Ms. Tracie Sober NQvember 7,2012 Valley Well Drilling, LLC

Transcription

o
Q
WILLIAM J. AILA. JR.
NEIL ABERCROMBIE
CHAIRPERSON
GOVERNOR OF HAWAII
WILLIAM D. BALFOUR. JR.
SUMNER ERDMAN
LORETTAJ. FUDDY. A.C.S.W .• M.P.H.
NEALS. FUJIWARA
JONATHAN STARR
TEDYAMAMURA
WILLIAM M. TAM
STATE OF HAWAII
DEPUTY DIRECTOR
DEPARTMENT OF LAND AND NATURAL RESOURCES
COMMISSION ON WATER RESOURCE MANAGEMENT
P.O. BOX 621
HONOLULU. HAWAII 96809
NQvember 7,2012
3306-25.pip.ext
I
Ms. Tracie Sober
Valley Well Drilling, LLC
91-458 Komohana Street
Kapolei, HI 96707
Dear Ms. Sober:
Extension of Pump Installation Permit for Well No. 3306-25
This is in response to your email letter dated October 15,2012 requesting an extension
for the compl~tion date of the NSLF-13 (Well No. 3306-25). Your request is approved. Your
new completion date is January 5, 2013. All other conditions of your permit remain the same.
If you have any questions, please contact Charley Ice of the Commission staff at
587-0218.
Sincerely,
WILLIAM M. TAM
Deputy Director
CI:ss
c: Mark and Wendy Song
4' • . •
o
o
"Tracie Sober"
<[email protected]>
11/05/2012 11 :35 AM
To <Charley.F.lce@hawaiLgov>
cc
bcc
Subject RE: 3306-25 NSLF-13
Sure. Ken Simon sold this property to Mark Song.
From: [email protected] [mailto:[email protected]]
Sent: Monday, November 05,201210:52 AM
To: [email protected]
Subject: 3306-25 NSLF-13
We want to extend this permit. Who is the current owner? The application says Ken Simon, Menehune
Water Co., and emails say Mark Song. Any relation? Is Mark associated with Menehune?
o
o
•
Tammy Desaki
<[email protected]
m>
10/16/201208:20 AM
To <charley [email protected]>
cc
bcc
Subject Mark Song Pump Letter of Extension
Hi Charley,
I attached a letter of extension for Mark Song pump. Please let me know if anything else is needed.
Thank you,
Tammy Desakl
Valley Well Drilling
Kapolei, HI 96707
Ph: 682-1767
Fax: 682-176C
-m
Mark Song Pump Letter of Extension. pdf
o
VALLEY WELL DRILLING, LLC
91-458 Komohana Street· Kapolei, Hawaii 96707
~• • • •=~~~~;':;-1767 • Fax S08-682-1768 • C-57 License 1124947
10/15/12
Commission On Water Resource Management
Charley Ice,
?
The ow'ner of the NSLF-13 (Well No. 3306-25) well lives out of state and just completed
construction. He is asking for an extension for the pump installation. He will install the pump
upon receipt of the letter of extension.
If you have any questions, please contact Jeff Sober or Tracie Sober at 682-1767.
Sincerely,
Jeff Sober
W
Search Results
Page 1 of 1
o
Search criteria: TMK Taxkey 1-6-6-28-13
PUBLIC RECORD DATA
Taxkey
r
1-6-6-28-13
•
Subdjy/Condo
.Bda .IRbi Land area Ljy area Last Sale J.nm
Inr
Address
F
66-1444
SONG, MARK E 0
KAUKONAHUA& WENDY E
Owner/Lessee
0
2.43 ac
o 8/26/2009 DEED $5
RD
This information has been supplied by third parties and has not been independently verified by Hawaii Information Service
and is therefore not uaranteed.
Copyright ©10/25/2012 by Hawaii Information Service
http://reserver2.hawaiiinformation.com/REsearch/SitesIHIS/Areas/Search...
10/25/2012
a
o
D
''Tracie Sober n
<[email protected]>
cc
03/06/2011 02:17 PM
Please respond to
<tracie@vwdhLcom>
bcc
Subject RE: 3306-25
Charley,
Can we request an extension for PIP for well number 3306-25. There are new owners for the property and
they had sent their contractor Richard to inquire on the requirements}or a building permit
Mark Song
{(w..~
t-vt. It" r< I AJ, r
35 Pembroke
'
~iJ
,~
Irvine, CA 92618
ph# (949)922-9901
email: [email protected]
Thanks,
Tracie
C
(J
Sent: Wednesday, March 02, 2011 2:39 PM
Subject: RE: real busy
Actually, because we already issued the cancellation, after checking, it would be better to have a fuller
picture of the situation with the ownership. For the record.
"Tracie Sober" <tracie@vwdhLcom>
03/02/2011 01 :59 PM
cc
Subject RE: real busy
Please respond to
<tracie@vwdhLcom
>
Charlie,
Can I request an extension for the PIP for 3306-25?
Thanks,
Tracie
Sent: Wednesday, March 02, 201112:05 PM
Subject: keeping busy
o
o
NEIL ABERCROMBIE
WILLIAM J. AI LA, JR.
GOVERNOR OF HAWAII
CHAIRPERSON
WILLIAM D. BALFOUR, JR.
SUMNER ERDMAN
NEAL S. FUJIWARA
DONNA FAY K. KIYOSAKI, P.E.
LAWRENCE H. MilKE, M.D., J.D.
LORETTA J. FUDDY, A.C.S.w., M.P.H.
STATE OF HAWAII
WILLIAM M. TAM
DEPUTY DIRECTOR
P.O. BOX 621
HONOLULU, HAWAII 96809
March 10,2011
3306-25.pip.ext
Ms. Tracie Sober
Kapolei, HI 96707
Dear Ms. Sober:
Extension of Well ConstructionlPump Installation Permit for Well No. 3306-25
This is in response to your letter dated March 6, 2011 requesting an extension for the
completion date of the NSLF-13 (Well No. 3306-25). Your request is approved. Your new
completion date is January 5, 2012. All other conditions of your permit remain the same.
If you have any questions, please contact Charley Ice of the Commission staff at
587-0218.
Sincerely,
WILLIAM M. TAM
Deputy Director
CI:ss
c: Mark Song
l~t··"~
_____________________________________
o
"Tracie Sober n
<[email protected]>
03/06/2011 02: 17 PM
o
To <[email protected]>
ee
bee
RE: 3306-25
Charley,
Can we request an extension for PIP for well number 3306-25. There are new owners for the property and
they had sent their contractor Richard to inquire on the requirements for a building permit
Mark Song
35 Pembroke
Irvine, CA 92618
ph# (949)922-9901
email: [email protected]
Thanks,
Tracie
Subject: RE: real busy
Actually, because we already issued the cancellation, after checking, it would be better to have a fuller
picture of the situation with the ownership. For the record.
"Trade Sober" <[email protected]>
03/02/2011 01 :59 PM
cc
Subject RE: real busy
Please respond to
<[email protected]
>
Charlie,
Can I request an extension for the PIP for 3306-25?
Thanks,
Tracie
Subject: keeping busy
e
How's it going?
1) You mentioned that you had info on those Kunia BMW wells; did you find any compeltion reports?
2) You're gonna laugh (I think): that NSLF-13 well (3306-25) that we just cancelled the PIP for (expired,
you should get the letter tomorrow.) -- the guy walked into our office asking how to get something for the
building department to issue a permit (do I need a well?), and 10 and behold, all he really needs to do is
get you to request a PIP extension (despite the awkward timing, we should be OK with that). His name is
Richard. Let the fun begin.
Q
..
~
WILLIAM J. AI LA, JR.
NEIL ABERCROMBIE
INTERIM CHAIRPERSON
GOVERNOR OF HAWAII
WILLIAM D. BALFOUR, JR.
SUMNER ERDMAN
NEAL S. FUJIWARA
DONNA FAY K KIYOSAKI, P.E.
LAWRENCE H. MilKE, MD., J.D.
WILLIAM M. TAM
DEPUTY DIRECTOR
STATE OF HAWAII
P.O. BOX 621
March 1,2011
3306-25.exp.not
Ms. Tracie Sober
Valey Well Drilling, LLC
Kapolei, HI 96707
Dear Ms. Sober:
Expiration of Pump Installation Permit for Well No. 3306-25
This is notice that your Pump Installation Permit for the NSLF 13 Well (Well No. 3306-25)
expired on January 5, 20 II.
While the well construction permitted at the same time has been completed and certificated, we
understand that no work was done on pump installation and there are no current plans to do so; 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. The completed well must remain capped and
locked until further notice. If no pump is to be installed, application should be made to seal the well. If
plans change the expected use to more than individual domestic use, a water use permit application must
be filed.
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 $5,000 per day.
If you have any questions, please contact Charley Ice of the Commission staff at 587-0218.
Sincerely,
M"'--""""~
WILLIAM M. TAM
Deputy Director
CI:ss
c:
Menehune Water Company
• 44."'.
o
o
"Tracie Sober n
<[email protected]>
02122/2011 03:11 PM
Please respond to
<tracie@vwdhLcom>
To <Charley.F [email protected]>
cc
bcc
Subject RE: loose ends
Yes to both.
Thanks,
Tracie
Sent: Tuesday, February 22,201111:16 AM
Subject: loose ends
3401-01 Hakerly ((Waialua): expired ... dead?
3306-25 NSLF 13 (Waialua): PIP expired ... dead?
CO~SION
FROM:
~tri 5Z
INIT.
TO:
CHENG, C.
CHING, F.
CHONG,R.
DANBARA, S.
ENGLAND, D.
FUJII, N.
HARDY,R.
k HOAGBIN, S.
ICE, C.
IMATA, R.
~ KAWAHARA, K.
KIMURA,J.
L
DATE:
fi
4/P/0 'I
TO:
SUSPENSE DATE:
INIT:
Y\~ fAJ,L~ tJSLf
PLEASE:
Approval
~ Signature
~ Information
4-
~(V\~(la..
-------------------
FOR:
I
KUNIMURA.I.
MILLS, D.
OHYE, L.
OHYE,M.
___ OSHIRO, K.
SAKODA, E.
SWANSON, S.
TORRES, R.
UYENO, D.
YODA, K.
YOSHINAGA, M
"'My twiftAlt-t,.· St-A-n
(11/08)
ON WATER RESOURCE MANAGgENT
See Me
Review & Comment
Take Action
Type Draft
~ Type Final
File
Xerox _
copies
--1:-
is ~ ""~
(Iff J
r
~ ",ct ~$
DWr\l,(
tv--L
c
"Tracie Sober"
<[email protected]>
o
04/20/200912:25 PM
o
To <Denise.E.Mills@hawaiLgov>
ce
bee
Subject Well#3306-25
Aloha Denise.
I just received the certificate of well completion for the above NSLF-13
well. Sean Ginella is not the landowner for this prope
Can you please
s below:
99-1205 Halawa Valley Street
Aiea, HI 96701
Thanks,
Tracie
..
"
o
o
/
LAURA H. THIELEN
LINDA LINGLE
CHAIRPERSON
GOVERNOR OF HAWAII
MEREDITH J. CHING
JAMES A. FRAZIER
NEAL S. FUJIWARA
CHIYOME L. FUKINO, M.D.
STATE OF HAWAII
KEN C. KAWAHARA, P.E.
DEPUTY DIRECTOR
P.O. BOX 621
April 21, 2009 /
3306-25 cwcc2
Mr. Ken Simon
99-1205 Halawa Valley St.
Aiea, HI 96701
Dear Mr. Simon:
Certificate of Well Construction Completion for Well No. 3306-25, TMK (1) 6-6-028:013
We are pleased to inform you that the Well Construction work permitted for the Well NSLF-13 (Well No.
3306-25) is complete and acceptable. 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(t), HAR prior to any well sealing or plugging
work.
4. In the event that the well operator andlor landowner changes, the Commission shall be notified prior
to the change.
5. In the event the benchmark in the con~rete base ofthe well is altered in any way, an updated version
of the Well Elevation page ofthe WeI1 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 from our website at
www.hawaiLgov/dlnr/cwrm/resources-.permits.htm.
6. If your well produces less than 70 gallons per minute, and no elevation survey has been completed,
you may be required to do one in the future.
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 Denise Mills of the Commission staff at 587-0251.
Sincerely,
4{~~i~
~ty Direc~iHi
DEM:ss
c: Honolulu Board of Water Supply
o
o
LINDA LINGLE
LAURA H. THIELEN
GOVERNOR OF HAWAII
CHAIRPERSON
/
MEREDITH J. CHING
JAMES A. FRAZIER
NEAL S. FUJIWARA
KEN C. KAWAHARA, PE.
STATE OF HAWAII
DEPUTY DIRECTOR
P.O. BOX 621
April 16, 2009 /
3306-25 cwcc
Mr. Sean Ginella
North Shore Land & Farming, LLC
95-1064 Kowa Street
Mililani, HI 96789
Dear Mr. Ginella:
Certificate of Well Construction Completion for Well No. 3306-25, TMK (1) 6-6-028:013
We are pleased to inform you that the Well Construction work permitted for the Well NSLF-13 (Well No.
3306-25) is complete and acceptable. To protect Hawaii's natural ground water resources for the benefit of all,
the following requirements apply to the use of your well:
I. Before this well can be pumped on a regular basis, a certificate of pump installation completion must
be obtained.
2. If the well is not in use it must be properly capped.
3. If the well is to be abandoned then the landowner must cause a licensed contractor to apply for a well
abandonment permit in accordance with § 13-168-12(f), HAR prior to any well sealing or plugging
work.
4. In the event that the well operator and/or landowner changes, the Commission shall be notified prior
to the change.
5. In the event the benchmark in the concrete base of the well is altered in any way, an updated version
ofthe 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. Hie Well Elevation portion of the Well
Completion Report Part I can be obtained by contacting Commission staff or from our website at
www.hawaii.gov/dlnr/cwrm/resources.-permits.htm.
6. If your well produces less than 70 gallons per minute, and no elevation survey has been completed,
you may be required to do one in the future.
Because groundwater in Hawaii is a public trust, and adverse effects at one well may affect other water
resources, an)' 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 Denise Mills of the Commission staff at 587-0251.
Sincerely,
DEM:ss
c: Honolulu Board of Water Supply
................
----------------------------------------------------------
~------.-'-
o
o
LINDA LINGLE
I
LAURA H. THIELEN
GOVERNOR OF HAWAII
CHAIRPERSON
DEPUTY DIRECTOR
STATE OF HAWAII
MEREDITH J. CHING
JAMES A. FRAZIER
NEAL S. FUJIWARA
P.O. BOX 621
April 16, 2009
I
3306-25 wcrl.acc.doc
Ms. Tracie Sober
Kapolei, HI 96707
Dear Ms. Sober:
Well Completion Report Part I for Well No. 3306-25
We received ~ur Well Completion Report Part I for the Well NSLF-13 (Well No. 3306-25)
on March 31, 2009 and acknowledge that it is complete.
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 sp~cific aspects of well usage and maintenance from you to
the well operator/landowner.
.
If you have any questions, please co~tact Denise Mills of the Commission staff at 587-0251.
!
Sincerely,
DEM:ss
c: Sean Ginella
----------------------------------------"'''
M~MO and ROUT~LlP
0
(ver. 02109/09)
04/01/09
I WCR 1 Check for
1.
Well No.
3306-25
(regulation/survey route)
From Charle@enis~yan
-!flY'
(initial)
2. Well Log Check Geology Code for Well Index:
m-
vYn
3. Pump Tests Check Denise Mills
Fm
Name~f).IlU
(initial)
l0
Yes
No
.Engla~
(initial)
tfv\\' ~V\)j)O ~ .
Step-Drawdown Test:
followed WCPI Stds
analysis attached
0
0
0
0
~ gpm no test required
Constant Rate Test:
followed WCPI Stds
analysis attached
0
0
0
0
~pm no test required
Potential Well Interference:
0
0
Potential Stream Impacts:
0
0
Additional Testing or Data Required:
0
0
Pump Test Comments Attached:
0
0
Proposed Pump Capacity is OK.:
0
0
R. Torres -?(initial)
4. Construction Check Mitch Ohye
If no. describe deficiency
Longitude
Latitude
NAD27
NAD83
5.
l.--\
l. \
Charl~eni~Ryan ---4'W"I-=---- (initial)
?~
"
'-:-( .
\ SC{,
\l,..
~'1
()
c\
T0 f~
(,;;;
4
take action based on above analYSis
ATTACHMENTS FOR PUMP INSTALLATION PERMIT (2x):
1 COVER LETTER
2 COUNTY COMMENTS (DWS/SMA)
3 DOH COMMENTS
4 DLNR COMMENTS (LD/OCCUDHP)
V
5 WCR 1 Accept
6 WELL CONST. COMPLETION CERTIFICATE
V
~not
}
necessary - only WCP or BOTH.
To be sent to driller/pump installer
<------ To
}
6.
7.
8.
9.
1O.
1"1
Landowner
Staff internal checks
Roy
~
_(in"' ) check (Entere~ WCR 1IWCCC accept date into database)
Sus~' (initial) finalize
Ken
(initial signature
Mitch
JLnitial) Entered PIP issue date if attached/required
Charle}(fienis~an File
- - - - - - - - - - - - - - - - -_ _ _ _ _
.,111. . .
o
o
State of Hawaii
/
Department of Land and Natural Resources
o
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:/twww.state.hi.us/dlnr/cwrm/
?~a ~ ., 2~
1.
State Well No.:
Well Name:
2.
Address:
3.
Drilling Company:
4.
Drilling method used during construction:
5.
Date Well Construction (drilled,cased,grouted) completed:
ntr
Z(
T;;
Rotary
Tax Map Key:
1
~
,','
II
t
c·
I.
Island:
rOCi3 0 ft \<~~ f?®4 hYf'l fZc\·
Vq
\ielt Pn IhnJ J ltG
014 ja'tt
••
\-.-C:
_O~q:.:..;h~ti_ __
h-(o- 01 ~ ~Ol~
D Percussion D Other (describe)
~·l~·Oq
Attach Completed Driller's Log
month/day/year
6.
Was the subject well cored?
7.
Step-Drawdown Test completed?
8.
Constant Rate
D Yes
~ No
pq No
D Yes
Attach Step-Drawdown Test form (12117/97 SDPTD Fonn)
D Yes
Attach Constant Rate
Reference point
After casing installation
(this information should be before any pump tests are
performed with casing installed)
Chloride:
~ ppm, Temperature:
19 .'1
OF
note:
to mean sea
subtract the depth to the water leve/.
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 1i'J
15. If a pump is not planned to be installed, please describe (below in the remarks section) how well is secured to
prevent unauthorized access (example: lockable cover, threaded coupling, etc.)
16. Remarks:
Vb.}1U
/SeAfi ("liVl( f!({.
4fJ-/ Dbtf
NCI£
/UWA.
a-
Mili/Mi/ HI '1t:fgq
Licensed Driller (print)
Signature
C-57 Lic. No.
---='b=-¥l,,;.....;..~..:....1"_ _ _ _ __
Date --=:.,3--,';~O:......·-=-09.:....-_ _ __
WCR1 Form 6112107 Page 1 of 5
J'tl!III!
o
o
12. AS-BUILT WELL SECTION
(Please attach as-built if different from diagram provided below)
141.~
.
/
Elevation at top of casing
ft., msl*", I-(to nearest 0.01 ft.)
--~
- Hole Oiameter: _....,\O,,--_,in.
t
I
~ ~ Minimum of 2' Radius & 4" Thick Concrete Pad
- Ground Elevation:
Bench mark
elevation:
110ft., msl 0 Surveyed 0 Estimated
Please refer to the
~ft.,msl*
0
Cement Grout:
ft.
(min. 70% of distance from
ground elevation to top of
water surface or 500 ft.,
whichever is less.)
o (Surveyed to
nearest 0.01 ft.)
J\ (Estimated)
I
_'l._
.;.:
[ I':;):."'.'
to ensure that your as-built is in compliance
with applicable standards.
-:
[\:::
Annular space between
hole and casing (1.5" for
positive displacement, 3"
for other methods):
Grouting method:
D(, Positive
displacement (if
annular space is
less than two
inches, attach
photo oftremie)
o Other
HAWAII WELL CONSTRUCTION AND
PUMP INSTALLATION STANDARDS
:-;.
Solid Casing: (~90% x (Ground Elev.-Water Level Elev»
..
.. :,,-
':~'
.; .:.
Length:
',':',
\
~
NominalOiameter:
Wall Thickness:
in.
ft.
~
in.
Q. Zio
in.
~IQ
Bottom Elevation:
ft., msl
Rock or Gravel Packing:
-:-:--:-,q7--:~_
ft.
Open Casing:
Material:
1-- Perforated
o
Screen
~O
l(I Crushed Basalt
Length:
o Rounded Gravel
Nominal Oiameter:
ft.
b
in.
Q.nD
Wall Thickness:
in.
~OO
Bottom Elevation:
ft., msl
TotalOepth
Iq~
ft.
Open Hole:
"-lAo
I
L_~
ft.
Length:
Oiameter: _ _ _ _ _ _ _ _ _ _ _ _ _ in.
__________
Bottom Elevation: _ _ _ _ _ _ _ _ _ ft., msl
*msl = mean sea level
Solid Casing Material:
Carbon Steel: compliant with (check one or more):
And compliant with (check one or more):
Stainless Steel: (check one):
0 ANSI/AWWA C200
0 API Spec. 5L
0 ASTM A242 or A606
0 Type E
0 ASTM A409 (production wells)
ABS Plastic conforming to ASTM F480 and ASTM 01527: (check one)
0 ASTM A53
0 Type S
0 ASTM A139
0 Grade B
0 Other
0 ASTM A312 (monitor wells)
0 Schedule 40
0 Schedule 80
.l\ Schedule 40
PVC Plastic conforming to ASTM F480 and (ASTM 01785 or ASTM 02241): (check one):
Thermoset Plastic: (check one)
0 Filament Wound Resin Pipe conforming to ASTM 02996
0 Schedule 80 0 Schedule 120
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 AWWA C950
o PTFE Fluorocarbon Tubing conforming to ASTM 03296
o FEP Fluorocarbon Tubing conforming to ASTM 03296
Open Casing Material:
Carbon Steel: compliant with (check one or more):
0 ANSI/AWWA C200
0 ASTM A242 or A606
0
API Spec. 5L
0 Type E
ABS Plastic conforming to ASTM F480 and ASTM 01527: (check one)
0 ASTM A139
0 Grade B
0 Other
0 Schedule 40
0 ASTM A53
0 Type S
0 Schedule 80
X Schedule 40
0 Schedule 80 0 Schedule 120
o Glass Fiber Reinforced Resin Pressure Pipe conforming to AWWA C950
o PTFE Fluorocarbon Tubing conforming to ASTM 03296
o FEP Fluorocarbon Tubing conforming to ASTM 03296
WCR1 Form 6112107 Page 2 of 5
e
State of Ha!ii
For Official Use Only:
DRILLER'S LOG
09 M.\E 31
A
9: 56
Well Number: 3306-25
--------------------
Depths (ft.)
Rock description, Water level, etc.
Dates
Depths (ft.)
0
to
11
stiff clay, It. brown, soft
3/19/09
to
11
to
13
boulder, blue w/gray, med. hard
3/19/09
to
13
to
20
stiff clay, It. brown, soft
3/19/09
to
20
to
29
decomposed rock, dark brown, med.
hard
3/19/09
to
29
to
35
It. brown, reddish rock, med. hard
3/19/09
to
35
to
39
hard blue basalt
3/19/09
to
39
to
41
red cinders, soft
3/19/09
to
41
to
100
hard blue basalt rock
3/19/09
to
100
to
110
red cinders, soft
3/20/09
to
110
to
119
hard blue basalt
3/20/69
to
119
to
126
red wlblack, blue cinders, soft
3/20109
to
126
to
130
hard blue fracture rock
3/20109
to
130
to
133
loose cinders, soft (red wlblack, blue)
3/20109
hit water at 130' bgs
to
133
to
138
blue basalt, hard
3/20109
to
138
to
155
loose cinders, soft (red wlblack,blue)
3/20109
to
155
to
180
hard blue basalt
3/20109
to
180
to
195
loose cinders, soft (red wlblack,blue)
3/20109
to
to
Rock description, Water level, etc.
Dates
to
Remarks:
DL Form 06/24/2004
o
EXAMPLE
cJ:~
Lat: 19°36'45"
Long: 154°57'18"
k~
Attach photos of completed well and
concrete pad
NAD83:
Latitude: ~ degrees 3, min 1'5·'" sec
Longitude: ~ degrees ~ mi~ sec
SKETCH OF WELL LOCATION
(Referenced to permanent landmark, i.e. building, road, fence, etc.)
Provide Latitude and Longitude of well referenced to NAD83 to nearest second
weR1 Form 6112107 Page 4 of 5
2.\
o
\5~ 0
f
'9';)
(J(o I
Ir
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~4 .~ uf.l
crUMP INSTALLATION PERMIT
Well NSLF-13, Well No. 3306-25
0
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 Well NSLF-13 (Well No. 3306-25) at TMK (1) 6-6-028:013, 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 Resouroe 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, H~waii Administrative Rules.
2.
No withdrawal of water shall be made other than for t~sting until a Certificate of Pump Installation Completion has been issued by
the Commission.
I
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 10-gpm-rated capacity pump or a lower capacity pump in the well. This
permanent capacity may be reduced in the event that the pump test data does not support the capacity.
5.
A water-level measurement access shall be permanently installed, in a manner acceptable to the Chairperson, to accurately record water
levels.
6.
The permittee shall install an approved meter or other appropriate means for measuring and reporting withdrawals and appropriate
devices or means for measuring chlorides and temperature at the well head.
7.
Well Completion Report Part II shall be submitted to the Chairperson within sixty (60) days after completion of work. This form
can be obtained by contacting staff or on the internet at www.hawaiLgov/dlnr/cwrrnlresourcespermits.htm.
!
8.
9.
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 relate~ 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 indeJify, defend, and hold the State of Hawaii harmless from and
any loss,
liability, claim, or demand for property damage, personal injury, or death arising out of any act o:c::P~ssion g e applicant,
assigns, officers, employees, contractors, and agents under this permit or relating to or connected with ~ gnmting ofthis permit.
12.
Special conditions in the attached cover transmittal letter are incorporated herein by reference.
~nst
-- ':
Date of Approval:
Expiration Date:
January 5, 2009
January 5, 2011
c...
~
, Chairper§9.n:'::
CD
ission on W er Resource ~gement·
~::~;
C)
I have read the conditions and terms of this permit and understand them. I accept and agree to meet these ~ditions 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 p,rmit to the Commission. I understand that this permit is not to be
transferred to any other entity. I also understand that n'n-compliance with any permit condition may be grounds for revocation
and fines of up to $5,000 per day starting from the permit ~ate of approval.
I
I
Installer's Signature:
Printed Name:
IC-57, C-57a, or A License #:
Tracie Sober
Firm or Title:
24947
--,-1-L°'=L-=·\)_9_ _
Please sign both copies of th is permit, return one to the Chairperson, and retain the other for your records.
Attachments
Date:
e
o
o
WELL CONSTRUCTION PERMIT
Well NSLF 13, Well No. 3306-25
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 Div¢rsion Works", this document permits the construction and testing of Well
NSLF 13 (Well No. 3306-25) at TMK (1) 6-6-028-013'1 Oahu, subject to the Hawaii Well Construction & Pump Installation
Standards (HWCPIS - February 2004) which include but are not limited to the following conditions:
1
1.
The ChairQerson of the Commission on Water Resource Manager'ent (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 co mences and staff shall be allowed to inspect installation activities in accordance with
§ 13-168-15, Hawaii Administrative Rules (HAR).
!
2.
This permit shall be prominently displayed, or made available, at!the site of construction work until work is completed.
3.
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 pump test worksheet can be obtained by contacting Commission staff or at
www.hawaii.gov/dlnr/cwrmlresources.-Jlermits.htm). The permittee shall submit to the Chairperson the test results as a basis for supporting an application to
install a permanent pump. No permanent pump may be installed until a pump installation permit is approved and issued by the Chairperson. 'No withdrawal of
water shall be made for purposes other ilian 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.
4.
In basal ground water, the depth of the well may not exceed one-fourth (1/4) of the theoretical thickness (41 times initial head) of the basal ground water unless
otherwise authorized by the Chairperson. If it can be shown that the well does not tap basal ground water then this condition may be waived after consultation
with and acceptance by Commission staff. However, in no instance can the well be drilled deeper than one-half (112) of the theoretical thickness without
Commission approval.
5.
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.
6.
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.
7.
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.
8.
The Well Completion Report Part I shall be submitted to the ~hairperson within sixty (60) days after completion of work (please contact staff or visit
www.hawaii.gov/dlnr/cwrmlresources.-Jlermits.htm for curren~ form).
9.
The permittee shall comply with all applicable laws, rules, and ord~nances; non-compliance may be grounds for revocation of this permit.
10.
The well construction permit application and, if relevant, any related staff submittal approved by the Commission are incorporated into this permit by reference.
II.
If the HWCPIS are not followed and as a consequence water is wasted or contaminated, a lien on the property may result.
12.
Any variances from the HWCPIS shall be approved by the Chairperson prior to invoking the variance.
13.
The work proposed in the well construction permit application shall be completed within two (2) years from the date:-~.f ~rmit aptilimal, unless.-qherwise
specified. The permit may be extended by the Chairperson upon a showing of good cause and good-faith performance. t\r~~est to exteftd the penhlishall be
submitted to the Chairperson no later than the date the permit expires.
C. ') ~.;
_
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..." ~
Sn:'T
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--1
14.
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 thel!~~ermi~ust apply' ~ a well
abandonment permit in accordance with §13-168-12(f), HAR, prior to any well sealing or plugging w o r k . . · : . - ) _
against:~ifoss, liabi~claim, ~r1J~mand
15.
The permittee, its successors, and assigns shall indenmify, defend, and hold the State of Hawaii harmless from and
for property damage, personal injury, or death arising out of any act or omission of the applicant, assigns, officers, employ~ ctmtractors,4Iild agents ~r this
3:. .:.
permit or relating to or connected with the granting of this pennit.
16.
This permit shall apply to the location shown on the application only. If the well is to be relocated, the permittee shall appe-iwa new ~onstructionlpump
installation permit m accordance with §13-168-12(f), HAR.
17.
;-f"":,--.
-
Date of Approval: January 5, 2009
Expiration Date: January 5, 2011
I have read the conditions and terms of this permit and unde~stand them. I accept and agree to meet these conditions as a prerequisite and
underlying condition of my ability to proceed and understancl that I shall not commence work until I have signed, dated, and returned the
permit to the Commission. I understand that this permit is n$t 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.
C-57 License #:
Driller's Signature:
Printed Name:
Tracie Sober
Date:
Firm or Title:
Please sign both copies ofthis permit, return one to the Chairperson, and retain the other for your records.
Attachment
H'l.·O'1
24947
.....=:....0::-'-'--_ _ __
o
o
----
LAURA H. THIELEN
LINDA LINGLE
CXNI:"NQfI Of' HAWAII
MEREDITH J. CHING
JAMES A FRAZIER
NEAL S. FUJIWARA
CHIYOME L FUKlNO, M.D.
DONNA FAY K KlYOSAKl, P.E.
LAWRENCE H. MIlKE, M. 0 .. J.D
KEN C KAWAHARA. P.E.
STATE OF HAWAII
DIPU'N DIRECTOR
DEPARTMENT OF lAND AND NATURAL RESOURCES
P.O. BOX621
HONOLULU. HAWAII 96809
November 25, 2008
TO:
Dr. Puaalaokalani Aiu, Administrator
Historic Preservation
FROM:
Ken C, Kawahara, P.E., Deputy Director
Commission on Water Resource Management
SUBJECT:
Transmitted for your review and comIttent is a copy of the captioned Well Construction/Pump
Installation permit application.
We would appreciate your comments on the captioned application with regard to the programs,
plans, and objectives specific to your division. Please respond by returning this cover memo form by
December 16. 1008. If we do not receive comments or a request for additional review time by this date,
we wi I assume you have no comments.
Please find the attached maps to locate the proposed well. If you have any questions abouttbis
permit application or request additional review time, please contact Denise Mills ofth~issi6iRtaff
at 587-0251. If you require additional inform~tion regarding specific information that~.
.
proviW6d by
the applicant, please contact the applicant direj::tly at the contact information provided <m'~ appli.on
form.
~,::: ::;;;
C"")
:.~ ~
-:-:-,
,'x
i~~
DM:ss
Attachment(s)
~;
RESPONSE:
[ ]
)6
[ ]
This is a [ ] public (county or state) project [ ] private project and [ ] will [ ] may disturb
We concur that the work described under this pennit will not disturb historic sites.
hisfo~~ ~ites,
......
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rn
'J
'n
:
ex')
cK-
We do not concur that the work described under this pennit will not disturb historic sites. We require the following for
our concurrence:
1f NO \l-f\&Wl\ ll\""~I~Al\l ~DUrC-e" \\X:tlt-lt~ tV/in ~c} areJ1.Comm{tQ't\.Q ~~rr
~a~ a\~ ~ \~"tti~l\\i-t~ *\'I~h~", ~ttt"\~o\i'£01-fl"(£t ...eXAcA-_
~l'£A VMtl . .!)t1V4n
Phone:
(Oq /L.-'~bl9
Date:_1---4-0/--=/~Jrx~
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LINDA LINGLE
LAURA H. THIELEN
GOVERNOR OF HAWAII
CHAIRPERSON
MEREDITH J. CHING
JAMES A. FRAZIER
NEAL S. FUJIWARA
STATE OF HAWAII
DEPUTY DIRECTOR
P.O. BOX 621
January 7, 2009
Ref: 3306-25 wcp
Ms. Tracie Sober
Kapolei, ill 96707
Dear Ms. Sober:
. Well Construction Permit
Well NSLF 13 <Well No. 3306-25)
Enclosed are two (2) copies of your approved Well Construction Permit for the captioned well. This
permit authorizes well construction activities, but excludes installation work for a permanent pump. As
part of the Chairperson's approval, the following special condition has been added and is part of your
permit under Permit Condition 17:
ISpecial Condition
1.
Attached for your information ar~ copies of the State of Hawaii, Department of Health's
(DOH's) review comments. Please IIOte the DOH's requirements for the discharge of effluent
during well drilling and testing activities. Please contact DOH's Noise Radiation and Indoor
Air Quality Branch at 586-4700 for information on construction noise abatement standards
and compliance requirements for this project.
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. You may obtain the Commission's aquifer
pumping test worksheet from our website at http://www.state.hi.us/dlnr/cwnniresources permits.htm or
by contacting our staff.
IMPORTANT - Drilling work shall not commence until a fully signed permit is returned to the
Commission. The signed permit shall be prominently displayed or made available at the well site during
all well construction work. 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 Denise Mills of the Commission staff at 587-0251.
Enclosures
c: Ken Simon (with DOH requirements)
USGS
Honolulu Board of Water Supply
o
c
..J
/
STRUCTION PERMIT
13. Well No. 3306-25
Note: This permit shall be prominently dis layed at the construction site until the work is completed
In accordance with Department of Land and Natural Reso
es, Commission on Water Resource Management's Administrative Rules,
Section l3-168, entitled "Water Use, Wells, and Stream Di ersion Works", this document permits the construction and testing of Well
NSLF l3 (Well No. 3306-25) at TMK (1) 6-6-028-013 Oahu, subject to the Hawaii Well Construction & Pump Installation
Standards (HWCPIS - February 2004) which include but ar not limited to the following conditions:
1.
The ChailP-erson of the Commission on Water Resource Manag ment (Commission), P.O. Box 621, Honolulu, Hl96809, shall be notified, in writing, at
least two (2) weeks before any work authorized by this permit c mmences and staffshall be allowed to inspect installation activities in accordance with
§13-168-15, Hawaii Administrative Rules (HAR).
2.
3.
The well construction permit shall be for construction and testing f the well only. The permittee shall coordinate with the Chairperson and conduct a pumping
test in accordance with the HWCPIS (the latest p p test worksheet can be obtained by contacting Commission staff or at
www.hawaii.gov/dlnr/cwrmlresourcesJermits.htm). The p ittee shall submit to the Chairperson the test results as a basis for supporting an application to
install a permanent pump. No permanent pump may be installed til a pump installation permit is approved and issued by the Chairperson. No Withdrawal of
water shall be made for purposes other ilian testing without a C rtificate of Pump Installation Completion. The permitted pump capacity described on the
pump installation permit may be reduced in the event that the p mp test does not support the capacity.
4.
In basal ground wattr, the depth of the well may not exceed one-fi urth (l/4) of the theoretical thickness (41 times initial head) of the basal ground water unless
otherwise authorized by the Chairperson. If it can be shown that e well does not tap basal ground water then this condition may be waived after consultation
with and acceptance by Commission staff. However, in no ins ce can the well be drilled deeper than one-half (112) of the theoretical thickness without
Commission approval.
5.
The permittee shall incorporate mitigation measures to prevent co struction debris from entering the aquatic environment, to schedule work to avoid periods of
high rainfall, and to revegetate any cleared areas as soon as possibl .
6.
In the event that historically significant remains such as artifac , burials or concentrations of shells or charcoal are encountered during construction, the
permittee shall stop work and immediately contact the Dep
ent of Land and Natural Resources' State Historic Preservation DiVIsion. Work may
recommence only after written concurrence by the State Histonc eservation Division.
7.
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 w II shall not constitute a determination of correlative water rights.
8.
The Well Completion Report Part I shall be submitted to the hairperson within sixty (60) days after completion of work (please contact staff or visit
www.hawaii.gov/dlnr/cwrmlresources Jermits.htm for current form).
1
9.
The permittee shall comply with all applicable laws, rules, and ord nances; non-compliance may be grounds for revocation of this p~it.
10.
The well construction permit application and, if relevant, any relaujd staff submittal approved by the Commission are incorporated into this permit by reference.
II.
If the HWCPIS are not followed and as a consequence water is wrufted or contaminated, a lien on the property may result.
12.
Any variances from the HWCPIS shall be approved by the Chairp
13.
The work proposed in the well construction permit application s all be completed within two (2) years from the date of permit approval, unless otherwise
specified. The permit may be extended by the Chairperson upon 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 expi s.
on prior to invoking the variance.
14.
If the well is not to be used it must be prorerly capped. If the we is to be abandoned during the course of the project then the permittee must apply for a well
abandonment permit in accordance with § 3-168-12(f), HAR, prio to any well sealing or plugging work.
IS.
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 a t 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.
16.
This permit shall apply to the location shown on the application o,ly. If the well is to be relocated, the permittee shall apply for a new well construction/pump
installation permit m accordance with §13-168-12(f), HAR.
17.
Special conditions in the attached cover transmittal letter are inco11l0rated herein by reference.
L
j
N, Chairperson
ater Resource Management
Date of Approval: January 5, 2009
Expiration Date: January 5, 2011
I have read the conditions and terms ofthis permit and under~tand 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 no to be transferred to any other entity. I also understand that non-compliance
with any permit condition may be grounds for revocation and nes of up to $5,000 per day starting from the permit date of approval.
Driller's Signature:
Printed Name:
I
Tracie Sober
.
C-57 License #:
24947
Date: _ _ _ _ _ _ __
Firm or Title:
Please sign both copies ofthis permit, return one to the Chairper~n, and retain the other for your records.
Attachment
o
o
/
LINDA LINGLE
LAURA H. THIELEN
GOVERNOR OF HAW"n
CHAIRPERSON
MEREDITH J. CHING
JAMES A. FRAZIER
NEAL S. FUJIWARA
DONNA FAY K. KIYOSAKI, P.E.
STATE OF HAWAII
DEPUTY DIRECTOR
P.O. BOX 621
January 7, 2009
Ref: 3306-25.pip
Ms. Tracie Sober
Kapolei, HI 96707
Dear Ms. Sober:
Pump Installation Permit
Well NSLF-13 (Well No. 3306-25)
Enclosed are two (2) originals of your approved Pump Installation Permit for the captioned well that
authorize permanent pump installation work for your well. As part of the Chairperson's approval, the
following special conditions were added and are part of your permit under Permit Condition 12:
Special fonditions
1.
2.
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). Documentation of the new
benchmark shall be submitted to the Commission within sixty (60) days after the pump is installed.
Attached for your information are copies of the Department of Health's (DOH's) comments on your
permit application. Please review DOH's requirements related to discharge of effluent from well and
pump testing activities. Please contact DOH's Noise Radiation and Indoor Air Quality Branch at 5864700 for information on construction noise abatement standards and compliance requirements for this
project.
The permittee is responsible for all conditions of the permit. This includes responsibility to submit a
complete and acceptable Well Completion Report Part II form to the Commission no more than sixty (60)
days after the pump installation work has been completed.
Please sign both permit originals and return one for our files.
IMPORTANT - Pump installation shall not begin until a signed permit is returned to the Commission.
The signed permit shall be prominently displayed or made available at the well site the pump installation
work. No withdrawal of water shall be made for any purpose, except well and aquifer testing, without a
certificate of pump installation completion. Please be aware fines of up to $5,000 per day may be
assessed for any violations of your permit conditions starting from the permit approval date.
If you have any questions, please call Denise Mills of the Commission staff at 587-0251.
c:
Ken Simon
USGS
Kauai Department of Water
C)IMP INSTALLATION PERMIT
Well NSLFH3, Well No. 3306-25
0
/
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 Well NSLF-13 (Well No. 3306-25) at TMK (1) 6-6-028:013, 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-I68-I5, 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.
4.
The pump installation permit shall be for installation of a 10-gpm-rated capacity pump or a lower capacity pump in the well. This
permanent capacity may be reduced in the event that the pump test data does not support the capacity.
5.
A water-level measurement access shall be permanently installed, in a manner acceptable to the Chairperson, to accurately record water
levels.
6.
The permittee shall install an approved meter or other appropriate means for measuring and reporting withdrawals and appropriate
devices or means for measuring chlorides and temperature at the well head.
7.
Well Completion Report Part II shall be submitted to the Chairperson within sixty (60) days after completion of work. This form
can be obtained by contacting staff or on the internet at $Vw.hawaii.gov/dlnr/cwrm/resources permits.htm.
8.
The permittee, well operator, and/or well owner shall
may be grounds for revocation of this permit.
c~mply
with all applicable laws, rules, and ordinances, and non-compliance
.
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.
to.
The work proposed in the pump installation permit apI/Ii cation shall be completed within two (2) years from the date of permit
approval, unless otherwise specified. The permit may ,e extended by the Chairperson upon a showing of good cause and goodfaith performance. A request to extend the permit shall ~e submitted to the Chairperson no later than the date the permit expires.
11.
The permittee, its successors, and assigns shall indemnitY, 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.
i
Date of Approval:
Expiration Date:
January 5, 2009
January 5, 2011
I
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 fr(lm the permit date of approval.
C-S7, C-57a, or A License #:
Installer's Signature:
Printed Name:
Tracie Sober
Firm or Title:
24947
--------
Please sign both copies ofthis permit, return one to the Chairperson, and retain the other for your records.
Attachments
Date:
Professional and Vocational Licensing (PVL) - powered by eHawaii.gov
o
0
Page 1 of 1
Professional and Vocational Licensing (PVL) Search - General Licensee
GENERAL LICENSEE
LIC ID: CT-24947
Active/Inactive: ACTIVE
NAME: VALLEY WELL DRILLING LLC
TRADE NAME:
STATUS: CURRENT, VALID & IN GOOD STANDING
ENTITY: ORGANIZATION (LIMITED LIABILITY COMPANY)
BUSINESS CODE:
ORIG LIC DATE: 02/12/2004
EXPIRE DATE: 09/30/2010
CLASS PREFIX: C
SPECIAL PRIVILEGE:
RESTRICTION:
EDUCATION CODE:
CONDITIONS AND LIMITATIONS:
BUSINESS ADDR: 91-458 KOMOHANA ST KAPOLEI HI 96707
MAILING ADDR:
Click here to enter search criteria for prior complaints history ->
For prior complaints and disciplinary history, contact licensing and business information center at (808)
587-3295.
License information on this site reflects information in the Professional and Vocational Licensing Division as of January 5, 2009; however, applicatio
and forms are subject to standard processing time, and the information here does not reflect pending changes which are being reviewed. The Site
updated daily, Monday through Friday, except holidays.
The State of Hawaii makes no guarantees as to the accuracy of the information accessed, the timeliness of the delivery of transactions, delivery
the correct party, preservation of the privacy and security of users and makes no warranties, including warranty of merchantability and fitness fOI
particular purpose. User is advised that if the information obtained herein is to be reasonably relied upon, user should confirm the accuracy of su
information with the provider thereof.
http://pvl.ehawaii.gov/pvlsearch/app?_a=d&_f=n&lictp=CT&licno=24947&off=&nm=VA...1/5/2009
o
o
LINDA LINGLE
RECEIVED
LAND DIVISION
GOVERNOR OF HAWAII
, • • 2S P 2:
LAURA H. THIELEN
CHAIRPERSON
MEREDITH J. CHING
JAMES A. FRAZIER
NEAL S. FUJIWARA
ObLAWRENCE H. MilKE, M.D., J.D.
STATE OF HAWAII
DEPUTY DIRECTOR
DEPARTMENT OF LAND AND NATURAL R~~~l're!L:"- ~!~ ~ir)
COMMISSION ON rwAT;~ B~;!?URCE
~ONOLULU,HAWAII 96809
&
~E.~[,S00RCES
STAT~ :.'r rlM'/AIi
November 25,2008
TO:
Morris Atta, Administrator
Land Division
FROM:
Ken C. Kawahara, P .E., Deputy Director
SUBJECT:
Transmitted for your review and comment is a copy of the captioned Well ConstructionlPump
We would appreciate your comments qn the captioned application with regard to the programs,
plans, and objectives specific to your division. I flease respond by returning this cover memo form by
December 26, 2008. If we do not receive comltiients 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 informadon, or request additional review time, please contact
Denise Mills of the Commission staff at 587-0251.
DM:ss
Attachment(s)
RESPONSE:
[ ]
A water lease/pennit is required of this applicant and an application for such will be requested by our
division.
fOJ
A water lease/pennit is not 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 ar€!:~hed.
[ ]
No objections
lot
Other comments:
:::v
c:::J
c::D
"-'~~
~-
-"'''
~~ ~
.
Original source of private title is Grant ~~ lSSlJai
Pq.'W"
to statehood.
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Contact Person: _ _.>.!G...
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______' _.__
Signed: _ _ _
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Date :--t.tD-kt..",C---,-1-eS---,-,20..1\,ICI'oJ1J-
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.
~1:04
DEC-17-j008
From:DOWSl=1FE,..i~!QTER BRANH 8085854351
TO:~587 0219
-
~#
RECEIVED
......--. .• ~;AFE DRINKiNG WATER BRANCH
NOY 28 2008
LINDA LINGLe
eo'JEft:~
¢I ,"",WAtt
MIiRIiDITH J. CHING
c.-t
JAM!;S A. FRAZIEP.
I'-JU-
N<:/U.S. FI.iJlWARA
CHlYOME L FUKlNO, I,I.D.
OONNA FAY K. I(IYOMIg, P E
LAWREIIICE J.i. wIIC:E. M.D., J.O
KENC. KAWAHAAA. PE.
STATE OF HAWAII
OrPWTYbIII:eC"I'I:Ilt
OEPARTMI:NT OF LANO A"IO NAtuRAL RESOURCES
COMMISSION ON WATER RESOURCE MANAGEMENl
po. BOXa.1
Q
HONOLULu, HAW/l..11 \lSW9
='CO
(above)~)UIC
Department of Health
Attention: Director's Office
Tomas See, Chief, Wastewater Branch
$tuart Yamada., Chief, Safe Drinking Water Branch
Alec Wong, Chief, Clean Water Branch
grd. elev.
14D
·
well d1a. =:;>r"
well depth = /10
H. Thielen, Chairperson
1-~ura
SUBJECT:
I
Honorable Chiyome L. Fukino, M.D., Director
..:i
Dr. Keith Kawaoka, Office of Hazard V1lluation and \ PfC..' I. K'.{ ~
FROM:
>30 b . 2 .'5"'
use = l) or'vl,t r; rIc.
location ;; tJ~/,.1o-~
November 25, 2008
TO:
In General:
tl
014,1--/<.,,\
line
J
I
tAL u:~i' tJf.( l
~
Wel1 Construction/Pump Installation permit App ication
NSLF-13 Well (Well No. 3306·25)
Transmitted for your review and comment is a copy of the captioned Well ConstructionIPump
Installatjon pennit application.
We would appreciate your comments on the captioned application for any conflicts or
inconsistencies with the programs, plans, and obj~tives specific to your department. Please respond by
r~turning thi5 cover memo form by D~rnber 26, 2008. lfwe do not receive comments or a request
for additional review time by this date, we will assume; that you have no comments.
Please find the attached maps to locate the proposed welL If you have any questions about this
permit app'Hcation, request additional infonnation, or request additional review time, please co.,tact
Denise MIlls of the Commission staff at 587-0251.
DM:ss
Attachment( s)
RESPONSE;
[I
n ..~ "ell q~ilifiC5 as II ,Oum! which will ~"'IIS ~ SQurQ' of potab~ watH t6 • pubhe v.'iIOT systom (.Mined .. ,..",illl! 25 or mcrQ peeple ~, 1.01" 00 da~. per
ye.. 0, h... 15 o;>r "",,".CI'\'iu COMCClioas) ;mel m"" ,.""ive Di<e<>lor of Ho"'th "ppwvOlI prigf 1<) ita usc 10 comply wi1b Hawaii Admilllllra!iYI: Rill •• (HAR),
I,I" 11. CJo~I>\": ~O. Rulos Relating UI PotUl. W;ttcr $ys'cros. §' 1·20-29
Tit'S well d:,es 1\01 qlQlify as a SOOl'ce ~""I!S .. Jl"bllo wow. 'Y"tem (~••v.. lc., tl.aro 25 people Of InCI,. peOple at I_I 00 day.lIOl year or I ~ sorvi"
CO_ClIOII$) an".f the well WaICr IS U$ed ("r d.tWOIlS. the pt"iv.~ Q\'IIIeJ' mould,"". fOr b~crtologi,a1 ODd ....."',001 preseuo:e beforo iniliolohng
u•• and
r<luti""ly moq!Cor tile WII" quality tMroa(\er }f(l'We_. if f\ltllr~ P\Wmed WIt ftoollllh~ SO\INC in~ca8C1 1<> _!he pobli" w~t.r system doll1li"oll. rIlen
.".:11
Dired". vf H".lth "l'provai
1£ required
prior '" im,l'mcn'"tioo.
If Ille woll ,s used to .apply 00tII potable ~nd lIOu"J'l'iable l'uxpose) m 8 single !.)'!I1eM. lhe USCf shall dimiJlAlr (;IQ"S·OQI\I)eC!(jO"$ and bacldIow conncc.lio~ b:.I'hY&lClllly 'Il£'=M 8 pebble and non'JKluililc syslc>;m 'try' 0Ql ~ir gap or an apJIro"lC(\ bacldlow prevtlllcr, and by c~Jy labeling all Dl;NlilQlab]e spi~on IIIIIh
wamilll! Sli!IIS ICl ptcvc:nt lnadVl:rtoot coI'I\umpbon of Qoo-poblbJe w~ter. BackOow pr_lion <kMs iibOllld be rwti""ly lml'ecled and t~d.
I J It doo; not "PP"iII' IballlIi. well wiD b. ",cd for ."",umpl:ive PUIl'05eB !DId is 00' ",bjeollo s..1; Drinl;ing \Valet It.el!U~tio.,.
(l
I 1 Far t~ ~ppljoe,,!', )'If<XlMlioll, a SOuroe of pc<o,iblo w~~wal=l WlltSllllnationl I i, I I ~ not I. <)!lIed near tile propos:ed well silc (info""ati"~ ~Ju:d)
I
I
I I
A.n NPOJ:S p.".nllt i. reqUired.
Other {e}evallt DOH rules/regulation!, infomution. qr f"Ommcmclt.ti.:>lI5 are alb.","".
I I
In the event tb,t the Iooation of the well dIoftee. bill i. ,luI within the p...,.,1 dC5Gfibed on thl, applicat.OIl, Ollt ~~&I0D 'Ollsidllt~ the "II=nts. \0 stlll be
'ppIoGllb\e, ~d we do not need 10 review the Il¢w Ibo;¢jO;>D
[J
No oQlOJIJ.enUiobjeQ('""s
Phone:
--------
Date:
DEC-17-2008 11:32AM
FAX: 8085864351
ID:DLNR CWRM
PAGE:004
R=94%
DEC-\7't008~1'05 F'Om'DoH'seF~TER BRANH 8~54351
To:~,587
0219
"",~
I
I
Well
Well No. 3306-25)
CWRM Application Source:
Safe Drinkin
Se~
att~ched
Section
Water Branch En
s
private water
Under round In'ection Control
informati~n
sheet.
UIe)
In general, a shallow wel
quickly from local ~ainfa
potable water source beca
of having unsatisfactory
consumed may compromise h
influence a well's ground
disposal systems (cesspoo
wells), lawnigarden/cropproximity to the ocean wh
occur.
, or a well that recha~ge5
1, should not be used as a
5e such a well increases the risk
roundwate~ quality that when
altho Factors that directly
ater quality include wastewater
s, septic systems, drainage
rowing activities, and even the
re salt water intrusio~ may
Well water qua:ity shaul be initially and periodlca~ly
tested for it's acceptable and intended use, especially if
for human consumption.
ater quality should not be
presumed acceptable and nchanging. Land-based activities
around the well and wit~in the well's recha~ge a~ea may,
over ~ime, have an unacc ptable effect on the wel:'s water
qua~~~y_
Well construct'o~ materials and related equipment
could also affect water uality.
Questions about Ule may
4258.
to Chauncey Hew at 586-
Additional Comments (identif
from which SDWB Section) :
In the proposed Well Section
box of the mate~ial used for
age, please check the appropriate
CWRM well Application Standard
Verso 5/1/07
DEC-17-2008 11:32AM
FAX: 8085864351
ock or gravel packing-
omments
(SDWB)
ID:DLNR CWRM
PAGE:005
R=94%
To:~587
0219
"")
WARNING!
As the owner of a privatdly-owned well, you should NOT assume that
water from your well is safe for consumption, It is your responsibility to make sure that your well
water is safe to drink. The only way to do this is to have your well regularly tested for
bacteriological and chemical contaminants.
There ~Ire no regulations controlling water quality in private wells serving individual residences
as there are for public water systems (public or privately owned utilities supplying water to 25 or
mOrep~qp.IE;!9r'1-5\ service.C()nne~ns). In other ,!"ords, ~here are no en~r¢eable Ii~its for
contaminants B~d ~o req~lrer:nents for re~ular testing. Pfl~~t~ ~ells are ~ften. found I~_ r.~:~1
area~, where m~n~i ae iVi~IEiS syc "as ()~'s\te wast~W/$terj~ISpo~~I"c~n cC!nta~~~ate/"tl'le~~O~Il~
W ten'I"
"
/ !"
f
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\
NVIRONMENTAL
\
,
PA recommend
\
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!
/
/
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\
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I
\
\ \
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.. _. .-_.I'
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\
ROTECTIO AGENCY EPA RECO MEN DAT-I
. , ' . , " ,'. J
I
,
\
\
th~.t priv8 e
el.1
I
I
"
I
\
\
OW~~fs/~st th~ ~ell.w~~r ~aCh\¥e~r-~or\~bn" .,,"<,:/
co t minants as Total Coliform a ena, Nitrlates, as well"asany other contamlnants"that·may
be of concern in your area. More frequent testing may be appropriate if you suspect a problem.
EPA also suggests that you consider testing for pesticides, organic chemicals, and heavy
metals before using it for the first time. Please refer to the EPA website on Private Drinking
Water Wells at http://www.epa.gov/safewater/privatewellsjfaq.html
\
\.
/
OTHER ~O~AMINA~T~
\
\
i 'j
I
/
I
testin~ cary:b~' ~~~ expJ~si~e. )ri~'-imPQ,rta~t tfuaf Y9u.!sp~n~~~me.tO'i~enTi wh~Lp.th~r
Water
.
potential C,ontam!n~nts t;n~ b~
contedi. Ple~e' refeq to: the ~Pf\ websl~ ()n rlv~(e On nklng
Water Wens ~t htt :/fwww.e,ov/safewaterltlvaeWells/what,oucandO:i1tmlll'
for more h6lP~!Jr i~formatrpn~ ;B~ awafi" Of.w~cff~n how Y9u u.~,e .nd dispo~_~ of tlolllsehoid and
of
garden cher'nlc:.als. Also d.et~rrfllne tti~ h~Catloty6f earbly septlo,ta'r\kS or qSS$pOOls,\and
agricultural Or industrial aCUviues in the, area;'-"General ir\:Jormi;ltioh,oiTkn6w;ichemicial
contamination of ground water in HawaTfCafi"~ilso
fou~da{ the 60Plwebsite . .
be
www.hawaii.gov/health/environmentallwater/sdwb/conmaps/OOf/conmaps05.pdf
LABORATORIES
local comme'iClallaboratot-ies can tiEffbund in the yellow p~'gr:'son e telephone book under
"laboratories.IAnalytiq'all\ Xfyhenev¢r possible, utilize a labor tory t at is certified or approved
for the specifi~ \c!rinKi1g w~t~ tests/ a~d caref.ully-fellQ~ their i Istructi ns f9r.>eollecting, storing,
and transporting the .sa/nples\ Just ge su~(tO"ask"~he-.lab to ~se EP a~p~oved':T~hod8 for
drinking wate~ aMlyti~'. A list\of Ilibf. cerpfitd or a~Ero'yed byl theD part~eQt~f Health can be
. found at www.naall.·ov/hlt/~m1lronentalfwater/sdwsdwb/dlTes.tan%20Lbs.df.As
lab certification s tUf changrS\T.0~stantl¥. ~nfirm the.l\ s tus w~e Y0!J..GontatH,he\lab.
Please note tha\the;list is
co tarinint,
lim\ted/~o currE!~~I~.r'~~Lll~~?'
in'~.Ubl.i_C ~~t~,~systems,
RESULTS
Once the lab provides you with the test results, you will be in a better position to determine if
your well water is safe to drink or what contaminant you need to treat for. Generally, you should
compare the results with Federal (www.ep$l.gov/safewater/mcl.html) and State
(www,hawaii.gov/health/environmental/waterlsdwb/sdwb/pdffState%20MCL.pdf) drinking water
standards. Where your test results are greater than the State or Federal maximum contaminant
levels. your well water should be considered as unsafe for consumption.
DEC-17-2008 11:32RM
FRX:8085864351
ID:DLNR CWRM
PRGE:006
R::::94 %
c
LAURA H. THIELEN
CHAIRPERSON
MEREDITH J. CHING
JAMES A. FRAZIER
NEAL S. FUJIWARA
CHIYOME L. FUKINO, M.D. '.
DONNA FAY K KIYOSAKI,.P.E:.- .'
LAWJilfE H. MIIKCfJI·D., J.[)..
K.DEP~.C""
KA·:a.A:, PE.
~
~~
c::::
(11;
STATE OF HAWAII
N
P.O. BOX 621
CO
:E~
~Z
~
~
November 25, 2008
....
::XJo
tlJ-t\
';G~
""
Z,..
''''"'
orN
:x:~
en
:I:
:iomas See, Chief, Wastewater Branch
Stuart Yamada, Chief, Safe Drinking Water Branch
Alec Wong, Chief, Clean Water Branch
Dr. Keith Kawaoka, Office of Hazard valuation and Emergency Response
cg
TO:
FROM:
~
1-f.,;1;,aura
SUBJECT:
Well ConstructionlPump Installation Permit App ication
NSLF-13 Well (Well No. 3306-25)
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 December 26, 2008. Ifwe do not receive comments or aeguest
for additional review time by this date, we will assume that you have no comments. ::;2 0
co
~"'i
c=-
Please find the attached maps to locate the proposed well. If you have any qu.;§@ns abdUl this ::0
permit application, request additional information, or request additional review time, p~.e~ contha
.."
.~ 0
~J
-z , n
.: .~
,
DM:ss
.:.z
'lJ
<::
Attachment(s)
,) 'f'
c..)
11
-~ ~>
;:"'- -~
,n(-_
::- -.
RESPONSE:
[I
,'-,
-'
I":t
This well qualifies as a soW'ce which will serve as a soW'ce of potable water to a public water system (defined as serving 25 or mO'i'e ;~~ple at le~ days per
year or bas IS or more service connections) and must receive Director ofHealtb approval prior to its use to comply witb Hawaii Administrative Rules (HAR),
Title II, Chapter 20, Rules Relating to Potable Water Systems, §11-20-29.
[I
This well does not qualify as a source serving a public water systelJl (serves less !ban 25 people or more people at least 60 days per year or IS service
connections) and iftbe well water is used for drinking, the private owner should test for bacteriological and chemical presence before initiating such use and
routinely monitor tbe water quality tbereafter. However, if fume planned use from this source increases to meet the public water system definition, tben
Director of Healtb approval is required prior to implementation.
[I
If tbe well is used to supply botb potable and non-potable purpose~ in a single system, the user shall eliminate cross-connections and backflow connections by
physically separating potable and non-potable systems by an air g~ or an approved backflow preventer, and by clearly labeling all non-potable spigots witb
warning signs to prevent inadvertent consumption of non-potable water. Backflow prevention devices should be routinely inspected and tested.
[I
It does not appear that this well will be used for consumptive purposes and is not subject to Safe Drinking Water Regnlations.
[1
[1
[1
For the applicant's information, a soW'ce of possible wastewater contamination [
I is [
) is not located near tbe proposed well site (information attached).
An NPDES permit is required.
Otber relevant DOH rules/regulations, information, or recommendations are attached.
[ 1 In tbe event that tbe location of tbe well changes but is still within tbe parcel described on this application, oW' division considers tbe comments to still be
applicable, and we do not need to review tbe new location.
No comments/objections
Contact Person: ~_--::-__J_O~h~n-,n_y_O_n_g_,-=-E_n_g_._o_n_O_a_h-;;:u__
Signed:
oe;:) ~ F-MIt1" ~ tJalJu
586-4294
Date:
I).-ol-of}
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e
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From-DEPT OF
Dec-02-2008 03:02pm
o
8085864352
HEAL~VIRON~NTAL ~
T-872
P.004/004
F-714
?~
\.Z/"VaE:?
L.I\LlRA H. 'l'HI£LeN
UNDALINGLE
00.£_ Of !tAw""
Ct1AI~PEAlIOfl
MfREDITHJ. CHING
JJ.~S A FRAZIER
NEAL. S. FUJIwARA
CHIYOME L. FUKINO. M.D.
DONNA FAY K. IOYOSAKI. PE
LAWRENCE H. MilKE. M.D .• J.D.
!tEN C. KAwAliAAA. P.e.
~EpmIl<llEl'T\O«
PEPARTMENT
COMMISSION ON
r \ :~:II'~~
lA' i '-~::l
L4J\{
. .. ~\.: ..N\J~
'-.:L)
Honorable Chiyome L. Fukino,
TO:
1
11';t~~·?"",
~
_ ';:;
nt,
Tomas See,
uart Yamada,
Wong, Chief,
lDr.leeKeith
Kawaoka,
H. Thielen, Chairpetson
1-~ura
Commission on Water Resource lManagement
FROM:
SUBJECT:
Well
comme"(lt is a copy of the captioned Well Construction.iPurnp
captioned application for any conflicts or
'""".erne to your deparunent. l'lease respond by
Ifwe do not receive conunents or a request
you have no comments.
nhiprtivpc:
Please ftnd the attached maps to locate
permit application, request additional informati
Denise Mills of the Commission staff at
proposed well. If you have any questions about this
additional review time, please contact
Or request
DM:ss
RESPONSE:
I 1 Tllis well qualifies ~s ~ 5QlIlCe ",hich willlK:l'VC &S a !i<Xmc
y~or or baa IS or mot.. ~rv''''' co'....cd"na) 8IId I1II>st ~oeiv.
Title 11. ClIIlp~rlO, RIIi.~ bluing t() POtable Water Sl'1i"m~,
!1
w""'" \0. P'lblie ,.~t.,.. ~y$t_ (deiiood as sttvil'l& 25 ot .1Iore people at least 60 ~s per
of H."llb opptilVi.1 piior t~ ita we to comply willi Hawaii Adminiauative Rilles (HARl.
§l
This well docs no. qlliOlify as a 9.0utCC sctVing a publio WII~r 5YsII!m
connections) ~1Ki iflh~ well waler is used fer drinkin~ 11K> l"iv~
(olltinely monitor \hi! wauot quality thereafter. How~_, if N4Ir.
Din:l:tor oiRe.Ii.n opprov"I;1 ~d prior to ilnplcJ1IOlllarir;>ll.
11
lftlw: well i& UKe! to
[)
It OclCIIl9';qIpIIl!I" thli! This well will 11= us~d for QO~'III1ptiv.
rI
For tho ..
l)
An Nl'IlES permit 1$ roq ..itl5d.
rl
()
l I
~llPply IIolI\ pmable and aon-potable P~"~
l'~ic'l1y ""porating potable 811<1 non.p<mble 'y,"""", by m;Dr I
III/ltlIing signs to p~\'''1II in~dv.t!1lIlt tONlllmption of lIOlI-potilble
l"li>!han 25 p~ople or mor" ptOplc at least 6(} ~8 per ycaror IS sclVioe
>uld tOil fOi bac~iological and cllemioal presence befotc initi~mg 5U"h \!lie ;m<I
u•• from thi" lKIWce incrcaaca 10 mc;!; the public _or 5)·ston. definiliOll. In""
a <mal. 'y>JmA, th~ uoet shall eliminate croas-conDccriona MId baokflow IlOnno"tioll$ by
an apptovt<! bacIcflow P"'vt>IIICT.11Il4 l>y .~Iy 1abcli"g illl IlDG-pat:obl. 'pill'"" with
B~ck£iow pn.""'IllOJI dl!viCCQ sIIo~ld be rouriDely inspcc:led and I~Sled.
8Ild is nOt sul\jca to Safe Dri'lking WRt.r~gul"iaNO,
ppllc~..r8 iruormalim. ;ll'Oll1". ofp""..bI.. waBtewattt COn~rr.inaIiOII I 1is I I iI' 11611000~.ad MOlr)luo prcpooad woll .iIe (informMiDn ilUd.l5d)
Olher TclevlIm POri 1'IIi~l¥cgulatioru;. mform~Ij(>II, QI" r.c~iotl. !Itt laa"'lcd.
In till: II'VCnllllllt m.. ~8.'IiOilofthcweU chlll\£CI bill i. ~lill within~. pmOOI described on thisappliuooon. ollrdlYlsion oo&iOm thc Ql;lmm4n~ lo.ilill b.
applic~blc>, 111111 "'e Qo ,,01 tlCcd 10 r~vicw tho new lo;>;!lj'n',
N'o OQ11\m.flls/~bJt!CtiOJIII
Contact Person: .
v
u~
'-"" ~.., I
Signed:
DEC-02-2008 02:48PM
FAX: 8085864352
26 <0 -.:t 3 \) 9
Date:
t 1-. z... Oe,
Phone:
ID:DLNR CWRM
PAGE:004
O~fLt!x.\
R=96%
D.c-O~008'-D3:0Zpm
•
From-DEPT OF
HE~ENVIRON~NTAL UNG~
808586435Z
~
T-87Z
P.001/004
F-714
FAX TRANSMITTAL
State of Hawaii Department of Health
Environmental Management Division
Clean Water Br8nch .. Engineering Section
Phone No.: (808) 586-4309
Fax No.: (808) 586-4352
Mr. Ryan Imata J Mr. Charley Ice Gis. Denise
Company: ComJllission On Water Resource Management
Fax No.: 587-0219
Fax to:
SUbject:
MIDb
Date: l z... '2.. 00
Fax from: Joanna L. Seto
Total Pages. incl. cover:
it
tl-
Well CODstruetioJl/Punap Installation Permit Appli~ation(s)
Wen No(s). O(o.'t.O--O\ . 130(0 - z5
r
The Department ofHealth~ Clean Water Branch (eWB) 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 Adrninistra~ive Rules (HAR), Title II, Chapter 55,
Appendix. I, effective October 42, 2007. Treated process wastewater effluent covered by
this general penn it includes well. drilling slurries, lubricating fluids wastewater, and well
putgewastewater. This general permit does not cover well pump testing. The applicable
Notice of Intent (NOl) Fonns anQ filing fee shall be submitted at least 30 calendar days
before the start of discharge to the:
Clean Water B:ran~.h
919 Ala Moana Boulevard, Room 301
Honolulu, Hawaii 96814-4920
The CWB-NOI Forms are available online at
hnp:J!www.nawaii.go\llhealthlenvironmentallwater/cleanwater/formsIgenJ,.index.html.
Inquiries maybe directed to the CWB at (808)586-4309 or by fax (808}586-4352~
2.
FarWell Pump Testing
1
The discharger shall take all measures *ecess~ry to prevent the discharge of pollutants from
entering Sta,tewal:ers. Such measUresshall~ude,jfnecessaiy~ conuHIlinent 6finitial
discharge until the disch~ge isessentmllYf~~ofi>ollutants. lfthedischargeis entering a
stream or riverbed, best m~gement practices>sh~U be implemented to prevent the
discharge from disturbing the clarity ofth~~~.ei"illgwa.ter. If the disc~ge is entering a
stOnn drain, the discharger must obtain wriUenp¢rroission from the owner ofthe storm
drain prior to discharge. Furthermore,besfll1~gement practices shall be implemented to
prcventthe discharge from collecting Sediments and other pOlh)ta.Ilts prior to entering the
storm drain.
DEC-02-2008 02:47PM
FAX: 8085864352
- - - - -_ _ _ _
ID:DLNR CWRM
,_'1I!l_I'l',,_"'~,~i!IiIMI'_.
PAGE: 001
R=96%
_ _ _ _ _ _ _ _ _ _ _ _ _' ' ' !ij'__
Uil~~~-'#t;'"'
• O.c-02~008'~3:02pm
From-OEPT OF HEA~NVIRONMENTAL ~GMT
8085864352
Mr. Ryan Imata I Mr. Charley Ice / Ms. Denise Mills
Commission On Water Resource Management
3.
~
T-872
P.QOZ/004
F-714
FAX TRANSMITTAL
Page 2
For Construction Activities Disturbing One (l) or More Acres of Total Land Area
By HAR7 Title 11. Chapter 55, Appendix C, effective October 22.2007, an NPDES pennit
or Notice of General Permit Coverage is required before the start of the construction
activities that result in the disturbance of one (1) or more acres of total land area. including
clearing, grading. and excavation. The total land area includes a contiguous area where
mu1tiple separate and distinct construction activities may be taking place at different times
on different schedules under a larger common plan of development or sale. An NOI (see
Comment No. I, abo~e) shall be submitted 30 calendar days before to the start of
construction acti \lities.
DEC-02-2008 02:47PM
FAX: 8085864352
ID:DLNR CWRM
PAGE:002
R=96%
COM.SION ON WATER RESOURCE MANAGEMENT
ROUTE SLIP FOR NEW APPLICATIONS
FROM:
DENISE
-----------------
17-NOy-08
DATE:
SUSPENSE DATE:
0
24-Nov-08
PLEASE:
CHING, F.
--FUJII,N.
GOODING, K.
-1-HARDY, R.
HIGA,D.
-2-HOAGBIN, S.
ICE,C.
IMATA, R.
-3-KAWAHARA,K.==
WELL NUMBER
KUNIMURA, I.
-S-MiIIs,D.
.1
NAKAMA, L.
~/
- 4 - OHYE, M.
I
SAKODA, E.
SWANSON, S.
UYENO, D.
YODA,K.
YOSHINAGA, M . -
3 ~ o~ - z5
WELL NAME
~ WELL CONSTRUCTION
Approval
~Signature
--;r-Information
NSLF 13
~PUMP INSTALLATION
See Me
- 1 - Review & Comment
--Take Action
--Type Draft acknow letter
-2-Type Final, label file folder, update People. db
-S-File
--Xerox
_ _ copies
WUP Number
D
NA • Individual DOM
WUPA
ATTACHMENTS FOR APPLICATION PROCESSING - Both applicant & staff generated
1 TRANS. LETTER
2
PERMIT PROCESS TABLE
3
4
5
6
7
8
9
CWRMMAP
APPL. FORM (11 COPIES)
USGS MAPS (11 COPIES)
TAX MAPS (11 COPIES)
PARCEL OWNER VERIF.
CONTRACTOR VERIF.
ALL INFO FILLED IN
10 BACKGROUND CHECK
11 $25 FEE DEPOSIT SLIP
12
MLS PRINTOUT
DCCA LICENSE SCREEN PRINTOUT
(SMA map printout http://gis.hicentral.comlwebsite/parcelzoninglviewer.htm.,or INGRID'S SMA/CD MAP)
(LUC map printout http://luc.state.hLus/luc_maps.htm., or INGRID'S SMA/CD MAP)
DHP/CDUP/SMA pre·screen
FOLDER:
o
D
MADE NEW FILE FOLDER, ATTACHED
FILE FOLDER ALREADY MADE, IN FILE CABINET
INCOMPLETE ACTION DATES:
DATE
"/It/JY
ACTION
,
t>lOf;>..
k
'~W-~- ~"'CUrl~ ~ ~"'-'
o
o
LINDA LINGLE
LAURA H. THIELEN
GOVERNOR OF HAWAII
CHAIRPERSON
MEREDITH J. CHING
JAMES A. FRAZIER
NEAL S. FUJIWARA
STATE OF HAWAII
DEPUTY DIRECTOR
P.O. BOX 621
November 25, 2008
3306-25 wcpia.ack
Ms. Tracie Sober
Kapolei, HI 96707
Dear Ms. Sober:
Well ConstructionlPump Installation Permit Application for Well No. 3306-25
We acknowledge receipt, on November 14,2008, of your completed Well
ConstructionlPump Installation permit application and filing fee for the NSLF-13 Well (Well No.
3306-25). You can expect your application to be processed within ninety (90) days from this date.
For your information, the attached ta~le describes the process, responsible parties, and
deadline requirements for drilling or modifyipg a well and installing, modifying, or replacing a
pump.
By this acceptance letter, we are also notifying the well operator and landowner that water
may not be pumped for purposes other than testing until the Commission has issued a certificate of
pump installation completion letter to the well operator and landowner. Additionally, please be
aware that the Commission may require the pump capacity to be reduced if the results of a pumping
test do not support the requested 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 the local area. If the Commission requires a smaller pump capacity
for this well, you may need to remove the installed pump and install a smaller pump before you can
withdraw water for reasonable and beneficial use.
If you have any questions about your permit application, please contact Denise Mills of the
Commission staff at 587-0251.
Sincerely,
DEM:ss
Attachment
c: Ken Simon, Menehune Water Company
/
o
o
LINDA LINGLE
LAURA H. THIELEN
GOVERNOR OF HAWAII
CHAIRPERSON
MEREDITH J. CHING
JAMES A. FRAZIER
NEAL S. FUJIWARA
DEPUTY DIRECTOR
DEPARTMENT
AND NATURAL RESOURCES
COMMISSION ON
TER RESOURCE MANAGEMENT
Tomas See, Chief, Wastewater Branch
Stuart Yamada, Chlef, Safe Drinking Water Branch
Alec Wong, Chief,iClean Water Branch
Dr. Keith Kawao ,Office of Hazard valuation and Emergency Response
TO:
(l~
1-~aura
Commission on Water Resour
FROM:
SUBJECT:
Well ConstructionlPump Instal ation Permit App ication
NSLF-13 Well Well No. 3306 25
Transmitted for your review and com ent is a copy of the captioned Well Construction/Pump
We would appreciate your comments
the captioned application for any conflicts or
inconsistencies with the programs, plans, and 0 ~ectives specific to your department. Please respond by
returnin this cover memo form b Decemb r 26 2008. 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 informafon, or request additional review time, please contact
DM:ss
Attachment(s)
RESPONSE:
•
!
[I
This well qualifies as a source which will serve as a source ofpotalj.le water to a public water system (defined as serving 25 or more people at least 60 days per
year or has IS or more service connections) and must receive Direqtor 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.
[I
This well does not qualify as a source serving a public water systel)l (serves less than 25 people or more people at least 60 days per year or IS service
connections) and if the well water is used for drinking, the private ~wner should test for bacteriological and chemical presence before initiating such use and
routinely monitor the water quality thereafter. However, if future ~Ianned use from this source increases to meet the public water system definition, then
Director of Health approval is reqnired prior to implementation. :
[I
If the well is used to supply both potable and non-potable purpose~ in a single system, the user shall eliminate cross-connections and backflow connections by
physically separating potable and non-potable systems by an air
or an approved backflow preventer, and by clearly labeling all non-potable spigots with
warning signs to prevent inadvertent consumption of non-potable tater. Backflow prevention devices should be routinely inspected and tested.
[I
It does not appear that this well will be used for consumptive purp ses and is not subject to Safe Drinking Water Regulations.
[I
[I
For the applicant's information, a source of possible wastewater c
g,
tamination [
I is [ I is not located near the proposed well site (information attached).
An NPDES permit is required.
[I
Other relevant DOH rules/regulations, information, or recommen ations are attached.
[I
In the event that the location of the well changes but is still within the parcel described on this application, our division considers the comments to still be
applicable, and we do not need to review the new location.
[I
No comments/objections
Contact Person:
Signed:
---------------------------+----------------
Phone:
-----------------
Date:
_________I_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _--."'·,,~f1"#"'
'"t
o
o
LAURA H. THIELEN
LINDA LINGLE
GOVERNOR OF HAWAII
CHAIRPERSON
MEREDITH J. CHING
JAMES A. FRAZIER
NEAL S. FUJIWARA
CHIYOME L. FUKlNO, M.D.
DONNA FAY K. KlYOSAKI, P.E.
STATE OF HAWAII
DEPUTY DIRECTOR
P.O. BOX 621
November 25, 2008
TO:
Morris Atta, Administrator
Land Division
FROM:
Ken C. Kawahara, P.E., Deputy Director
SUBJECT:
Transmitted for your review and comment is a copy of the captioned Well Construction/Pump
December 26, 2008. If we do not receive comments or a request for additional review time by this date,
permit application, request additional information, or request additional review time, please contact
DM:ss
Attachment(s)
RESPONSE:
[ ]
A water lease/permit is required of this applicant and an application for such will be requested by our
division.
[ ]
A water lease/permit is not required of this applicant.
[ ]
A water lease/permit has been obtained by the applicant through lease no. _ _ _ _ _ _ _ _ _ ___
[ ]
Other relevant Land Division rules/regulations, information, or recommendations are attached.
[ ]
No objections
[ ]
Other comments:
Contact Person:
------------------~-------------
Signed: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Phone: ----------
Date: -------------
o
o
LINDA LINGLE
LAURA H. THIELEN
GOVERNOR OF HAWAII
CHAIRPERSON
MEREDITH J. CHING
JAMES A. FRAZIER
NEAL S. FUJIWARA
CHIYOME L FUKINO, M.D.
STATE OF HAWAII
OEPUTY DIRECTOR
P.O. BOX 621
November 25, 2008
TO:
Dr. Puaalaokalani Aiu, Administrator
Historic Preservation
FROM:
Ken C. Kawahara, P .E., Deputy Director
SUBJECT:
Well ConstructionlPump Installation Permit Ap lication
NSLF-13 Well (Well No. 3306-25) TMK:(1) 6 -028:013
December 26, 2008. If we do not receive comments or a request for additional review time by this date,
permit application or request additional review time, please contact Denise Mills of the Commission staff
at 587-0251. 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.
DM:ss
Attacbment(s)
RESPONSE:
[ ]
This is a [ ] public (county or state) project [ ] private project and [ ] will [ ] may disturb historic sites.
[ ]
We concur that the work described under this permit will not disturb historic sites.
[ ]
We do not concur that the work described under this permit will not disturb historic sites. We require the following for
our concurrence:
Contact Person: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Phone: - - - - - - -
Signed: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Date:- - - - - - - -
.@ ..
I...."
o
o
LINDA LINGLE
LAURA H. THIELEN
GOVERNOR OF HAWAII
CHAIRPERSON
MEREDITH J. CHING
JAMES A. FRAZIER
NEAL S. FUJIWARA
F
~TATE
DEPARTMENT
COMMISSION ON
OF HAWAII
OEPUTY DIRECTOR
LAND AND NATURAL RESOURCES
ATER RESOURCE MANAGEMENT
P.O. BOX 621
November 25,2008
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 ConstructionlPump Installation Permit Review
Well ConstructionlPump Installation Permit Application
NSLF-13 Well (Well No. 3306-25)
Transmitted for your review and comment is a copy of the captioned Well
ConstructionlPump Installation permit application. If you have any comments on this
application, please submit them by December 26, 2008. If we do not receive comments we
will assume you have no comments.
If you have any questions about this permit application, please contact Denise Mills of
the Commission staff at 587-0251.
Sincerely,
L
L
C
DM:ss
Attachment
-------------------------,
~--, ..
a
Professional and Vocational Liising (PVL) - powered by eHawaii.gO
Page 1 of 1
Professional and Vocational Licensing (PVL) Search - General Licensee
GENERAL LICENSEE
LIC ID: CT-24947
Active/Inactive: ACTIVE
NAME: VALLEY WELL DRILLING LLC
TRADE NAME:
STATUS: CURRENT, VALID & IN GOOD STANDING/MAINT. REQUIREMENT DUE
ENTITY: ORGANIZATION (LIMITED LIABILITY COMPANY)
BUSINESS CODE:
ORIG LIC DATE: 02/12/2004
EXPIRE DATE: 09/30/2010
CLASS PREFIX: C
SPECIAL PRIVILEGE:
RESTRICTION:
EDUCATION CODE:
V
CONDITIONS AND LIMITATIONS:
BUSINESS ADDR: 91-458 KOMOHANA ST KAPOLEI HI 96707
MAILING ADDR:
Click here to enter search criteria for prior complaints history ->
For prior complaints and disciplinary history, contact licensing and business information center at (808)
587-3295.
License information on this site reflects information in the Professional and Vocational Licensing Division as of November 18, 2008; howevi
applications and forms are subject to standard processing time, and the Information here does not reflect pending changes which are being reviewE
The site is updated daily, Monday through Friday, except holidays.
The State of Hawaii makes no guarantees as to the accuracy of the information accessed, the timeliness of the delivery of transactions, delivery
the correct party, preservation of the privacy and security of users and makes no warranties, including warranty of merchantability and fitness fOi
particular purpose. User is advised that if the information obtained herein is to be reasonably relied upon, user should confirm the accuracy of su
information with the provider thereof.
http://pv1.ehawaii.gov/pvlsearchlapp?_a=d&_f=n&lictp=CT&licno=24947&off=&nm=V... 11/18/2008
o
o
Page 1 of 1
Copyright 11/18/2008 by Hawaii Information Service
Assessed Values reflect tax year 2008.
Search criteria: TMK Taxkey 1-6-6-28-13
•
PUBLIC RECOREf'DATA
Taxkey
Subdiv ICondo Tnr Address
Owner I Lessee
/ ' Bds Bths Land area Liv area Last Sale Instr
Price
1-6-6-28-13
F
FARRINGTON MENEHUNE WATER COMPANY 0 0
2.43 ac
0 5/18/2005 QD $495,000
HWY
INC
This Information has been supplied by third parties and has not been independently verified by Hawaii Information Service and
Is therefore not uaranteed.
http://webre1.hawaiiinformation.comIREsearchIBaselLib/ActionMenuPrintModal.htm
11/18/2008
aARTMENT OF LAND AND NATURAL RESoAES
UAC OR ATTACHED WORKSHEET
DOCUMENT NO ...
F YR APP D
SRC/
OBJ
COST
CTR PROJECT
S 09 326 C
1026
0752
PH ACT
AMOUNT
(1)
$25.00
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
TOTAL
REMARKS:
LINE
LINE
LINE
LINE
LINE
LINE
LINE
LINE
LINE
LINE
(1)
(2)
(3
(4)
(5)
(6)
(7)
(8)
(9)
(10)
NSLF 13 Well
$ 25.00
DATE' November 14, 2008
NAME/DESCRIPTION (WANG INPUn
Valley Well Drilling LLC
o
o
/
STATE OF HAWAII
F~~~,~~OnIY:
APPLICATION FOR A WELL CONSTRUCTION.L
PUMP INSTALLATION PERMIT
UH
NOV I ~
A 9:
06
c,
Instructions: Please print in ink or type and send completed application with attachments to the Commissiop,AQ,· 'iC' \i i ~ J .,,, ~ Tt
Water Resource Management, P.O. Box 621, Honolulu, Hawaii 96809. Application must be accompanied bY'I1-~": ' i i , ) ' i ' " " " \ , c,.'\
copies and a non-refundable filing fee of $25.00 payable to the Dept. of land and Natural Resources. RftSf: :·:C~: t.,l U(,,:[}IEr;
Commission may not accept incomplete applications. For assistance, call the Regulation Branch at 587-0225.' J=or
further information and updates to this application form, visit http://www.hawaiLgov/dlnr/cwrm.
r
WELL LOCATION INFORMATION
1, STATE WELL NO. (if already assigned)
3, ISLAND
/2, WELL NAME
33[;1,. ... Zlj
N'Si-f I:)
14.™K
Qq\Wl
-~-~:
sec
The following must be attached before this application is accepted as complete:
• Portion of 7.5-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 infrastruclure
• For dug wells, attach a grading plan with cross section profiles showing existing and finish grades
5, WELL OPERATOR'S NAME/COMPANY
Well Operator's Contact
6. LANDOWNER'S NAME/COMPANY
I
Mi:he hVH)t WqtcY' CO_~'U'1j1
Well Operator's Mailing Address
*1
S'1\'Y1C "I~ ~ V\:\""Im
Si mOl
~r
/ Landowner's Contact
~~101
I
PROPOSED WELL CONSTRUCTION
7. Proposed Work
)&I Construct New Well
o Modify Existing Well
Abandon/Seal Well
8. Construction Type
~ Drilled
DOug
Shaft
Tunnel
o
o
o
.llii
pare
Landowner's Mailing Add~ess
I
qq -rz.05 ijqlq Wet \tt 11 \1
A1",~
\<-Cl\
pial
Landowner's E-mail
PROPOSED PUMP INSTALLATION
10. Proposed Work
Install New Pump
Replace Pump
~
o
11. Proposed Pumping Rate, gpm
(gallons per minute)
ICl
13. Method of flow measurement
Flowmeter
Other (explain)
S
o
12. Proposed Amount of
Withdrawal, gpd (gallons per day)
50G
9. Is this well part of a battery of wells? 0 Yes g No
14. Proposed Surveyor name and license number (a surveyor Is required for all Well Construction Permits and may be required for some Pump
Installation Permits)
PROPOSED USE
o
15. Municipal (water systems serving greater than 25 individuals or 15 service connections)
ill
16. Domestic
l
Number of units to be served:
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 permit:
21. Conservation District Use Permit (COUP)
Well is in Conservation District
Required, COUP #
date approved
Not Required (attach documentation from OCCl)
---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.
Well is not in Conservation District
I)iI I have not checked if well is in or out of Conservation District. I understand that checking if the well is in a Conservation District may expedite my
review. I further understand that issues raised may delay or result in denial of the permit issuance, or revocation of thej>ermit after it is issued.
22, Special Management Area Permit (SMAP)
Required, SMA #
date approved _ _ _.,Not Required (attach documentation from applicable County agency)
1'iiJ I have not checked with the county about whether or not an SMA Permit is required. I understand that checking with the County prior to making this
application may expedite my review. I further understand that issues raised by this agency may delay or result in denial ofthe permit issuance, or
revocation of the permit after it is issued.
23. State Historic Preservation DiviSion (SHPD) of the Department of land and Natural Resources
I have consulted with the HPD regarding potential impacts of well construction activities on historic sites. I have attached applicable documentation
from the HPD.
r:iIl I have not consulted with the HPD regarding potential impacts of well construction activities on historic sites. I understand that checking with the HPD
prior to making this application may expedite my review. I further understand that issues raised by this agency may delay or result in denial of the
permit issuance, or revocation of the permit after it is issued. Additionally, the history of past land use is attached.
Additional remarks, explanations, etc. (attach additional sheet if more space is needed)
o
o
o
o
o
o
o
o
NOTE: Signing below indicates that the signatories understand and SYfear that the information provided is accurate and true to the best of their knowledge.
Further, the signatories understand that upon permit approval: 1) the ptoposed work is to be completed within two (2) years ofthe 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 mayresult in fines of up to $5000/day.
25. PUMP INSTAllER (Must be filled out if application is for Pump Installation)
24. WEll DRillER (Must be filled out if application is for Well Construction)
Valla \'f&\\ »yj Ihnq .t.LC
Licenseefbusiness name
1rd!rrY1
Signature
~
J (
·tft:tClr
Print
lA4tJ-
S?(P/~.
I
saky
Ct. S'
~r,,/I~t·" '1
Licensee business name
C-57 License No.
\\')0 ·01
Signature
Date
r
llA V-t . (C-r:: IV)
._;t ...H::,( k 6tt. NI.-
"'~)J\
f
Ii/IUD /
C-57/C-57a/A License No.
Print
I. ' /
.
Date
WCPI Application Form 02/26/2007
o
o
PROPOSED WELL SECTION (Please attach schematic if different from diagram provided below)
Hole Oiameter: _1;...O__,in.
Elevation at top of casing
J11.. ft., msl*
f4--L-----.j
._
Minimum of 2' Radius & 4" Thick Concrete Pad (to contain benchmark
surveyed to nearest 0.01 ft.)
Ground Elevation:
ft., msl*
140
Please refer to the
Cement Grout: 100ft.
(min. 70% of distance from
ground elevation to top of
water surface or 500 ft.,
whichever is less.)
Grouting method:
P4 Positive
displacement
o
Other
HAWAII WELL CONSTRUCTION AND
PUMP INSTALLATION STANDARDS
to ensure that your as-built is in compliance with
applicable standards.
Annular space between hole
and caSing (1.5" for positive
displacement, 3" for other
methods):
1·6
~~--I
Solid Casing:
(~
90% x (Ground Elev.-Water Level Elev»
Total Length:
\
Nominal Oiameter:
WallThickness:
in.
'lU
ft.
?
0 . 1. fj1
Bottom Elevation:
in.
in.
ft., msl*
-\()
Rock or Gravel Packing:
TotalOepth
IgO
ft.
.,.."....,.:q~~..,...- ft.
p( Perforated
Open Casing:
Material:
o
ft.
Nominal Oiameter: ___6_______ in.
Rounded Gravel
Wall Thickness:
Estimated Water Level
0 .1S~
Bottom Elevation:
Elevation:
12-
Screen
40
Total Length:
o Crushed Basalt
o
"'60
in.
ft., msl*
note: Neither bentonite nor mud should be used in
saturated zone during drilling
ft. msl*
Open Hole:
Length: _ _
--INa...1.l_______ ft.
Oiameter: _ _ _ _ _ _ _ _ _ _ _ _ _ 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 L~el Elevation )
Example: Estimated + 2 ft. Water Level Elev. -
Bottom Elevation of Well Limit
=( 2 _ 41 ~ (2) = -18.5 ft.
Solid Casing Material:
Carbon Steel: compliant with (check one or more): 0 ANSI/A'MNA C200
0 API Spec. 5L
0 ASTM A53
0 ASTM A 139
0 ASTM A242 (or A606)
0 Type E
0 Type S
0 Grade B
0 Other
0 ASTM M09 (production wells)
ASS Plastic conforming to ASTM F480 and ASTM 01527: (check one)
0 Schedule 40
0 Schedule 80
Schedule 40 0 Schedule 80 0 Schedule 120
o Filament Wound Resin Pipe conforming to ASTM 02996
!S
o
o
o
Glass Fiber Reinforced Resin Pressure Pipe conforming to A'MNA C950
PTFE Fluorocarbon Tubing conforming to ASTM 03296
FEP Fluorocarbon Tubing conforming to ASTM 03296
Open Casing Material:
Carbon Steel: compliant with (check one or more): 0 ANSIIA'MNA C200
0 API Spec. 5L
0 ASTM A53
0 ASTM A139
0 ASTM A242 (or A606)
0 Type E
0 Type S
0 Grade B
0 Other
ASS Plastic conforming to ASTM F480 and ASTM 01527: (check one)
0 Schedule 40
0 Schedule 80
Schedule 40 0 Schedule 80 0 Schedule 120
Thermoset PlastiC: (check one)
Centrifugally Cast Resin Pipe conforming to ASTM 02997
]I(
o
o Glass Fiber Reinforced Resin Pressure Pipe conforming to AWNA C950
o
o
PTFE Fluorocarbon Tubing conforming to ASTM 03296
FEP Fluorocarbon Tubing conforming to ASTM 03296
WCPI Application Form 02/26/2007
o
';,."
34
',:
.';~',;~:",,-
.. £.:;;:;~;:;::;~9:~
,I., ....,,;:;.~~
-'. ''':••.•.Ji.
P.:::·-·· -.........>...
~,:,.
/
,
I
:f
i ,.
.
":'"
:.'
33
:
...
,,,
PS?
.t~
(:,
~
/
' ", /' I~'/:J).:. \ ,"
, " If"],,, /
!
/
TMK: 6-6-28: 9
Lot 6
I
TMK: 6-6-28: 12
I
,
I
,,'
Lot 7
TMK: 6-6-28: 14
~
.~
/
,
I

Ms. Tracie Sober NQvember 7,2012 Valley Well Drilling, LLC

Transcription

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