission on Water Resource Management (Commission), P.O. Box 621, Honolulu, HI 96809, shall be notified, in writing, at least two (2) weeks before any work authorized by this permit commences and staff shall be allowed to inspect installation activities in accordance with §13-168-15, Hawaii Administrative Rules.
This permit shall be prominently displayed, or made available, at the site of construction work until work is completed.
The well construction permit shall be for construction and testing of the well only. The permittee shall coordinate with the Chairperson and conduct a pumping test in accordance with the HWCPIS (the latest rump test worksheet can be obtained by contacting Commission staff or at www.hawaii.gov/dlnr/cwrm/forms.htm). The ~ittee shal suomit to the Chairperson the test results as a basis for supporting an application to install a permanent pump. No permanent pump may be Installed until a pump installation permit is approved and issued by the Chmrperson. No withdrawal of water shall be made for purposes other than testing without a Certificate of Pump Installation Completion. The permitted pump capacity described on the pump installation permit may be reduced in the event that the pump test does not support the capacity.
In basal ground water, the depth of the well may not exceed one-fourth (1/4) of the theoretical thickness (41 times initial head) of the basal ground water unless otherwise authorized by the Chairperson.
The permittee shall incorporate mitigation measures to prevent construction debris from entering the aquatic environment, to schedule work to avoid periods of high rainfall, and to revegetate any cleared areas as soon as possible.
In the event that historically significant remains such as artifacts, burials or concentrations of shells or charcoal are encountered during construction, the permittee shall stop work and immediately contact the Department of Land and Natural Resources' State Historic Preservation DiVision. Work may recommence only after written concurrence by the State Histonc Preservation Division.
The proposed well construction shall not adversely affect existing or future legal uses of water in the area, including any surface water or established instremn flow standards. This permit or the l;Iuthorization to construct the well shall not constitute a determination of correlative water rights.
The Well Completion Report Part I shall be submitted to the Chairperson within sixty (60) days after completion of work (please contact staff or visit www.hawaii.gov/dlnr/cwrm/forms.htm for current form). .
The permittee shall comply with all applicable laws, rules, and ordinances; non-compliance may be grounds for revocation of this permit.
The well construction permit application and any related staff submittal approved by the Commission are incorporated into this permit by reference. This permit is also subject to the HWCPIS. If the HWCPIS are not followed and as a consequence water is wasted or contmninated, 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 prop<)sed in the well construction permit application shall be completed within two (2) years from the date of permit approval, unless otherwise specified. The pennit may be extended by the Chairperson upon a showing of good cause and good-faith performance. A request to extend the permit shall be submitted to the Chairperson no later than the date the permit expires.
If the well is not to be used it must be properly capped. If the well is to be abandoned during the course of the project then the permittee must apply for a well abandonment permit in accordance with § 13-1 68-12(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 dmnage, personal injury, or death arising out of any act or omission of the applicant, assigns, officers, employees, contractors, and agents under this permit or relating to or connected With the granting of this permit.
This permit shall apply to the location shown on the application only. If the well is to be relocated, the permittee shall apply for a new well construction/pump installation permit In accordance with Hawaii Administrative Rules §13-168-12(f). .
Special conditions in the attached cover transmittal letter are incorporated herein by reference.
Date of Approval: May 25, 2007 Expiration Date: May 25, 2009
ALLAN A. SMITH, Interim Chairperson
Commission on Water Resource Management
I have read the conditions and terms of this permit and understand them. I accept and agree to meet these conditions as a prerequisite and underlying condition of my ability to proceed and understand that I shall not commence work until I have signed, dated, and returned the permit to the Commission. I understand that this permit is not to be transferred to any other entity. I also understand that non-compliance with any permit condition may be grounds for revocation and fines of up to $5,000 per day starting from the permit date of approval.
Ms. Tracie Sober Valley Well Drilling, LLC 91-235A Oihana St. Kapolei, HI 96707
Dear Ms. Sober:
o o
STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES
COMMISSION ON WATER RESOURCE MANAGEMENT P.O. BOX 621
HONOLULU, HAWAII 96809
Pump Installation Permit Paves 2007 Well (Well No. 3306-23)
ALLAN A. SMITH INTERIM 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
June 14,2007
Enclosed are two (2) originals of your approved Pump Installation Permit for the captionedwell(s) that authorize permanent pump installation work for your well( s). As part of the Chairperson's approval, the following special conditions were added and are part of your permit under Permit Condition 11:
Special Conditions
1. If the elevation benchmark needs to be altered, the permittee, well operator, and/or well owner shall ensure that the benchmark is transferred (or the well resurveyed) and documentation of the new benchmark shall be submitted to the Commission within sixty (60) days after the pump is installed.
2. Attached for your information are copies of the Department of Health's (DOH) review comments. Please note DOH's requirements related to discharge of emuent from well drilling and testing activities.
The permittee is responsible for all conditions of the permit. This includes ensuring the submission of a completed Well Completion Report Part II form within sixty (60) days after the pump installation work is completed. Be advised that you may be subject to fines of up to $5,000 per day for any violations of your permit conditions starting from the permit approval date.
Please sign both permit originals and return one for our files.
IMPORTANT - Pump installation shall not commence until a fully signed permit is returned to the Commission.
If you have any questions, please call Lenore Nakama of the Commission staff at 587-0218.
Paves 2007 Well, Well No. 3306-23 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 Payes 2007 Well (Well No. 3306-23) at TMK 6-6-028:006, Oahu, 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 30 gpm rated capacity, or less, pump in the well. This permanent capacity may be reduced in the event that the pump test data does not support the capacity.
5. A water-level measurement access shall be permanently installed, in a manner acceptable to the Chairperson, to accurately record water levels.
6. The permittee shall install an approved meter or other appropriate means for measuring and reporting withdrawals and appropriate devices or means for measuring chlorides and temperature at the well head.
7. Well Completion Report Part II shall be submitted to the Chairperson within 60 days after completion of work. This form can be obtained by contacting staff or on the internet at www.hawaii.gov/dlnr/cwrm.
8. The permittee, well operator, and/or well owner shall comply with all applicable laws, rules, and ordinances, and non-compliance may be grounds for revocation ofthis permit.
9. The pump installation permit application and any related staff submittal approved by the Commission are incorporated into this permit by reference. This permit is also subject to the HWCPIS. If the HWCPIS are not followed and as a consequence water is wasted or contaminated, a lien on the property may result. Any variances from the HWCPIS shall be approved by the Chairperson prior to invoking the variance.
10. The work proposed in the pump installation permit application shall be completed within two (2) years from the date of permit approval, unless otherwise specified. The permit may be extended by the Chairperson upon a showing of good cause and goodfaith performance. A request to extend the permit shall be submitted to the Chairperson no later than the date the permit expires.
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 ofthis permit.
12. Special conditions in the attached cover transmittal letter are incorporated herein by reference.
Date of Approval: Expiration Date:
May 25,2007 May 25,2009
Wf7H 1'a-
ALLAN A. SMITH, Interim 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 tines of up to $5,000 per day starting from the permit date of approval.
Installer's Signature: C-57, C-57a, or A License #: 24947 Date: -------
Printed Name: Tracie Sober 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
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,--------------------....... , .... -,,~ .... ~
o o
...
o LINDA LINGLE
GOVERNOR OF HAWAII PETER T. YOUNG
CHAIRPERSON
RECE!VE.O L ,A, .Jf') f':!\lj'SIOU
r''1.,' \" :., - '1 rt
MEREDITH J. CHING JAMES A. FRAZIER NEAL S. FUJIWARA
CHIYOME L. FUKINO, M.D. LAWRENCE H. MilKE, M.D., J.D.
STEPHANIE A. WHALEN
TO:
FROM:
SUBJECT:
STATE OF HAW~~Ol APR 2b A 10: 28 DEPARTMENT OF LAND AND NATURAL RESOURCES
COMMISSION ON WATER RESOURC~~fJI.~E~I;iN-:rO & HONO~~U~~:;~:I ~ATUF.II,L. i:CSQURCES
STArE fL' Hf.;,Vi:\l!
Russell Tsuji, Administrator Land Division
April 25, 2007
W. Roy Hardy, Hydrologic Program Manager 1 Commission on Water Resource Management
Well Construction/Pump Installation Permit Application Paves Well (Well No. 3306-23) TMK 6-6-028:006
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.. CJ1 en
Transmitted for your review and comment is a copy of the captioned Well ConstructionlPump Installation permit application.
We would appreciate your comments on the captioned application with regard to the programs, plans, and objectives specific to your division. Please respond by returning this cover memo form by May 25, 2007. Ifwe do not receive comments or a request for additional review time by this date, we will assume you have no comments.
Please find the attached maps to locate the proposed well. If you have any questions about this permit application, request additional information, or request additional review time, please contact Lenore Nakama of the Commission staffat 587-0218.
LN:ss Attachment(s)
RESPONSE:
[ ] A water lease/permit is required of this applicant and an application for such will be requested by our division.
1m A water lease/permit is!!2! required of this applicant.
[ ] A water lease/permit has been obtained by the applicant through lease no. _________ _
[ ] Other relevant Land Division rules/regulations, information, or recommendations are attached.
[ ] No objections
<: ;f1 CJ
XX Other comments: Original source of private title was issued prior to statehood.
Contact Person: Gary Martjn Phone: 587-0421
Signed:_---:t~~~---Jf---~-----__ _ Date :--.I.-"'f-,I~r't'\I'--'.3~C:---"""," • ,: Ii r '- _' 2007
-BOARD OF WATER SUPPLY
CITY AND COUNTY OF HONOLULU 630 SOUTH BERETANIA STREET HONOLULU, HI 96843
U7 MAY 18
o MUFI HANNEMANN, Mayor
RANDALL Y. S. CHUNG, Chairman SAMUEL T. HATA ALLY J. PARK ROBERT K. CUNDIFF MARC C. TILKER
May 14,2007 LAVERNE T. HIGA, Ex-Officio BARRY FUKUNAGA, Ex-Officio
CLIFFORD P. LUM
Mr. W. Roy Hardy Hydrologic Program Manager
~ ';'r I~~ . -U~:.:T
: ! '''-k'' 1
Department of Land and Natural Resources State of Hawaii P. O. Box 621 Honolulu, Hawaii 96809
Dear Mr. Hardy:
Manager and Chief Engineer
DEAN A. NAKANO Deputy Manager and Chief Engineer
Subject: Your Letter of April 25, 2007 Regarding Well Construction/Pump Installation Permit for Paves Well (3306-23), Thompson Corner
We have no objection to the issuance of permits for a domestic well and pump installation at TMK 6-6-028:006.
If you have any questions, contact Chester Lao at 748-5931.
LINOAUNGLE APR 2 7 2007 PETER T YOUNG OO·IIi.~()J'4oIAW~1 QIfI"'PlR5ON
.A. "'lo MEREDITW J C~IN(l :; ~ JAMES A. FRAZIER
TO:
FROM:
STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL FUOSOURCES
COMMISSION ON WATER RESOURCE MANAGEMENT P.O BOX &21
HONOLULU. HAVVIJI '36alII
April 25, 2007
Honorable Chiyome 1. Fukino, M.O" Director Department of Health Attention; Director's Office
Harold Yee, Wastewater Branch Stuart Yamada, Safe Drinking Water Branch Alec Wong. Clean Water Branch
Peter T. Young, Chairperson ~ Commission on Water R~ource Management
1'1\1.7. NEAL S. FUJIWARA c..H CHIYOME L. FIJKlNO. M.O
N U LAWRENCe H. Mill<!::. MO. J 0 - SnPHANIE A. WHAlEN
SUBJECT: Well Construction/Pump Installation Pennit Application Paves Well (Well No. 3306-23)
Transmitted for your review and comment is a copy of the captioned Well ConstructionlPump Installation permit application.
We would appreciate your comments on the captioned application for any conflicts or inwm;istcnciC5 with the programs, plans, and objectives specific to your department. Please respond by returnin this cover memo form Mav 2S 2007. If we do not receive comments or a request for additional review time by this date, we WI I 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 additiol1al information, or request additional review time, please contact Lenore Nakama of the Commission staff at 587-0.218.
LN:ss Attachment(s)
RESPONSE: 11
II
II
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11 1 )
[ I
mis well qualifi£~ a$ a I()'~ct wh"h will scrv~ as a .;011"00 ofl)Olable walti' 10 i pubh~ \\"aW ,ystcm (defined:a!< W'\Iil\g 2$ oc loor~ p/:oplc allam ~o day.! ~ year or has 15 or more scrviQc COI1llCCli(1lls) ar\~ lIIu$t ..... iVO! Di=tOf o(HI:9.~~ appro~lIll!!!n 10 illl ~ 10 WIlPIy with Hawnii Adm.n'$tQtive R.~ (HAR). "fitl" II. Chapter 2(). Ru!~ R.l~ifll!l() POl~bJ. Weier S)'51ems. ~l 1-20-29.
Tili~ well <ioeSIlQt qv~lify as lJl SOl((o;)C S<:{V;"g 3 public wak:r sy>tom <,c:n"C:' b. thaa 25 pcQpl; or more pc<1plo allea~ 60 d~Y51)el" yeW" or 1 ~ seMCC ~onn~lIon.) and iClk well water i~ ,1$CId (!IT dti,..iQl;. tho privot. _ ~b.vlol tol for bacteriol08ical and .h.II\~1 po:=_ b;f.,.., inili;zlinS .uch o<e Gild roubl~l)' monitor the waiCT qUiililty tI"'Te;,f\.r. HQYo"vl:I". ifflllurc pl3nr1fd U3I: fiom mis iOurce 1~5tO meet I~e p.lbli~ _or ~ defi."'on .beD Dir~or (If Heall!1 awv~~J i$l""O\llli~ ~ 10 i.nplel11clllatiOI\
It'lbe: woll is u&<:d 10) 5I,lW'Y both j)<)tabl • ..,d """"I'<*;obl. P'IrJK1"'" in a $ill8le sYJI'm,t~e llSCf wll &Iitnill;ll" aQS6-00~)1eCtions and bodellow connections by l)Ilys~lIy $I!p<Il"iltinl1 po1;t1;)le 8nd nO!'-l)otablc systems by an air BlIP or an WPI'O~ b~ci(tlQW prevc~et. ;md by ~1 .... 1y bbo:hnJ all non· jXllal,le SfligOiS with w.minE 5)BnS to preVCRI inadv<II11!.' consumption of non-pOIlbl~ w;\f~r. ~t'low prO.eltIi<m device> sho\.ld be ",,"ioely illlpemd and tested.
" d~5 )~ appear thaI this well will be \1#4 for QOftSUrJll)tm; p~ and is not SIII:!iIXl to :;:,f. OTil,1r,in~ Wilier Re~ullti(lns
In the ~nt thlt the location "f!he WIlli changes bill is ~iII wilhin 11K pmcl dcwlbcd Oil this ,.wheal)"", OUt division considers tlte W"'m~nI& to SliD be 8IlPli~tblt. :IIId w< do D<>I no<d to ",view 1111; n~w IOQlion.
The Safe Drinking Water Branch administers programs in the areas of: 1) public wa1er systems; 2) underground injection control; and 3) groundwater protection. Our general comments on projects are as follows.
Publit Water Systems
• Federal and state regUlations define a public water system as a system that serves 25 or more individuals at least 60 days per year or has at least 15 service connections. All public water system owners and operators are required to comply with Hawaii Administrative Rules, Title 11, Chapter 20, titled Rules Relating to Potable Water Systems.
All new public water systems are required to demonstrate and meet minimum capacjty requirements prior to their establishment. This requirement involves demonstration that the system will have satisfactory technical, managerial and financial capacity to enable the system to comply wjth safe drinking water standards and requirements.
Projects that propose development of new sources of potable water serving or proposed to serve a public water system must comply with the terms of Section 11-20-29 of Chapter 20. This section requires that all new public water system sources b~ approved by the Director of Health prior to its use. Such approval is based primarily upon the submission of a satisfactory engineering report which addresses the requirements set in Section 11-20-29.
• The engineering report must identify all potential sources of contamination and evaluate altemative control measures which could be implemented to reduce or eliminate the potential for contamination~ including treatment of the water source. In addition, water quality analyses for all regulated contaminants. perfonned by a laboratory certified by the State Laboratories Division ofthe state of Hawaii, must be submitted as part of the report to demonstrate compliance with all drinking water standards. Additional parameters may be required by the Director for this submittal or additional tests required upon his or her review of the infonnation submitted.
All sources of public water system Sources must undergo a source water assessment which will delineate a source water protection area. This proccss is preliminary to the creation of a source water protection plan for that source and activities which will take place to protect the source of drinking water.
MAY~tB-2B07 1£1:£14 From:DOH/SAFE WATER BRANH 8085854351 ~'''' \.,
To:8B8 587 £1219 "'",", ... ..1
• Projects proposing to develop new public water systems or proposing substantial modifications to existing public water systems must receive approval by the Director of Health prior to construction of the proposed system or modification. These projects include treatment, storage and distribution systems of public water systems. The approval authority for projects owned and operated by a County Board or Department of Water or Water Supply has been delegated to them.
All public water systcms must be opcrated by certified distribution system and water treatment plant operators as defined by Hawaii Administrative Rules, Title II, Chapter 11-25 titled; Rules Pertaining to Certification of Public Water System Q~rators.
All projects which propose the use of dual water systems or the use of a non-potable water system in proximity to an existing potable water system to meet irrigation or other needs must be carefully design and operate these systems to prevent the cross-connection ofthese systems and prevent the possibility of backflow of water from the non-potable system to the potable system. The two systems must be clearly labeled and physically separated by ajr gaps or reduced pressure principle backflow prevention devices to avoid contaminating the potable water supply, In addition backflow devices must be tested periodically to assure their proper operation. Further, all non-potabk spigots and irrigated areas should be clearly labeled with warning signs to prevent the inadvertent consumption on non-potable water. Compliance with Hawaii Administrative Rules, Title 11, Chapter 11-21 titled; Cross-Connection and Backflow Control is also required.
All projects which propose the establishment of a potentially contaminating activity (as identified in the Hawai'i Source Water Assessment Plan) within the source water protection area of an existing source of water for a public water supply should address this potential and activities that will be implemented to prevent or reduce the potential for contamination of the drinking water source.
For further information concerning the application of capacity, new source approval. operator certification, source water assessment, backflow/cross-connection prevention or other public water system programs, please contact the Safe Drinking Water Branch at 586-4258.
Underground Injection Control (UIC)
Injection wells used for the subsurface disposal of wastewater, sewage effluent, or surface runoff are subject to environmental regulation and permjtting under Hawai'i Administrative Rules, Title 11, Chapter 11-23, titled Underground Injection Control (UIC). The Department of Health's approval must be first obtained before any injection well construction commences. A UIC pennit must be issued before any injection well operation occurs.
Authorization to use an injection well is granted when a UIC permit is issued to the injection well facility. The UIC permit contains discharge and operation limitations.
monitoring and reporting requirements, and other facility management and operational conditions. A complete VIC permit application form is needed to apply tor a UIC pennit.
• A UIC permit can have a valid duration of up to five years. Pennit renewal is needed to keep an expiring pennit valid fOf another term.
For further information about the UIC permit and the Underground Injection Control Program. please contact the UIC staff of the Safe Drinking Water Branch at 586-4258.
Groundwater Protection Program
• Projects that propose to develop a golf course are asked to use the Guidelines Applicable to Golf Courses in Hawai'i (Version 6) in order to address certain groundwater protection concerns, as well as other environmental concerns.
MEREDITH J. CHING JAMES A. FRAZIER NEAL S. FUJIWARA
CHIYOME L. FUKINO, M.D. LAWRENCE H. MilKE, M.D., J.D.
STEPHANIE A. WHALEN
TO:
STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES
COMMISSION ON WATER RESOURCE MANAGEMENT P.O. BOX 621
HONOLULU, HAWAII 96809
April 25, 2007 c:::l ::u
(":' -.J '. (,,·0
<::"-~. Honorable Chiyome L. Fukino, M.D., Director Department of Health
C:j ..... lU :-:1"1 ~- ?3
, q ( ,- ; Attention: Director's Office '.
~ ) tl _ ... ~ Harold Vee, Wastewater Branch Stuart Yamada, Safe Drinking Water Branch Alec Wong, Clean Water Branch
c::::> .. :-]
,.-'
: " <- ):II - 11 :.:: : ; , 0 ." - : ..
Peter T. Young, Chairperson 1 -I 7""'! c..,) - :',J ......; CJ1 Commission on Water Resource Management
FROM:
SUBJECT: Well Construction/Pump Installation Permit Application Payes Well (Well No. 3306-23)
Transmitted for your review and comment is a copy of the captioned Well Construction/Pump Installation permit application.
We would appreciate your comments on the captioned application for any conflicts or inconsistencies with the programs, plans, and objectives specific to your department. Please respond by returning this cover memo form by May 25, 2007. If we do not receive comments or a request for additional review time by this date, we will assume that you have no comments.
Please find the attached maps to locate the proposed well. If you have any questions about this permit application, request additional information, or request additional review time, please contact Lenore Nakama of the Commission staff at 587-0218.
LN:ss Attachment( s)
RESPONSE:
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This well qualifies as a source which will serve as a source of potable water to a public water system (defined as serving 25 or more people at least 60 days per year or has 15 or more service connections) and must receive Director of Health approval prior to its use to comply with Hawaii Administrative Rules (HAR), Title II, Chapter 20, Rules Relating to Potable Water Systems, § 11-20-29.
This well does not qualify as a source serving a public water system (serves less than 25 people or more people at least 60 days per year or 15 service connections) and if the well water is used for drinking, the private owner should test for bacteriological and chemical presence before initiating such use and routinely monitor the water quality thereafter. However, if future planned use from this source increases to meet the public water system definition then Director of Health approval is required prior to implementation.
If the well is used to supply both potable and non-potable purposes in a single system, the user shall eliminate cross-connections and backflow connections by physically separating potable and non-potable systems by an air gap or an approved backflow preventer, and by clearly labeling all nonpotable spigots with warning signs to prevent inadvertent consumption of non-potable water. Backflow prevention devices should be routinely inspected and tested.
It does not appear that this well will be used for consumptive purposes and is not subject to Safe Drinking Water Regulations.
For the applicant's information, a source of possible wastewater contamination [ lis II is pot located near the proposed well site (information attached).
An NPDES permit is required.
Other relevant DOH rules/regulations, information, or recommendations are attached.
In the event that the location of the well changes but is still within the parcel described on this application, our division considers the comments to still be applicable, and we do not need to review the new location.
~ No comments/objectioos NO ~~ -Contact Person: LO t'J MOv1 /<Om I
STATE OF HAWAII OEPAATMI=KT OF LAND AND NATURAL RESOUFtCES
COMMISSION ON WATER RESOURCE MANAGEMENT PO.a<lX621
HONOLULU. HAWAII 9680Q
April 25, 2007
Honorable Chiyome 1. Fukino, M.D_, Director Department of Health Attention: Director's Office
Harold Yee, Wastewater Branch Swart Yamada, Safe Drinking Water Branch Alec Wong, Clean Water Branch
PeterT. Young, Chairperson ~ Commission on Water Resource Management
Well ConstructionfPump Installation Permit Application Payes Well (Well No. 3306-23)
T-386 P.002/C02 F-759
peTER T. YOUNG ~ ~.O> II/~~
MIOIUODITH J. CHiNa JAMES A. FAA2IER f'l . NEAL 5 FUJIWARA LJV
CHIYOME L FUKlNO. M.O. lAllliRENCe H. MIII<Ii. M.D .. J.D.
STj;!PHANE A. WHAlEN
Transmitted for your review and comment is a copy of the captioned Well ConstructionJPump Installation permit application_
Please find the attached maps to locate the proposed well. lfyou have any questions aboutthis pennit application, requestadditionaJ infonnation, or reqlle~1 additional review time, please contact Lenore Nakama oflhe Commission staff at 587-0218.
LN:ss Attachment(s)
RESPONSE:
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[ 1
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[ I
r/ ( 1
This wdl qUillilieg ... a sour"" wni..,11 will s.Bt'IIe as a ,;ouTCC o!p.>l;tbl~ waletlO a public IWtcr;),Slcm (~fine4 asStl"\lin~ 25 or mOIl: I..:opl~ ill kI;\.~ 60 days per yeat Of hil,11 S or more ,;cni", wn.-Iiolli) and ill'"! tc""ive Dircl;t<1f <If tiua"ll apptoval w:iAl:,to iT, ...... ," comply "'irb Hlwuil Adminiolr;otiv. R,jles (HAR). Titl~ 11. ChaPlct 20. RulQ R"l;lIiMg lof'cmblc Water Sy&l.:m;;. ~11.~1).19. .
This well \I()oj$ 1101 qualitY ti D &OIn'Ce- ~Bl'vinG a public WDtI:T 6)'M"m (:>et\l1!~ 180S than 25 people or more ~plc at least 60 dayIi p.:r y_ (r( I S """~ CODlltCriollli) and if Ihe well WIler is me,1 fill' dri"kill&, the priYllte owner »hoald ~ for bact""oioboleol and ghomieai preaen~ b.:for.: iruliatlnll tillel, IIR i,"4 \'QlIli.lCly monitor 1M walEI' quality thcn:aftcr. tIO"'b~. iffulucc planned ~ nom Ihi, )Iource increases to I1IOCtTh~ publi.: ~IG.· sySlcm definition tholn DiT~e\Ot ofHcalth approv,,1 i~ I'O<lllil'Cd nriflI: 10 implcmenralion.
If Ilk: Mil is ~ to supply both parable and DOD-polablo: pul'f!OSSS ill II sintk sy&l~II1. Iht U~ :<1\0"111 eli,lIUl&lc CI06HOIIII'IQlionS and I~ow eonne<:tion& by pllY~ictlf:li gepIITII!lny p(II~ble ~ld 11ClJl-potBi))C sy6tcms by .n air SlIP or 8II applovcd bagkilw" PfIl'ICI11CI". ad by <:Icarly labo:litlj! iIIll\o~· jlOrable spiROI& willi ",.min& sig116 1(> prCVrmlll14dVCtlCJlT ronsulUptioll of~!able watc,'. BacldIow pr~Ii(tJ, dltvtetS should tit: roulinely 11Ispe«...o andl~.
Ii don 001 ~thaI: Ibis w.:ll "ill bI! used for consumptive purpQ$'~ ",14 is 'IOTSubjec1\o S~t'c DrinkiPIl Water Reculalion~.
An "-'PDIiS penns is required.
Otbcr rclcYllni DOH J'u)caltcgulationti. im(1f11.-lioll, Of tccommendDTio~s Me 1I11l\dled.
III (he event lhilt Tho. locatio" ofmc well ~i811!fi'S bql is 51ill ~min!be paT...:llk=ib\!:d on Ihis appliC81:ioll. our diVI5i(lll cQ(lSi(\ets,~ oommcnls 10 still ill: IIppli"'llJlc, l1l1I1 w; ~o ROI need 10 rcvivw lb. ~ I_rio".
Apr+;O-200T 10:20am From-DEPT OF HEA~ENVIRCW~NrAl t.f\GM'T
'-' 8085864352 o T-38S P.DOl/002 F-759
e· Department of Health, Clean Water Branch has the lollowing <:omments:
For Well-Drilling Activities
ly discharge to State waters of treated process wastewater effluent associated with well dnlli~ activities 'is gUlated by Hawaii Administrative Rules, Title 11, Chapter 55, Appendix I, effective ·Septerrtber 22, 1997. 'eated.,proces5 wastewater effluent covered by this general permit includes well drilling slurries, hJbricating .lids wastewaters, and well purge wastewaters, This general, permit does not cover ~tt pump testing. The ;:>plicable Notice of Intent Forms and filing fee shan be submitted at least thirty (30) days, before 1he start of rscharge to,the'Department of Health. Clean Water Branch at 919 Ala Moana Boulevard. Room 301, onolulu
t Hawaii 96814-4920 or P.O. Box 3378, Honollllu, Hawaii 96801.3378. Inquiries·may be diteded to
ae.Clean Water Branch at (BOB) 586-4309 or by fax at (80S) 586-4352.
•. . For Well Pump Te~ting
'he discharger shall take all measures necessary to prevent the discharge of pollutantS froin entering State" lIaters .. Such measures shat include. ff necessary. c~ntainment of the initial disdlarge until the discharge s essentially free of pollutants. If the discharge is entering a stream or river bed. best man~gem8nt' .. K"actices shaD be implemented to prevent the dilcharge from disturbing the clarity of the receiving .water. If he discharge is entering a storm drain. the dis!=harger must obtain written permission from the owner of hat storm drain prior to discharge. Furthermore, best management practices shall be implemented to ::w,vent the discharge from colleding sediments and other pollutants prior to entering the storm drain.
STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES
COMMISSION ON WATER RESOURCE MANAGEMENT P.O. BOX 621
Ms. Tracie Sober Valley Well Drilling, LLC 91-235A Oihana St. Kapolei, HI 96707
Dear Ms. Sober:
HONOLULU, HAWAII 96809
April 25, 2007
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
3306-23.rev
Well ConstructionlPump Installation Permit Application for Well No. 3306-23
We acknowledge receipt, on April 4, 2007, of your completed Well ConstructionlPump Installation permit application and filing fee for the Payes Well (Well No. 3306-23). You can expect your application to be processed within ninety (90) days from this date.
For your information, the attached table describes the process, responsible parties, and deadline requirements for drilling or modifying a well and installing, modifying, or replacing a pump.
By this acceptance letter, we are also notifying the well operator/landowner that water may not be pumped for purposes other than testing until the certificate of well construction/pump installation completion letter is issued to the well operator and landowner. Additionally, the permitted pump capacity described on the pump installation permit may be reduced in the event that the pump test does not support the capacity. No certificate of pump installation will be issued until the Commission has determined that the pump capacity will not have adverse effects on the aquifer, other nearby wells, or streams. In other words, you may need to remove the pump and install a smaller pump at the Commission's discretion before you can withdraw water for purposes other than testing.
If you have any questions about your permit application, please contact Lenore Nakama of the Commission staff at 587-0218.
LN:ss Attachment
c: Linda Payes
Sincerely,
WrH W.ROYHARDY Hydrologic Program Manager
o o LINDA LINGLE
GOVERNOR OF HAWAII PETER T. YOUNG
CHAIRPERSON
TO:
FROM:
STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES
COMMISSION ON WATER RESOURCE MANAGEMENT P.O. BOX 621
HONOLULU, HAWAII 96809
April 25, 2007
Honorable Chiyome L. Fukino, M.D., Director Department of Health Attention: Director's Office
Harold Yee, Wastewater Branch Stuart Yamada, Safe Drinking Water Branch Alec Wong, Clean Water Branch
Peter T. Young, Chairperson 1 Commission on Water Resource Management
MEREDITH J. CHING JAMES A. FRAZIER NEAL S. FUJIWARA
CHIYOME L. FUKINO, M.D. LAWRENCE H. MilKE, M.D., J.D.
STEPHANIE A. WHALEN
SUBJECT: Well ConstructionlPump Installation Penn it Application Payes Well (Well No. 3306-23)
Transmitted for your review and comment 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 May 25, 2007. If we do not receive comments or a request for additional review time by this date, we will assume that you have no comments.
Please find the attached maps to locate the proposed well. If you have any questions about this penn it application, request additional infonnation, or request additional review time, please contact Lenore Nakama ofthe Commission staffat 587-0218.
LN:ss Attachment( s)
RESPONSE:
[ I
[ I
[ I
[ I
[ I
[ I
[ I [ I
[ I
This well qualifies as a source which will serve as a source ofpolable water to a public water system (defined as serving 25 or more people at least 60 days per year or has 15 or more service connections) and must receive Director of Health approval prior to its use to comply with Hawaii Administrative Rules (HAR), Title II, Chapter 20, Rules Relating to Potable Water Systems, §11-20-29.
This well does not qualify as a source serving a public water system (serves less than 25 people or more people at least 60 days per year or 15 service connections) and if the well water is used for drinking, the private owner should test for bacteriological and chemical presence before initiating such use and routinely monitor the water quality thereafter. However, if future planned use from this source increases to meet the public water system definition then Director of Health approval is required prior to implementation.
Ifthe well is used to supply both potable and non-potable purposes in a single system, the user shall eliminate cross-connections and backflow connections by physically separating potable and non-potable systems by an air gap or an approved backflow preventer, and by clearly labeling all nonpotable spigots with warning signs to prevent inadvertent consumption of non-potable water. Backflow prevention devices should be routinely inspected and tested.
It does not appear that this well will be used for consumptive purposes and is not subject to Safe Drinking Water Regnlations.
For the applicant's information, a source of possible wastewater contamination I lis II is not located near the proposed well site (information attached).
An NPDES permit is required.
Other relevant DOH rules/regulations, information, or recommendations are attached.
In the event that the location of the well changes but is still within the parcel described on this application, our division considers the comments to still be applicable, and we do not need to review the new location.
MEREDITH J. CHING JAMES A. FRAZIER NEAL S. FUJIWARA
CHIYOME L. FUKINO, M.D. LAWRENCE H. MilKE, M.D., J.D.
TO:
FROM:
SUBJECT:
STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES
COMMISSION ON WATER RESOURCE MANAGEMENT P.O. BOX 621
Russell Tsuji, Administrator Land Division
HONOLULU, HAWAII 96809
April 25, 2007
W. Roy Hardy, Hydrologic Program Manager 1 Commission on Water Resource Management
Well ConstructionlPump Installation Permit Application Paves Well (Well No. 3306-23) TMK 6-6-028:006
STEPHANIE A. WHALEN
Transmitted for your review and comment is a copy of the captioned Well ConstructionlPump Installation permit application.
We would appreciate your comments on the captioned application with regard to the programs, plans, and objectives specific to your division. Please respond by returning this cover memo form by May 25. 2007. 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 Nakama of the Commission staff at 587-0218.
LN:ss Attachment(s)
RESPONSE:
[ ] A water lease/pennit is required of this applicant and an application for such will be requested by our division.
[ ] A water lease/pennit is!!.2! required of this applicant.
[ ] A water lease/pennit has been obtained by the applicant through lease no. __________ _
[ ] Other relevant Land Division rules/regulations, infonnation, or recommendations are attached.
W. Roy Hardy, Hydrologic Program Manager ~ Commission on Water Resource Management
Well ConstructionlPump Installation Permit Application
STEPHANIE A. WHALEN
Transmitted for your review and comment is a copy of the captioned Well ConstructionlPump Installation permit application.
We would appreciate your comments on the captioned application with regard to the programs, plans, and objectives specific to your division. Please respond b~ returning this cover memo form by May 25, 2007. If we do not receive comments or a request for ad itional review time by this' date, we will assume you have no comments.
Please find the attached maps to locate the proposed well. If you have any questions about this permit application or request additional review time, please contact Lenore Nakama of the Commission staff at 587-0218. If you require additional information regarding specific information that can be provided by the applicant, please contact the applicant directly at the contact information provided on the application form.
LN:ss Attachment(s)
RESPONSE:
[ ] This is a [ ] public (county or state) project [ ] private project and [ ] will [ ] may disturb historic sites.
[ ] We concur that the work described under this pennit will not disturb historic sites.
[ ] We do not concur that the work described under this pennit will not disturb historic sites. We require the following for our concurrence:
STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES
COMMISSION ON WATER RESOURCE MANAGEMENT P.O. BOX 621
HONOLULU, HAWAII 96809
April 25, 2007
Mr. Clifford Lum, Manager and Chief Engineer Board of Water Supply City and County of Honolulu 630 South Beretania Street Honolulu, HI 96843
Dear Mr. Lum:
Well ConstructionIPump Installation Permit Review Well ConstructionIPump Installation Permit Application
Paves Well (Well No. 3306-23)
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
Transmitted for your review and comment is a copy of the captioned Well Construction/Pump Installation permit application. If you have any comments on this application, please submit them by May 25, 2007. Ifwe do not receive comments we will assume you have no comments.
If you have any questions about this permit application, please contact Lenore Nakama of the Commission staff at 587-0218.
LN:ss
Sincerely,
wrH W.ROYHARDY Hydrologic Program Manager
_._-_ ...• _-_._-------------_._._._ ....... .
Professional and Vocational Li~sing (PVL) - powered by eHawaii.gov V __ r
Page 1 of 1
Professional and Vocational Licensing (PVL) Search - License Class
• PUBLIC RECORD DATA Taxkey Subdiv /Condo Tnr Address Owner I Lessee ~ Bths Land area Liv area Last Sale Instr J
nel-6-6-28-6 F FARRINGTON PAVES, LINDA L 1.94 ac 0 7/1/2005 QD $39~ HWV REVOC LIV TR
This information has been supplied by third parties and has not been independently verified by HawaII Information Service and Is therefore not uaranteed.
4/14/2005 1225-05 Kai Halalu 1 Miller Family Trust
7/8/2005 0421-04 Szeton Derk Norton
11/25/2005 4527-18 Kaonoulu 5 Keuranes Ltd.
12/4/2005 3004-06 Kaala Farms 1 Kaala Farms
Well Construction Driller Pump Inst. Type Issued Signed WCR1 Accept
C-24947 C-24947 BOTH
C-24947 C-24947 BOTH 8/212004 9/21/2005 7/26/2006
C-24947 C-24947 BOTH 8/212004 9/21/2005 7/26/2006 ",
C-24947 C-24947 BOTH 10/2212004 1114/2004 4/1212006 10/17/2006
C-24947 C-24947 BOTH 712912005 8/112005 3/16/2006 5/16/2006
C-24947 C-24947 BOTH 31712005 9/21/2005 7/26/2006
C-24947 C-21457 BOTH 4/27/2005 5/112006 8/10/2006 12119/2006
C-24947 C-24947 BOTH 7/1212005 7/2112005
C-24947 C-24947 BOTH 1/11/2006 111812006
C-24947 C-24947 BOTH 1211212005 12114/2005
Pump Installation Issued Signed WCR2 Accept
7/29/2005 8/112005 101121200610/1212006
4127/2005
7/1212005 7/21/2005 o 1/11/2006
1211212005 12129/2005
1218/2005 0519-07 Miller 01 Robert J. Miller C-24947 C-24947 BOTH 1211212005 12119/2005 8/912006 10113/2006 1211212005 12119/2005 7/21/2007 3/21/2007
12/8/2005 3306-13 NSLF-015
1218/2005 3306-14 NSLF-023
1/3/2006 3306-15 Bareis Springs
3/1/2006 5721-03 Taafuli
4/17/2006 3306-17 Christensen 1
6/19/2006 3306-20 NSLF-007
6/19/2006 3306-18 NSLF-001
9/5/2006 3306-19 NSLF-024
9/17/2006 2408-07 Lualualei 2
9/17/2006 2408-06 Lualualei 1
N. Shore Land & Farming. LL C-24947 C-24947
N. Shore Land & Farming. LL C-24947 C-24947
Orion Bareis C-24947 C-24947
Judith Taafuli C-24947 C-24947
Christensen Brothers Constru C-24947 C-24947
North Shore Land & Farming. C-24947 C-24947
North Shore Land & Farming. C-24947 C-24947
North Shore Land & Farming. C-24947 C-24947
Pineridge Farms Inc.
Pineridge Farms Inc.
C-24947
C-24947
101712006 2710-08 Waianae-Schmidt Peter Schmidt C-24947 C-24947
101712006 3306-21 Haleiwa-Saville Scott Saville
11/14/2006 0421-05 Dillon-01 Andrew Dillon
1/23/2007 0519-02 Kapaa-Sams
2/10/2007 3104-01 Hakerley
3/27/2007 3306-22 Kamalani
Monday, April 09, 2007
Neil Sams
Hakerley Waialua
Kamalani Ranch Co.
C-24947 C-24947
C-24947 C-24947
C-24947 C-24947
C-24947 C-24947
C-24947 C-24947
BOTH 1211212005 12/19/2005
BOTH 1211212005 12119/2005
BOTH 112512006 1/27/2006
BOTH 31712006
BOTH 4/24/2006 4/26/2006
BOTH 6/20/2006 6/27/2006
BOTH 6/21/2006 6/27/2006
BOTH 9/19/2006 9/21/2006
PUMP
PUMP
BOTH 10/11/2006 10/16/2006
BOTH 10/11/2006 10/16/2006
BOTH 11/15/2<l06 11/20/2006
BOTH 218/2007 2121/2007
BOTH 2115/2007 2121/2007
BOTH
1211212005 12128/2005
1211212005 12128/2005
1/25/2006 112712006
31712006
4/24/2006 4/26/2006
6/20/2006 6/27/2006
6/21/2006 6/27/2006
9/19/2006 9/21/2006
9/19/2006
9/19/2006
10/11/2006 10/16/2006
10/1112006 10/16/2006
11/15/2006 1112012006
218/2007 212112007
2115/2007 2117/2007
Page 1 ofl
.ARTMENT OF LAND AND NATURAL RESOaES DOCUMENT NO ., UAC OR ATIACHED WORKSHEET DATE A '14 2007 : Ipn ,
SRC/ COST F YR APP D OBJ CTR PROJECT PH ACT AMOUNT NAME/DESCRIPTION (WANG INPUT)
S 07 326 C 1026 0752 (1 ) $25.00 Linda Payes
" " " " " " (2) 25.00 W G Minami Inc.
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
TOTAL $ 50.00
REMARKS: LINE (1) Payes 2007 Well LINE (2) WG Minami 2007 LINE (3 LINE (4) LINE (5) LINE (6) LINE (7) LINE (8) LINE (9) LINE (10)
STATE OF HAWfl 0 r--------./ !
I
DEPARTMENT OF LAND AND NATURAL RESOURCES COMMISSION ON WATER RESOURCE MANAGEMENT
For Official Use Only:
APPLICATION FOR A WELL CONSTRUCTION I PUMP INSTALLATION PERMIT
Instructions: Please print in ink or type and send completed application with attachments to the Commission on Water Resource Management. P.O. Box 621, Honolulu, Hawaii 96809. Application must be accompanied by 10 copies and a non-refundabl: filing fee of ~25.00 payable to the Dept. of Land an? Natural Resources. The'eM'rJrs«:"rt:~~ 'Nli 'N! TF" Commission may not accept Incom~lete a~ph~atlons. F?~ assIstance, call the RegulatIon Branch at 587-0225. For [-:. I, .. ~' I ,;~2 ·f'~·r; ~:, ·~~i!;:~ 'T further information and updates to this application form, ViSit http://www.hawaii.gov/dlnr/cwrm. r t· S')!, ;;L·,_ .' ,,' ... r ''''.'
WELL LOCATION INFORMATION 3. ISLAND /4. TMK
~ ---L-lZL The following must be attached before this application is accepted as complete:
zone sec plat
• Portion of 7.S-Minute Series USGS topographic map (scale 1 :24.000) with well location labeled and include the name of the quad map • Property tax map. showing well location referenced to established property boundaries • Photograph of the proposed well Site • A schematic diagram showing the well site, access road and proposed well infrastructure
Well Operator's Maili~gAddress J
q~~ MAtAlY\lA ST· I Landowner's Mailing Add!'e$
HoNe l.lA LV1 1-1 \ 41n~ lto /
I Well Operator's E-mail
NI\ Landowner's Phone I landowner's Fax
PROPOSED WELL CONSTRUCTION PROPOSED PUMP INSTALLATION 7. Proposed Work ~ Construct New Well o Modify Existing Well o Abandon/Seal Well
8. Construction Type ~ Drilled o Dug o Shaft o Tunnel
10. Proposed Work .DO Install New Pump o Replace Pump
11. Proposed Pumping Rate, gpm (gallons per minute)
:JJ 12. Proposed Amount of Withdrawal, gpd (gallons per day)
9. Is this well part of a battery of wells? 0 Yes /!J No 500
I landowners Contact
1 landowner's E-mail
13. Method of flow measurement a Flowmeter o Open Pipe o Weir o Orifice o Other (explain)
14. Proposed Surveyor name and license number (a surveyor is required for all Well Construction Permits and may be required for some Pump Installation Pennits)
PROPOSED USE
o 15. Municipal (water systems serving greater than 25 individuals or 15 service connections)
~ 16. Domestic Number of units to be served: I o 17. Industrial (describe)
o 18. Irrigation (describe crop and no. of acres)
o 19. Military (describe)
o 20. Other (describe)
OTHER LEGAL REQUIREMENTS If required, items 21. and 22. must be obtained before the CommiSSion can legally issue a pennit:
21. Conservation District Use Permit (CDUP) o Required, COUP # date approved ___ _ o Not Required (attach documentation from OCCL) Oil I have not checked with OCCL about whether or not a COUP is required. I understand that checking with OCCL prior to making this application will
expedite my review. I further understand that issues raised by this agency may delay or result in denial of the permit issuance, or revocation ofthe permit after it is issued.
22. Special Management Area Permit (SMAP) o Required, SMA # date approved ___ .,.-o Not Required (attach documentation from applicable County agency) CS( I have not checked with the county about whether or not an S~A Permit is requir~. I understand that checkin~ with .the County Pri~~ to making this
application will expedite my review. I further understand that Issues raised by thIS agency may delay or result In denIal of the permit Issuance, or revocation of the permit after it is issued.
23. Historic Preservation Division (HPD) of the Department of Land and Natural Resources o I have consulted with the HPO regarding potential impacts of well construction activities on histOric sites. I have attached applicable documentation
from the HPD. ~ I have not consuRed with the HPD regarding potential impacts of well construction activities on historic sites. I understand that checking with the HPD
prior to making this applic.ation will expedit~ my rt:v~e~. I further u.nderstand tha.t issues raised by this ~gency may ,9.~.v;~ re~l!J!2f:;nia!"of !h.1. permit issuance, or revocation of the permit after It IS Issued, AdditIonally, the hIStory of past land use IS attached. tt}t.NH. llVtGlr<f- "-"'N~
Additional remarks, explanations, etc. (attach additional sheet if more space is needed)
I NOTE: Signing below indicates that the signatOries understand and swear that the i~formation provided i~ a,ccurate and true to the best of their knowledge. Further, the signatories understand that upon permit approval: 1) the proposed work IS to be completed within two (2) years of the approval date; 2) the contractor shall submit to the Commission a well completion/abandonment report within 60 days after the completion date of the permitted work; 3) in the event that the application is not completed correctly, any permit may be suspended until the item is brought in to compliance, and any work done while the permit is in suspension may result in fines of up to $5000/day. 24. WELL DRILLER (Must be filled out if application is for Well Construction) 2S. PUMP INSTALLER (Must be filled out if application is for Pump Installation)
Valley Well Drillio:.J, LLC 24947 Valley Well Drilling, LIe 24947 Licensee business name C-57 License No.
PROPOSED WELL SECTION (Please attach schematic if different from diagram provided below)
Hole Diameter: 10 in.
Elevation at top of casing lOl ft., msl* .. , Minimum of 2' Radius & 4" Thick Concrete Pad (to contain benchmark surveyed to nearest 0.01 ft.) ()
Ground Elevation' 10 ft msl* ., .. . "
..... . .... Please refer to the
Cement Grout: ~Q ft. (min. 70% of distance from
HA WAIl WELL CONSTRUCTION AND
ground elevation to top of ..... PUMP INSTALLATION STANDARDS
water surface or 500 ft., "':' .::: to ensure that your as-built is in compliance with
whichever is less.) ..... appl icable standards.
Grouting method:
/(! Positive displacement
Annular space between hole and casing (1.5" for positive
Solid Casing: (2 90% x (Ground Elev.-Water Level Elev»
displacement, 3" for other methods):
o Other t.~ in.
Rock or Gravel Packing:
loo ft. Material:
Total Depth
two ft. o Crushed Basalt
o Rounded Gravel
Estimated Water Level
.....
" "
. I I I t I I,
Total Length: \10 ft.
Nominal Diameter: ~ in .
Wall Thickness: Q .2:'76 in.
Bottom Elevation: -10 ft., msl*
Open Casing: !ll Perforated o Screen
Total Length: 4<l ft.
Nominal Diameter: 6 in.
Wall Thickness: o .1.:~~ in.
Bottom Elevation: ::fa 0 ft., msl* Elevation:
2.0 1 I·' .J t note: Neither bentonite nor mud should be used in
ft. msl* saturated zone during drilling
Open Hole:
Length: N~
ft.
Diameter: in.
Bottom Elevation: ft., msl*
* The approximate elevation must be referenced to mean sea level (msl) at the time of application filing. Final elevations of well components shall be submitted in the Well CompletionlWell Abandonment reports and referenced to a benchmark which has been established by a surveyor licensed by the State.
For non-salt water Basal Wells - bottom elevation of well should not be deeper than 1/4 of aquifer thickness or, Bottom Elevation of Well Limit = (Water Elevation _ 41 x Water Le~el Elevation )
. . fW .. ( 4Ix(2») Example: Estimated + 2 ft. Water Level Elev. - Bottom Elevation 0 ell Limit = 2 - 4 = -18.5 ft.
Solid Casing Material: Carbon Steel: compliant with (check one or more): 0 ANSI/AWWA C200 0 API Spec. 5L 0 ASTM A53 0 ASTM A 139
And compliant with (check one or more): 0 ASTM A242 (or A606) 0 Type E 0 Type S 0 Grade B 0 Other
