1'. · memo and routjiup (ver.1110107) q 03/22/07 wcr 2 check for well no. 0519-07 (survey to...

MEMO and ROUTJiuP (ver.1110107) Q

03/22/07

WCR 2 Check for Well No. 0519-07 (survey to regulation memo)

1. Pump Tests Check' special condition of PIP? Yes/No) Roy Hardy (initial if yes) Yes No If no. describe deficiency

Step-Drawdown Test:

followed WCPI Stds 0 analysis attached 0 proposed pump cap o.k. 0

Aquifer Pump Test:

followed WCPI Stds T & S analysis attached

Well Interference: estimated Steady-State drawdown at 1-mile radius is ____ ft.

analysis attached

Stream Surface Water Impacted:

o o

o

o

o o o

o o

o

_PumpingStepDrawdown.xls used _ <70 gpm no test required

_AquiferTest used _Cooper-Jacob. xis used _PumpingCooper-JacobRECOVERY.xls used _ <50 gpm no test required

_ Theis.xls used

o .- If yes, identify most probable stream

'i'_j 2. Pump Installation Check Mitch Ohye ~t-! ."'-, __ (initial) 1'. N; If no,. describe deficiency

data complete followed Special Cond & Elev.

well database updated ,~ ~ /

__ w--'--__ (initial) take action based on above analysis

ATTACHMENTS FOR ACCEPTANCE: 1WCR2 ACCEPTANCE LETTER

2PUMP INST. COMPLETION CERTIFICATE I 1" To be sent to driller

J To be sent to landowner/operator

} Staff internal checks

4. ROY~~) check(Entered WCR 21PICC accept date into database) 5. Susan .-to~gbin (initial) finalize & enter on WUR database

/charl~nO~yan File

LINDA LINGLE GOVERNOR OF HAWAII

Ms. Tracie Sober

STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES

COMMISSION ON WATER RESOURCE MANAGEMENT P.O. BOX 621

HONOLULU, HAWAII 96809

March 29,2007

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

Dear Ms. Sober:

Well Completion Report Part II for Well No. 0519-07

PETER T. YOUNG CHAIRPERSON

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

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

STEPHANIE A. WHALEN

0519-07. wcr2

We received your Well Completion Report Part II for the Miller 01 Well (Well No. 0519-07) on March 21,2007 and acknowledge that it is complete.

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

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

Sincerely,

W.ROYHARDY Hydrologic Program Manager

LN:ss

c: Robert J. Miller


Mr. Robert 1. Miller 4362 Kanaele Rd. Kapaa, HI 96746

Dear Mr. Miller:


COMMISSION ON WATER RESOURCE MANAGEMENT P.o. BOX 621


March 29, 2007

Certificate of Pump Installation Completion for Well No. 0519-07




STEPHANIE A. WHALEN

05J9-07.wcc

We are pleased to inform you that the Pump Installation work permitted for the Miller 01 Well (Well No. 0519-07) is complete and acceptable and welcome you as a new member to the community of well owners and groundwater users in Hawaii. This certificate of pump installation completion allows you to commence pumping your well for reasonable & beneficial water use.

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

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

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

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

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

5. Your approved pump has a capacity ofl0 gpm at a head of380 ft. In the future, pump replacements of equal or lesser capacity will not require an additional permit from the Commission, but will require the submission of a Well Completion Report Part II by the licensed pump installer. If the pump replacement is greater than the existing pump, you will need to apply for a new pump installation permit.

Mr. Robert Miller Page 2 March 29,2007

6. The landowner shall cause the well operator to maintain the installed meter or other appropriate means for measuring and reporting withdrawals and water levels, and appropriate devices or means for measuring chlorides and temperature. These data shall be measured monthly and reported to the Commission on a monthly basis, on forms provided by the Chairperson (attached), in accordance with § 13-168-7, HAR.

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

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

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

If you have any questions, please contact Lenore Nakama of the Commission staff at 587-0218 or toll-free at 974-4000 (Hawaii), 274-3141 (Kauai), 984-2400 (Maui), or 1-800-468-4644 (Lanai & Molokai), extension 70218.

LN:ss Encl: Water Use Report Forms

c: Kauai Department of Water Supply Valley Well Drilling, LLC

Sincerely,

wrH W.ROYHARDY Hydrologic Program Manager

" ,

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

WELL COMPLETION REPORT - PART II Pump Installation

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

1. State Well No,: Ot:jIO!- 03 Well Name, --'.M=--,-,\~LL~e~R~O~'--....!....:N!.Y.t.!.L\I___ Island: K,qVfl\ 2. Address: 4')10 1.. j(..ollvlC 10 Rei.. k4 I2"IoI Tax Map Key 4 -id ~O 12 ~ 0 1'7 ___ _ 3, Pump Installation I Company: VALLEY WELL DRILLING, LLC

4. Date Pump Installed:'lJ - I (p - 01-monthldaylyear'~~~~--~-

5. PERMANENT PUMP INFORMATION Pump Type, Make, Serial No.:

Rated Capacity: --:-:---,,--___ ----ti..-\oOl-_____ gpm at head of: ~3~~V'O'-L......------ ft. Motor Type, H.P., Voltage, L, fn rpm: ~\VInq UJ~ MS10~ \'''\-\f ,13DV /0460 ~rM Pump type (check one):

o Deep Well Turbine

~ Submersible

o Centrifugal

6. Method of flow measurement:

o Rotary o Propeller

o Rotary-Displacement o Reciprocating

o Rotary-Gear o Impulse

IlC Flowmeter Manufacturer P-~:t tA SHill Model no. M 50 ~ lAS ~ Size \ /I

o Other, explain and attach schematic

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

8. Attach the rating curve for the installed pump.

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

10, Well Owner

11, Land Owner

12 Remarks

Company ________ Contact Robef..t JMilk~ Address 4~fo l. \(C'l\1Ol file \2.<:\. K4P~'1 I \1\ 4l?'l-41o

Phone l ~O'g) ~ 2, -Z'K \I Fax (~O~) ~7.; -X~ II Company _________ ----,- Contact ROb,c,f..t U. M't\\y~

Address 4~~ 1. \(qnq t,\~ R~· K4 r""l § \-\ I 4(i1-t1rte? Phone e~o'g) ~L? . ~~ 1\ Fax t~O~) ?l? ~ ~~ I'

~~~--

-~~~.---~----.~~~~-~-----~~---~~----

Pump Installation Contractor (print) Tracie Sober C-57/C-57a/A Lic, No. =-24~9:::..4.:..;7~ ____ _

Signature Date 'J .\pt ·O::t

WCR2 Form 3117106 Page 1 of 2

/

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

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

~jfll§I!II§lIIl§1I11

U\ LLt::"tL C> 1

Flevation of top of chase tube I !aD . 2 \ ft. mean sea level

,

,

Pump intake depth = \$1- ft. (referenced to bench mark)

Chase tube depth = 111 ft. (referenced to bench mark)

If airline installed, bottom of airline elevation = N~ ft. mean sea level

WCR2 Form 3/17/06 Page 2 of 2

c Model 165 16 GPM Performance Curves

FLOW RANGE: 10 -20 GPM OUTLET SIZE: 11/4" NPT NOMINAL DIA. 4"

2300 ", ~,~,

2200 ,,;..-.-......:........-............. -........,'-"~_~ ~~5~ l 2100

""~r v A'

'/ P '-~ '" '." "'0"_~~,' ~

r---~--~~--~-T !

2000

1900

1800

1700

1600

1500

1400

1300 i=' UJ 1200 UJ l..i... --- 1100 0 <C UJ 1000 I

900

800

700

600

500

400

300

200

100

0 0 2 4 6 8 10 12 14 16 18 20

CAPACITY (GPM)

SPECIFICATIONS SUBJECT TO CHANGE WITHOUT NOTICE. 4" MOTOR STANDARD, .5-5 HP/3450 RPM.

Performance conforms to ISO 2548 Annex B @ 2 ft. min. submergence.

6" MOTOR STANDARD,7.5-10HP/3450 RPM.

GRUNDFOS,(

MEMO and ROUTE'iLiP (ver. 01/27/06) 0 I WCR 1 Check for Well No. 0519-07 (survey to regulation memo)

1. Pump Tests Check Kevin Gooding )t:lJ (initial) Yes No If no. describe deficiency

Step-Drawdown Test:

followed WCPI Stds 'KI analysis attached 0 proposed pump cap o.k. 0

Aquifer Pump Test:

followed WCPI Stds T & S analysis attached

Well Interference: estimated Steady-State drawdown at 1-mile radius is ____ ft.

analysis attached

o o

o

o o o

o o

o

Stream Surface Water Impacted: o o +- If yes, identify most probable stream

Geology Code for Well Index: b2 ~L

2. Construction Check Mitch Ohye

\ i

\[\J(initial) Yes No If no. describe deficiency

data complete 0 0 followed Special Cond & elevations 0 / 0 well database updated [J/ 0

Latitude

NAD27 I 'j

NAD83 1--1, D5 ('.4

Longitude

, <;;'1 '\ -;;, i. :;

08/10106

3. Charle€:::eno,.yan --"uJ",,--=-__ (i n itia I) take action based on above analysis

ATIACHMENTS FOR PUMP INSTALLATION PERMIT (2x):

1COVER LETTER

2COUNTY COMMENTS (DWS/SMA)

3DOH COMMENTS

4DLNR COMMENTS (LD/OCCUDHP)

I -.l vJIW~ , "-.)Q,,.V'-

'_" _ not necessary - only WCP or BOTH.

} To be sent to driller/pump installer

<------ To Landowner

} Staff internal checks

4. Roy it) (i check (Entered WCR 1IWCCC accept date into database) 5. Susan H gbin (initial) finalize 6. Mitch signature (Entered PIP issue date if required) 7. Charl6([£enO,yan File


Ms. Tracie Sober




October 17,2006


Dear Ms. Sober:

Well Completion Report Part I for Well No. 0519-07



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

STEPHANIE A. WHALEN

DEAN A. NAKANO ACTING DEPUTY DIRECTOR

0519-07.wcrla

We received additional information for your Well Completion Report Part I for the Miller 01 Well (Well No. 0519-07) on October 13,2006 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 specific aspects of well usage and maintenance from you to the well operator/landowner.

If you have any questions, please contact Lenore Nakama of the Commission staff at 587-0218 or toll-free at 974-4000 (Hawaii), 274-3141 (Kauai), 984-2400 (Maui), or 1-800-468-4644 (Lanai & Molokai).

LN:ss

c: Robert 1. Miller

Sincerely,

W.fTf7 1't

DEAN A. NAKANO Acting Deputy Director






October 17, 2006



STEPHANIE A. WHALEN


0519-07,wccc

Mr. Robert J. Miller 4362 Kanaele Rd. Kapaa, HI 96746

Dear Mr. Miller:

Certificate of Well Construction Completion for Well No. 0519-07

We are pleased to inform you that the Well Construction work permitted for the Miller 01 Well Well (Well No. 0519-07) is complete and acceptable and welcome you as a new member to the community of well owners and groundwater users in Hawaii.

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

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

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

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

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

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

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

If you have any questions, please contact Lenore Nakama of the Commission staff at 587-0218 or tollfree at 974-4000 (Hawaii), 274-3141 (Kauai), 984-2400 (Maui), or 1-800-468-4644 (Lanai & Molokai).

LN:ss

c: Department of Water Supply Valley Well Drilling, LLC

Sincerely,

Wf7H 1"t


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

Data Input

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

Results

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

Well Casing Minimum Wall Thickness

Material Minimum Thickness per standards Wall Thickness Provided

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

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

Annular Space Depth of Grouting

Calculated Depth of Grouting Depth of Grouting provided

Minimum Annular Space required Thickness of Annular Space

yes no

steel stainless steel

0519-07 Miller 01

other

no pvc plastic Schedule 40

pvc plastic no requirement

Schedule 40

o

208.29 170

10 245

29.66

plastic

220 5

0.258 25

1216.06 304.015

-36.71 okay Section 2.2

0.258 too small Section 2.4(b)

160.767 220 okay Section 2.4(c)

in compliance Section 2.4(d) too deep for plastic Section 2.4(d)

125.041 170 okay Section 2.6(c)

2 2.5 okay Section 2.6(d)

c o

VALLEY WELL DRILLING 91-235 A Oihana Street • Kapolei, Hawaii 96707 808-682-1767 • Fax 808-682-1768 • C-57 License #17965

October 11,2006

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

RE: State Well No. 0519-07 Miller 01 Well

Dear Commission:

REC'E1V'E'D

U& llCT 13 AS! 31

Please disregard the previous well completion report dated August 7, 2006 for the above mentioned well. Originally we had calculated the benchmark elevations using a GPS and the elevations were incorrect. --- _ ..

In the previous completion report, we included the initial water level as the depth when we first hit water while drilling. After a conversation with Lenore today, she had indicated that the information you are looking for is the initial parameters prior to the pump test.

Attached is the corrected well completion report for the above mentioned water well. Please call with any questions or if you need more information.

Sincerely,

Tracie Sober

State of HcCaii 0 COMMISSION ON WATER RESOURCE MANAGEMENT Department of Land and Natural Resources

WELL COMPLETION REPORT - PART I Well Construction

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

1. State Well No.: 0t5I~-01 Well Name: )J\\lLElZ: 01 nlbL\,.. 2. Address: 4a~ 2 I<A:NA E:-1.E- P-p. i<A:fhl\ r ""\ q~11~ Tax Map Key:

3. Drilling Company: VALLEY WELL DRILLING, LLC

For Official Use Only: /

S OCT 13 A 9: 3 1

4. Drilling method used during contruction: ri(l Rotary 0 Percussion 0 Other (describe)

5. Date Well Construction (drilled,cased,grouted) completed: 10 IZO,o~ Fill out attached Driller's Log mOnth/d y/year

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

6. Was the subject well cored? 0 Yes 9!i No

7. Step-Drawdown Test completed? ~ No 0 Yes Attach Step-Drawdown Test form (12117/97 SDPTD Form)

8. Constant Rate Aquifer Test completed? 9Q No 0 Yes Attach Constant Rate Aquifer Test form (12117/97 CRPTD Form)

Initial parameters:

9. Water-level:

10. Chloride:

11. Temperature:

_1t~~~t-=-G--'LbC-=....u!\UN~ ___ ft. above msl Date and time of measurement:

5:r.~ month/day/year time

ppm Date and time of sampling: 412ft, lO (P 1430 ---------- mohthiday/year time

1-~ of Date and time of measurement: 411410" 1430 ---------- mo~th/day/year time


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

14. Fill in attached surveyor's report.

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: -X"'init\t'I) V\I,,\1$;v@ "'15.OjOmsL en 41z.~loCo@ 1400. DlAc tIJ h1'~g

?('Cf>~U\-V ~F1ti() 1tl"11Cy- \"(\1(\ ® Zq·Co"m~) ill lolo~10lo @o~oo

Licensed Driller (print) VALLEY WELL DRILLING, LLC

Tracie Sober

Signature

24947 C-57 Lic. No. ___________ _

Date \0 ·11 ·O~


Bench mark If' ~I e eva ,oni f)"

13. AS-BUILT WELL SECTION (Please attach as-built if different from diagram provided below)

l ". ,.f . ." ) ~'/' \ .

Elevation at top of casing ~ ft., ~sl* (to nearest 0.01 ft.)

- -------.,. :. . .

Hole Oiameter: 10 in,

'. >

Minimum of 2' Radius & 4" Thick Concrete Pad

Ground Elevation: I foa .1 ft., msl

Please refer to the

~ft.,msl* (Survey to nearest 0.01 ft.)

Cement Grout: I~O ft. OJ W HAWAII WELL CONSTRUCTION AND

(min. 70% of distance from Qj PUMP INSTALLATION STANDARDS ground elevation to top of

> OJ

..J to ensure that your as-built is in compliance

water surface or 500 ft., whichever is less.) .l!l

'" $:

with applicable standards,

Grouting method: ~ Positive

displacement

Annular space between :> OJ

Solid Casing: (z 90% x (Ground Elev,·Water Level Elev))

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

w '0 c: :0 0

Length: liO ft.

Nominal Oiameter: 2 in.

o Other 2. 'j in. ~ x

cie

Wall Thickness: ~ .:z~a:o 0·230 in.

Bottom Elevation: -'!JGJ·~O ft .. msl a

Rock or Gravel Packing: '" 1\1

TotalOepth

14~ft, -:t'? ft.

Material:

~ Crushed Basalt

Open Casing: ~ Perforated o Screen

Length: 2."f? ft.

o Rounded Gravel I Nominal Oiameter: 6 in.

Water Level Elevation:

7/3 .. lJ.J ft, msl*

I Wall Thickness: o . t'KQ in. I -<64 .''10 I Bottom Elevation: ft .. msl ,

,/,A '\

Open Hole:

Length: tJ~ ft.

Oiameter: in.

Bottom Elevation: ft., msl *msl = mean sea level

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

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

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

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

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

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

o Centrifugally Cast Resin Pipe conforming to ASTM 02997

o Reinforced Plastic Mortar Pressure Pipe conforming to ASTM 03517

o Glass Fiber Reinforced Resin Pressure Pipe conforming to 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 ANSIIAWWA C200 0 API Spec. 5L 0 ASTM A53 0 ASTM A 139


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

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

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








"..,."

~ State of Hawaii For Officiall1se O~'

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

Well Number: 0519-07 ~'-------

l, Depths (ft.) IROCk description, Water level, etc·i Dates

~o Itol 50 I Red, silty clay 3/11/06 - --1 ~--+-I -------.--+-----1 50 i to I 80 1 Red, silty clay 3/23/06 ~ ~-+----------------~--~

• 80 jtoi ~0- ___ ~ed, silty cI~! ____ ~~/24/0~ I 90 -ito8~ hoed bl"e mok i 3/24106

I 120 itoi 137 I medium blue rock i 3/24/06

1-------1 r---- I i ---i 137 ito i 140 I hard blue rock I 3/25/06 1--,., ~ ~---L----------+------I I ~toL 170 I medium hard blue rock I 4/10/06

! ,! i I i 170 Ito I 181 I very hard blue rock /4/11/06

!-;-~- -[ to ~ i soft black rock I 4/12/0~-L----J L,. I~,---~ ! ! I I I ! 210 itO! 236 , soft crumbly rock, 1 4/26/06 ~ 'L i I ;---i i -_ .. , . +----- ---

I 236J' to i 240 1 soft to medium black rock I 4/27/06 r--'- , f---r- . --I 240 itol 245! medium to hard black rock I 4/27/06 ~-, I~-+-- '---il----~

! Itoi ! I !;-----i ,----+------------+------i , ! : I'

I :to~,---+!--------------L----: ~,' _~to l-J

1 ito! ! " t -- ~ L! --+- ---------- -II: -- -J' ~ ____ ito

l

t: i-I --+-----+! ----.. -, :to! i ,

Remarks: Miller 01 Well

OS OCT 13 A 9: 3 1

C J~J,11\SS~{)N nN W~Jt~ R' ,-ri,'t'C' 1,/'·' ,I.r:, "

, I! Depths (ft.) iROCk description, Water level, etc., Dates i

, ' ~

ito i i ~ i-' --+------------ -----t---,.~ , !

! I ,to I ·----------1--,

-----j -,--~,--------------- -+--Ito I

~--!

~--!Itol i Ito I

I------li to I I

Ito

bl i ________ !-------1

1------1, -----~---~ I to I I ~

f-~ 1--- I ---"t-----i itoL ! "

~--!!tol I ---t-----1 -------i I I f------.. i ~_-jitol i i I

Itol I : I 1----4 1 I ! ...J

I--__ I::~ :1 f-------1 I I, ----------------+1- '_._

" ' lto! !

to

~ r---+-i ------------.--"--.. itol !

I------!I I I 'I' ,!

to! j

i ------------'~i -.-

I

Dl Form 06/2412C'c

\

\ \

\ \ , , I

\ / \ -V

/ /q; I

/

A ttach photos of completed well and concrete pad

/ (

! I

/

I

~) / - --c~cc---

t; l> ~~,l"S .. V, t:- . L> /// -//._-_' _/~j £

~

• : i ---____ ---1

I I SKETCH OF WELL LOCATION

(Referenced to pennanent laj]dmark? i.e. building, road, fence o etc_) Provide LatitI.l.de and Longitude of well referenced to N AD8} to nearest second

VtlCR1 Form 1/ r 7106 Dage ~ 0: ~


Ms. Tracie Sober




September 6, 2006


Dear Ms. Sober:

Well Completion Report Part I for Well No. 0519-07


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


STEPHANIE A. WHALEN

DEAN A. NAKANO ACTING OEPUTY DIRECTOR

0519-07.wcrl

We have received your Well Completion Report Part I for the Miller 0 I Well (Well No. 0519-07). However, matters which must be addressed before we can accept your report as complete are as follows:

I. A water level of -27.71 ft. below mean sea level is highly unusual (WCR Part I, Section 9). Please verify the water level in the well.

2. We also note that the well appears to have in excess of one-fourth of the theoretical aquifer thickness. This will need to be revisited after you have addressed the above matter and may be an issue with the well construction.

Until these matters are addressed, we cannot issue the certificate(s) of well construction completion and/or pump installation completion that transfer(s) responsibility of all aspects of well usage and maintenance to the well operator/landowner. Please remember that the well may not be pumped for purposes other than well and aquifer testing until the certificates of I) well construction completion and 2) pump installation completion have been issued, otherwise such pumpage would constitute a violation of the permit conditions. Since the permit is issued to the contractor, the contractor will be responsible for any non-testing pumpage violations when the certificates of completion have not been issued. Please respond to the above item(s) within thirty (30) days of this letter's date. Failure to do so may result in fines of up to $5,000 per day.

LN:ss

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

Sincerely,

Wf7f1 1't


/

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

Data Input

Well Number Well Name Ground Elevation Cement Grout Grouting Method Hole Diameter Total Depth

. Estimated Head Public Water Supply Well? "

Solid Casing Material "

Solid Casing Specification Solid Casing Length Solid Casing Diameter !~.

Solid Casing Wall Thickness Open Casing Length

Results

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

Well Casing Minimum Wall Thickness

Material ." "

Minimum Thickness per standards Wall Thickness Provided .

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

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

Annular Space Depth of Grouting

Calculated Depth of Grouting Depth of Grouting provided

Minimum Annular Space required Thickness of Annular Space

yes no

steel stainless steel

0519-07 Miller 01

208.29 170

positive displacement 10

245 -27.71

no I pvc plastic Schedule 40

220 5

0.258 25

-1136.11 -284.0275

-36.71

pvc plastic no requirement

0.258

212.4 220

Schedule 40

165.2 170 1.5 2.5

o

plastic

too deep Section 2.2

too small Section 2.4(b)

okay Section 2.4(c) in compliance Section 2.4(d) too deep for plastic Section 2.4(d)

okay Section 2.6(c)

okay Section 2.6(d)

I).

"""'" .....t COMMISSION ON WATER RESOURCE MANAGEMENT Department of Land and Natural Resources

WELL COMPLETION REPORT - PART I Well Construction

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

1. State Well No.: 051C1-01 Well Name: M\ I\t~ 01 Wt II 2. Address: 1~{g1. l(qootll~ R~. Kqf. qq ,l .. lI '1l114~ T~xMap Key:

For Official Use Only:

AUG 9 A8: 39

Island:

4 .. ~ -0 11.:01!O 3.

4.

5.

Drilling Company: VQ \ \C~ Ht\ \ Dri I' '\18 1 u· G. . Drilling method used during contruction: CllI Rotary 0 PerciJssion 0 Other (describe)

f'

Date Well Construction (drilled,cased,grouted) completed: ltJ?c1/o(, /' m'diihlclay/year

Fill out attached Driller's Log

In addition to the driller's log. if a geologic log was prepare'1"lease submit with this form. I

Was the subject well cored? 0 Yes III NO/" 6.

7.

8.

Step-Drawdown Test completed? ~ No 0 'Yes i

Attach Step-Drawdown Test form (12117/97 SDPTD Form)

Constant Rate Aquifer Test completed? 9Q No .J] Yes l

Attach Constant Rate Aquifer Test form (12117/97 CRPTD Form)

Initial parameters:

9. Water-level:

10. Chloride:

11. Temperature:

,/

.... ~ ft., above msl Date and time of measurement: ____ ~~i-______ __

____ ..::.6_5 ......... .:..... -=.c;> ________ .:,ppm Date and time of sampling:

::t~ OF Date and time of measurement: ------~----------


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

14. Fill in attached surveyor's report.

~ 1-&JaOfo 14~() mnlhlrtear time

4~Z1 ok \1"?O mo th/day/year time

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:

Licensed Driller (prrt) _W...:....;.....~_C_\_'C--"'s--'ab'-'~'-'--_____ _ C-57 Lic. No. _.....;Z:.....4.!....q...:..tH-...:.....:.. _____ _

Signature 1J?ti'm ~ Date _-"",6_' ·-'-t......::·O:..:~'----___ _


/

13. AS-BUlL T WELL SECTION (Please attach as-built if different from diagram provided below)

~{;,('\ Elevation at top of casi~ ft., msl* (to nearest 0.01 ft.) ,

Bench mark elevation: .. ~;)

~ 1rnKmsl* ~ t~"n~arest 0.01 ft.)

Grouting method:

~ Positive displacement

o Other

Total Depth

Cement Grout: i3D ft. (min. 70% of distance from ground elevation to top of water surface or 500 ft., whichever is less.)

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

2.6 in.

Rock or Gravel Packing:

:10 ft.

......

Hole Diameter: lOin.

,L.-..

'.

Minimum of 2' Radius & £ Thick Consrete pa~ ( ,

Ground Elevatiof:' ~ft., msl ~" :

:;- Please refer to the CIl W HAWAII WELL CONSTRUCTION AND Qi PUMP INSTALLATION STANDARDS > CIl ~

'-CIl

to ensure that your as-built is in compliance with applicable standards.

~ :> ~ CIl

Solid Casing: k 90% x (Ground Elev.-Water Level Elev))

W "0

Length: 7.71J ft. c:

.' ::I .' e : .' ~

Nominal Diameter: ? in.

Wall Thickness: G:; ·~1f6a .Z5.G in. x

"?ft. I Bottom Elevation: -II. tl ft., msl 0 en , 1\1

~4'S ft. Material: Open Casing: ~ Perforated o Screen

9lI Crushed Basalt Length: 2.6 ft.

o Rounded Gravel

~i~1 Elevation: ,.. • \ ft. msl*

/

'I 1 Nominal Diameter: &~!O.1~(f in.

J I~' Wall Thickness: in. 1 t. l r Bottom Elevation: -~{a.:tl ft., msl

• I.

I

Open Hole:

Length: ft.

Diameter: ~ in. M\LLe.~ 0 \

Bottom Elevation: ft., msl *msl = mean sea level

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



ABS Plastic conforming to ASTM F480 and ASTM 01527: (check 6ne) 0 Schedule 40 0 Schedule 80

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

Thermoset Plastic: (check one) 0 Filament Wound Resjn Pipe conforming to ASTM 02996



o Glass Fiber ReinfClrced Resin Pressure Pipe conforming to AWWA C950

o PTFE Fluorocarb~n Tubing conforming to ASTM 03296


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

And compliant with (check one or more): 0 ASl1M A242 or A606 0 Type E 0 Type S 0 Grade B 0 Other

Stainless Steel: (check one): 0 As1M A409 (production wells) 0 ASTM A312 (monitor wells)


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








/

,...." .........

State of Ha~aii ...., COMMISSION ON WATER RESOURCE MANAGEMENT Department of Land and Natural Resources DRILLER'S LOG

For Official Use 0'"';

AUG 9 A8: 39 Well Number: 0519-07

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

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

0 to 50 Red, silty clay 3/11/06 to

50 to 80 Red, silty clay 3/23/06

j

80 to 90 Red, silty clay 3/24/06 to --I

I -=f ---. , 90 to 120 hard blue rock I 3/24/06 ]0

---

120 to 137 medium blue rock 3/24/06 -. Ito I

137 to 140 hard blue rock 3/25/06 1,/ to

140 to 170 medium hard blue rock 4/10106 to ,

170 to 181 very hard blue rock 4/11/06 Ito ~--- -- --

181 to 210 soft black rock I 4/12106

---+---~ 210 to 236 soft crumbly rock, I 4/26/06 ~-- ~ I --

Ito f--l to' -----1----236 to 240 soft to medium black rock 4/27/06 to

-----

240 to 245 medium to hard black rock 4/27/06 to

to to

to to

to to , --

FJ::~I i ----+--/ }--+--------tJ L]::If-----+-I-----i-tol , !

--- ---- ----Itol I

i

Remarks: t I

Miller 01 Well ! I (

DL Form 06/24/20G;;

· . c

Attach photos of completed well and concrete pad

o

I SKETCH OF WELL LOCATION

A'. \ /Y"1' \ -==- l<....f'-/

{1'Y ("fN[ -~

5" 7' 18"

, ~ !

(Referenced to permanent landmark, i.e. building, road, fence, etc.) Provide Latitude and Longitude of well referenced to NAD83 to nearest second

weR1 Form 1117106 Page 4 of 5




Mr. Mike Sober Valley Well Drilling, LLC 92-235A Oihana St. Kapolei, HI 96707

Dear Mr. Sober:


May 1,2006

Variance Approval for Well No. 0519-07




STEPHANIE A. WHALEN


Ref: 0519-07,variance

This is in response to your request for a variance from Section 2.4(d) of the Hawaii Well Construction and Pump Installation Standards to allow 240 feet of plastic casing to be installed in Well No. 0519-07. From your letter, we understand that the following measures will be taken to prevent breakage or collapse of the plastic casing due to the heat and pressure from grouting:

• The seal will consist of 5% bentonite to help reduce the temperature while curing. • The casing will be set with the cement-bentonite grout in timed staged lifts. • The cement will be poured in 2-3 lifts and the casing will be checked periodically

with a bailer.

Based on the above grouting plan, we are approving your request for a variance.

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

LYN:ss

Sincerely,

Wf7H 7't


o o

. Gooding/DLNRIStateHiUS Ilk-KevinL To Lenore Y Nakama/DLNRIStateHiUS@StateHiUS

cc 04/26/200601 :18 PM

bcc

Subject Miller 01 Well 0519-07

History: ~ This message has been replied to.

Valley Well Drilling requested a variance. They want to put a total of 240 feet of PVC casing.

Mike says that he will:

1. use 5% bentonite to lower the cement curing temperature 2. do 2 -3 times lifts 3. casing will be checked periodically with a bailer

Also he says that the formation is competent.

I think that we can approve this variance.

Kevin

------------_._-_ ... _-_ ..

04/26/2006 10:54 8086821758 \,II"')D HI PAGE 01/01

oS 14 - D7

Valley Well Drilling, LLC

To: Kevin Gooding From: Mike Sober

587·0219 Pages: 1

Company: DLNR-CWRM Date: 412612006

Re: Miller 01 Well #059-07 cc:

o Urgent o For Review D Please Comment 0 Please Reply 0 Please Recycle

• Comments:

Kevin,

We would like to request a varianCE! on the construction material of the above stated well. The total depth of the well will be 240 feet. The casing length will be 200 feet and 40 feet will be slotted. The formation is competent.

The seal will consist of cement with 5% bentonite which will help reduce the temperatl.m~ while curing. In order to maintain the collapse strength of the casing, we propose to set the casing with the cementbentonite grout in timed staged lifts. The cement will be poured in 2-3 lifts and the casing checked periodically with a bailer. The cement seal will be approximately from 0' bgs to 160' bgs.

Thanks for your consideration,

Mike Sober

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

8PR-26-2006 10:498M F8X:8086821768 ID:DLNR CWRM PRGE: 001 R=96%

o 0 WELL CONSTRUCTION PERMIT

Miller 01 Well, Well No. 0519-07 Note: This permit shall be prominently displayed at the construction site until the work is completed

In accordance with Department of Land and Natural Resources, Commission on Water Resource Management's Administrative Rules, Section 13-168, entitled "Water Use, Wells, and Stream Diversion Works", this document permits the construction and testing of Miller 01 Well (Well No. 0519-07) at TMK 4-6-012:075, Kauai, subject to the Hawaii Well Construction & Pump Installation Standards (HWCPIS - February 2004) which include but are not limited to the following conditions:

I.

2.

3.

4.

5.

6.

7.

8.

9.

10.

II.

12.

13.

14.

15.

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

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

The well construction permit shall be for construction and testing of the well only. The permittee shall coordinate with the Chairperson and conduct a pumping test in accordance with the HWCPIS (the latest rump test worksheet can be obtained by contacting Commission staff or at www.hawaii.gov/dlnr/cwrmlforms.htm). The permittee shal submit to the Chairperson the test results as a basis for supporting an application to install a pennanent pump. No pennanent pump may be Installed until a pump installation permit is approved and issued by the Chairperson. No withdrawal of water shall be made for purposes other than testing without a Certificate of Pump Installation Completion. The permitted pump capacity described on the pump installation permit may be reduced in the event that the pump test does not support the capacity.

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

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

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

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

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

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

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

The work proposed in the well construction permit application shall be completed within two (2) years from the date of permit approval, unless otherwise specified. The permit may be extended by the Chairperson upon a showing of good cause and good-faith performance. A request to extend the permit shall be submitted to the Chairperson no later than the date the permit expires.

If the well is not to be used it must be prorerly capped. If the well is to be abandoned during the course of the project then the permittee must apply for a well abandonment permit in accordance with § 3-168-12(f) prior to any well sealing or plugging work.

The permittee, its successors, and assigns shall indemnify, defend, and hold the State of Hawaii harmless from and against any loss, liability, claim, or demand for property damage, personal injury, or death arising out of any act or omission of the applicant, assigns, officers, employees, contractors, and agents under this permit or relating to or connected with the granting of this permit.

This permit shall apply to the location shown on the application only. If the well is to be relocated, the permittee shall apply for a new. well construction/pump installation permit In accordance with Hawaii Administrative Rules § 13-168-12(f).

,:--.'J: Special conditions in the attached cover transmittal letter are incorporated herein by reference. cJ -:J ., :,

. I; Wf7H 7't

c, -.,.-. ~~ , . ~

Date of Approval: December 8, 2005 Expiration Date: December 8, 2007

PETER T. YOUNG, CQ,airperS9Jl Commission on Water Resouroe'Management ..

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

Driller's Signature: ~ C-S7 License #: 24947 Date: tl-J 1'\ 11:15

Printed Name: Mike ober FIrm or TItle: Valley Well Drilling, LLC

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

Attachment

O PUMP INSTALLATION PERMI1I-\ Miller 01 Well, Well No. 0519-07 \J

Note: Tllis permit sllall be prominently displayed at tile site until tile work is completed

In accordance with Department of Land and Natural Resources, Commission on Water Resource Management's Administrative Rules, Section 13-168, entitled "Water Use, Wells, and Stream Diversion Works", this document permits the pump installation for MiIIer 0] Well (WeIl No. 0519-07) at TMK 4-6-0]2:075, Kauai, subject to the Hawaii Well Construction & Pump Installation Standards (HWCPIS - February 2004) which include but are not limited to the following conditions:

I. 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 installlltion activities in accordance with § 13-168-15, Hawaii Administrative Rules

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

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

4. The pump installation permit shall be for installation of a 40 gpm rated capacity, or less, pump in the well. This permanent capacity may be reduced in the event that the pump test data does not support the capacity.

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

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

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

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

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

10. The work proposed in the pump installation permit application shall be completed within two (2) years from the date of permit approval, unless otherwise specified. The permit may be extended by the Chairperson upon a showing of good cause and goodfaith performance. A request to extend the permit shall be submitted to the Chairpers.on no later than the date the permit expires.

I I. The permittee, its successors, and assigns shall indemnify, defend, and hold the State of Hawaii harmless from and against any loss, liability, claim, or demand for property damage, personal injury, or death arising out of any act or omission of the applicant, assigns, officers, employees, contractors, and agents under this permit or relating to or connected with the granting of this permit.

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

Date of Approval: Expiration Date:

Decem ber 8, 2005 Decem ber 8, 2007

PETER T. YOUNG, Chairperson Commission on Water Resource Management

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

Installer's S;gnature: ~-#-= C-S7, C-S7a, 0' A Ucense #: 24947 Date: 1'Lj 11.1<15.

Printed Name: Mike Sober Firm or Title: Valley Well Drilling, LLC


Attachments




/


STEPHANIE A. WHALEN





December 12,2005

Ref:0519-07. wcp


Dear Mr. Sober:

Well Construction Permit Miller 01 Well (Well No. 0519-07)

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

Special Conditions

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

2. Section 2.4 (d) of the Hawaii Well Construction and Pump Installation Standards (2004) provides that plastic casing shall not be used in wells where well depth exceeds 200 feet or where drilling tools are contemplated to be used to re-enter the well following installation of the casing. Installation of Schedule 80 PVC casing shall not exceed 200 ft in length. unless a variance from the Chairperson is granted in advance. The variance request shall be made in writing and shall include a plan for casing installation that shows adequate methods or measures will be in place to prevent casing collapse or damage during installation.

Please refer to the Permit Processes Worksheet (transmitted with your acknowledgement letter) for further information regarding the process of drilling a well and installing a pump.

No withdrawal of water shall be made other than for testing purposes until a certificate of pump installation completion has been issued by the Commission.

Please sign both permit originals and return one for our files. For copies of the aquifer pump test worksheet, please call staff or visit www.state.hi.us/dlnr/cwrm/forms.htm.

Mr. Mike Sober Page 2 December 12, 2005

IMPORTANT - Drilling work shall not commence until a fully signed permit is returned to the Commission. The permit shall be prominently displayed or made available at the constr,uction site during construction. Be advised that you may be subject to fines of up to $5,000 per day for any violations of your permit conditions starting from the permit approval date.

If you have any questions, please call Lenore Y. Nakama of the Commission staffat 587-0218 or toll-free at 974-4000 (Hawaii), 274-3141 (Kauai), 984-2400 (Maui), or 1-800-468-4644 (Lanai & Molokai), extension 70218.

Sincerely,

tv.,,'!'!-? 1't

Peter T. Young Chairperson

Enclosures

c: Robert J. Miller (with applicable comments - DOH SDWB, CWB) USGS Kauai DWS

~ ,.,..... '-' 'W'

WELL CONSTRUCTION PERMIT

Miller 01 Well, Well No. 0519-07 Note: This permit shall be prominently displayed at the construction site until the work is completed

In accordance with Department of Land and Natural Resources, Commission on Water Resource Management's Administrative Rules, Section 13-168, entitled "Water Use, Wells, and Stream Diversion Works", this document permits the construction and testing of Miller 01 Well (Well No. 0519-07) at TMK 4-6-012:075, Kauai, subject to the Hawaii Well Construction & Pump Installation Standards (HWCPIS - February 2004) which include but are not limited to the following conditions:

I.

2.

3.

4.

5.

6.

7.

8.

9.

10.

II.

12.

13.

14.

15.

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

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

The well construction permit shall be for construction and testing of the well only. The permittee shall coordinate with the Chairperson and conduct a pumping test in accordance with the HWCPIS (the latest rump test worksheet can be obtained by contacting Commission staff or at www.hawaii.gov/dlnr/cwrm/forms.htm). The permittee shal suomit to the Chairperson the test results as a basis for supporting an application to install a permanent pump. No permanent pump may be mstalled until a pump installation permit is approved and issued by the ChlUrperson. No withdrawal of water shall be made for purposes other than testing without a Certificate of Pump Installation Completion. The permitted pump capacity described on the pump installation permit may be reduced in the event that the pump test does not support the capacity.

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

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

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

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

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

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

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

The work proposed in the well construction permit application shall be completed within two (2) years from the date of permit approval, unless otherwise specified. The permit may be extended by the Chairperson upon a showing of good cause and good-faith performance. A request to extend the permit shall be submitted to the Chairperson no later than the date the permit expires.

If the well is not to be used it must be prorerly caf,ped. If the well is to be abandoned during the course of the project then the permittee must apply for a well abandonment permit in accordance with § 3-168- 2(f) prior to any well sealing or plugging work.

The permittee, its successors, and assigns shall indemnifY, defend, and hold the State of Hawaii harmless from and against any loss, liability, claim, or demand for property damage, personal injury, or death arising out of any act or omission of the applicant, assigns, officers, employees, contractors, and agents under this permit or relating to or connected with the granting of this permit.

This permit shall apply to the location shown on the application only. Ifthe well is to be relocated, the permittee shall apply for a new well construction/pump installation permit m accordance with Hawaii Administrative Rules §13-168-12(f).

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

Date of Approval: December 8, 2005 Expiration Date: December 8,2007

PETER T. YOUNG, Chairperson

Commission on Water Resource Management

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

Driller's Signature: C-57 License #: 24947 -.;......-'-------

Date:



Attachment


Ref:0519-07.pip


Dear Mr. Sober:

STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOIJRCES



Pump Installation Permit Miller 01 Well (Well No. 0519-07)




STEPHANIE A. WHALEN


December 12,2005

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

Special Conditions

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

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

The permittee is responsible for all conditions of the permit. This includes ensuring the submission of a completed Well Completion Report Part II form within sixty (60) days after the pump installation work is completed. Be advised that you may be subject to fines of up to $5,000 per day for any violations of your permit conditions starting from the permit approval date.

Please sign both pennit originals and return one for our files.

IMPORTANT - Pump installation shall not commence until a fully signed permit is returned to the Commission.

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

Sincerely,

Wf7H ~

Peter T. Young Chairperson

Enclosure

c: Robert J. Miller (with applicable comments - DOH SDWB, CWB) USGS KauaiDWS

.---,- PUMP INSTALLATION PERMI~. "'-' Miller 01 Well, Well No. 05 I 9-07 ...."

Note: This permit shall be prominentlv 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 Miller 01 Well (Well No. 0519-07) at TMK 4-6-012:075, Kauai, subject to the Hawaii Well Construction & Pump Installation Standards (HWCPIS - February 2004) which include but are not limited to the following conditions:

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

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

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

4. The pump installation permit shall be for installation of a 40 gpm rated capacity, or less, pump in the well. This permanent capacity may be reduced in the event that the pump test data does not support the capacity.

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

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

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

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

9. The pump installation permit application and any related staff submittal approved by the Commission are incorporated into this 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 Chairpers.on no later than the date the permit expires.

11. The permittee, its successors, and assigns shall indemnify, defend, and hold the State of Hawaii harmless from and against any loss, liability, claim, or demand for property damage, personal injury, or death arising out of any act or omission of the applicant, assigns, officers, employees, contractors, and agents under this permit or relating to or connected with the granting of this permit.

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

Date of Approval:

Expiration Date:

Decem ber 8, 2005 December 8, 2007

PETER T. YOUNG, Chairperson

Commission on Water Resource Management

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

Installer's Signature: C-57, C-57a, or A License #: 24947 Date:



Attachments

(

NOV-25-2005 07:11 FROM:KAUAI HISTORIC PRES 8087427329 i"""\.


STATE OF HAWAII

TO: 8086928020 .-... . ..."

PETER T. YOUNG Cl111JIV'(;R30N

80A~ OF lAND AND Nl\I\JRAL RESOURCES C'.o68I1$8ION ON WATI!R ~:!OUMC~ MANllGa.tENT

ROBeRT MATSUDA DEPUTY DIRECTOR - LANll

DEPlJTV DIRECTOR _ WATEn

AQUATIC RESOURCES

DEPARTMENT OF LAND AND NATURAL RESOURCES

IlO.All"G AND OC~AN Re:CREI>TI()I\I SUReMI OF CONVEYANCeS

COMUI8B1ON ON WATEII RESOURCE MANl\QEMENT CONS~"TION AKJ COASTAL LJ\NDG

COlG!RvATiON ANI) I'II!SOORCiro ~NFOR<;~~NT fN<-~INeERlNG

POST OFFICE BOX 621 HONOLULU. HAWAII 95809

FORl:ImIY AND WILDLIFE HISTORIC PRal~ATION

KAHOOlAWIlISlAND Rt~~ COMIII:;~iOI>I lJINO

~TATIi PARKS

HAWAI'I HISTORIC PRESERVATION DIVISION REVIEW

Applicant/Agency:

Address:

Dean A. Nakano, Acting Deputy Director For: Robert Miller

Log #: 2005.2519 Doc #: 0511 NM48

DLNR- Commission on Water Resource Management P.O. Box 621 Honolulu, HI 96806

SUBJECT: Chapter 6E-8 Historic Preservation Review - Well Construction/Pump Inatallation Permit Application, Kauai Miller·01 Well (Well No. 0519.(7)

Ahupua'a: Kapaa District, Island: Kawaihau, Kauai TMK: (4) 4-6-012: 075

1. We believe there are no historic properties present, because: ./ a) intensive cultivation has altered the land ., b) reSidential development/urbanization has altered the land _c} previous grubbing/grading has altered the land _d) an acceptable archaeological assessment or inventory survey found no historic properties _9) other:

2. This project has already gone through the historic preservation review process, and mitigation has been completed _ .

./ Thus, we believe that "no historic properties will be affected~ by this undert~king t-::;

stall: Nancy MCMahJ l?it ~ ~ Date: 11122105 :- i Title: Archaeologist for Ka 'j r~

( ::)

U .J:..

Results

DEC-OB-2005 THU 01:21 PM

LlNDII LINGI.E c.~vrn~oo a: .-IAWI\II

Mr. J<l11 Costa, Director Phmning Dep,H1ment Co,mly oCKmmi 4396 Rice Street Lihue, Hawilii 96766

DcaI' Mr. Cosla:

QOK PLANNING DEPT, FAX NO, 808 2416699

STATE OF HAWAII DEPARTIv'ENT OF LAND AND NA1'UAAL RESOURCES

COMMISSION ON WATER RESOURCE MANAGEMENT ~.o. BOX621

HONOLULU, kAWAU g58C9

Novc;lllber 8,2005

Special Manilg,ement Arcl'\ Use Permit Requil'cm"nts for Well COnWudi()Il/PlIIllP ]IlSlallationPermil Application

Miller-O [ Well (We)) No. 0519-07)

!~ i,

.'. J

p, 01

r'~TER T YO~JNG 1:11Q,I'U'r~~.o,~

MFRF.I:I"I H J CHINe JfllVES A. rrMZIt:R I\~AL S FU;IWAfoI.A

CHI'iOME L r,)KINO, M D. LIIWRENCE H MilKE, M D .• .I D,

STEPIIANIl:; II, WHAI EN

D~AN A NAKANO A-:'ljillCLlLl'Llt QIIlICfQll

Transmitted [01' your review ilnd commem is a copy (11' (he c<1ptioned Wcll Construction/Pump Insliill;ltioll permit applic<lliol1.

We WOIJld nppl'eciate your COlllments on the capli()ncd Clpplication with regaru to tile SMA peI'nliUing reqllil'ements specific to your division. Please n's ond b 'rcturtlin Ihis C(I\ICI' memo form b Dec{'mbcr 8 ZOOS. I fWI;: do not receive comments or a requeST or addition,i! review time y thid date, W~ WI a~sumc YOll have no comments.

Please find the attached II1f1pS 10 loc<lte the proposed well. I f you have allY quc.5tions <lbollt this PCrllllt application, request ildditional information, or reque,t additional review tillie, plca~c COllt<lct Lenore Y. Nilkmna of the COlllmission SlalTat 587-0218.

RESPONSE:

Sincerely,

Wfll-? 1'-.

DEAN 1\. NAKANO ACling Deputy Director

I ] '1 hi", w¢11 proj"ct [ ]l'cquircs III doc. not require ~ S\1A. Ira SMA is rcqllir~d it [ J has [ J 11<1$ nul bcc'n appl'ov~lI and r lis [ ] i~ not cllmntly active.

I ] Other relevanl ruk.,!r~gLlbli()n$. inf(Jnllalioll, or rC\~OInIlJCnJ:tli[)ns ~I'C ntlac1'.t~d.

[ ] Otber commenlS;

Phone: 2~lU,~_.

Dme:_J\\~o6 ___ ....

OEC-08-2005 01:41PM FRX:808 2416699 ID:OLNR CWRM PRGE:001 R=9]%

11-30-05 12: 18pm From-DOH/Safa Dr;"~ini Water Branch 8085864351 T-i54 P.006/006 F-i43

.r" RECEIVED SAFE DRINKING WATER BRANCH

~INDA lINGl.E NoV 1 0 2005 PJ;:TIOR T. YOUNG

c.I"IAtftt"ERSO,", GC\IOl.NcfC Of HAW~II

TO:

FROM:

STATE OF HAWAII DEPARTMENT OF LAND ANO NATUAAL RESOURCES

COMMISSION ON WATER RESOURCE MANAGEMENT P.O. BoxeZ1

HDNOLULU. HAWAII goe09

November 8, 2005

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

Harold Vee. Wastewater Branch William Wong, Safe Drinking Water Branch Alec Wong, Clean Water Branch

Peter T. Young. Chairperson 11 Commission on Water Resource Management

MEREDITH J. CHING JAMES A FRAZIER NEJlL S, FUJIWARA

CHIYOMf: ~, FUKINO, M.O, LAWRENCE H. MilKE. M.D., J.O.

STE?HANIE A.. WHAL!;N

oEAN A. NAAANO ACTING lEPIITY ill"r:.crOR

SUBJECT: Well Construction/Pump Installation Permit Application \1.iIler-Ol Well (Wen No_ 0519-07)

Transmitted for your r~view and comment is a copy of the captioned Well ConstructionIPump Installation pennit application.

We would appreciate your comments on the captioned application for any conflicts or inconsistencies with the prob'Tatns, plans, and objectives specific to your deparnnent. Please respond br returning this cQver memo fonn by December 8, 2005. Jfwe do not receive comments or a request tor additional review time by this date, we will assume that you haw :no COlnmCI'lts_

Please find the attached maps to locate the proposed well. If you have any questions about this pcrmit application, Tequest additional information. or request additional review time, please contact Lenore Y. Nakama ofthe Commission staffat 587-0218.

LYN:ss A ttachmen t( s)

RESPONSE~

[ 1

[ 1

Ii

[ )

[ J I]

[ ]

This well Qu.~Ii{\es a> a 8O\L"'~ which wjll ",',",e ... a SO\lrce of pot obi. watcrto a Pl.bJ,c waler system (define.:! ass~lIg 25 or more p<oplc: atl~~1 ~O d~y, per ~car or hilS 15 or more ;etvice ~onn.clions) and mu~, receiv~ [)ir<:elor of Ho"hh approval ~ 10 its use to 1;I.1'''ply "ith 11UW"41. Admini.tr;1ti.c Rule, (HAR), TiTI~ 11, Chapter ;;0, Rilles RclatinJl 10 Potable Wat~rSyste",", ~1I-2D-29,

This wdl docs not 'ltl2.liry as a soutce serving .1 public water ",y~tCIII (scrv.~ less tllan 2;; poopJc or more p"opJ~ al ICilST ~O days per ~Ir ~ 15 SCT\11;t; conn¢cl'''''') and If th. well wale,- i. I.<:ed for drin~m~, Ihe pri .. i11. owner .1l~1I1d Ie" for ba~I.Tiological and ~h~mical pros'",oo before initiatin!! such U5~ ... ,d routipely "'Llllitor The waler quality Ih~tL01rlicr. I-1ow~'Icr. if nl:UTe pJarulcd lIse fTolll Ihis source illcreases to m.el the publi. ",;Ito" systcm dcJ'inilion then Director"f Eeallh apDT,,,.1 is rcquir .. d !!!l!!.!: to impl •• ncl1tation.

If the w~1I is used tn .uppJy b~th p~ubJc and !lon'pOlable P"TP",es in a .ingl. "ystcm.lh~ "~.r ;halJ diminale clos;-oolUle.tiol .• and backtlow (Onn.ell(lIl' by pl1y.itally scpRt<Jtin~ p()tablc nnd nun-pclabJ~ ~y'I.'llS by aTl ~'T gap or IIll ~pv",vcd bacldlow T,>TevcmCf. and by d~arly Illb~ling allllonpolabl<: gJ'fJ!Of~ with waming ;\ign:i to p(cvent ln41d ..... t:ttcnt ~I:m~umpuon (If flon.potablc WBl:er. Batkilow prcve:nll011 dcvi~~s. :should b¢ rc)Utincly iUSPC-ClCd OlJ"Jd lC'S'lC(i.

11 docs not "PpM! Illat Ihi~ w~1l will be I".d for consumplivc pUIpo~ •• .,ld is not "lhjto:;110 Safe Dnnki,lg Water Re~ulaliOIlS.

For ,h. applicant's 'nfonnation. ~ ,nutee Llf possible w&st~nl~T cOlLtamlllstion [ Ii. I ) Is not l(Jci1l~d .lear the pToposed well sit: (;nfonn3lion ~\t'Ichec).

An NPDlJlS pClIllit is r~~"iT.d.

Olher rcie'<lP' l)OH ruJesfr~l!L11ations. intOrmali'''l. or r~oom'"<Il;lations iLr,; attached.

JJJ Ihe event .hot Iht Jocati(ln Dr the well <;han!!"; but is ~lill wilhin thc p~rcel described ~m lhis .pplic~t;on, \lUr division c"n,idcrs the <;{lmrn~lltS to still b. ~n)ll)l :CJlible, :::a...,d y..'C d .. "1 not ne!ed LO revjew me new Iocan"on.

Phone; 586-4258

Signed: ____ tb~~----~~~~----~~~--------~-

HOl)-30-2005 12: 15PM FRX:8085864351 ID:DLHR CWRM PRGE:006 R=96%

o ";'DI()~ tkr-

LINDA LINGLE A II .'. w::.A;r,:ER T. YOUNG H1fY' CHAIRPERSON GOVERNOR OF HAWAII

TO:

FROM:


COMMISSION ON WATER RESOURCE MANAGEMENT po. BOX 621


November 8, 2005

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

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

Peter T. Young, Chairperson 1 Commission on Water Resource Management



STEPHANIE A. WHALEN


cJ1

SUBJECT: Well Construction/Pump Installation Permit Application Miller-01 Well (Well No. 0519-07)

..

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

We would appreciate your comments on the captioned application for any conflicts or inconsistencies with the programs, plans, and objectives specific to your department. Please respond by returning this cover memo form by December 8, 2005. Ifwe do not receive comments or a request for additional review time by this date, we will assume that you have no comments.

Please find the attached maps to locate the proposed well. If you have any questions about this permit application, request additional information, or request additional review time, please contact Lenore Y. Nakama of the Commission staff at 587-0218.

LYN:ss Attachment( s)

RESPONSE:

[ I

[ I

[ I

[ I

~ .x [ I

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

This well does not qualitY as a source serving a public water system (serves less than 25 people or more people at least 60 days per year or 15 service connections) and if the well water is used for drinking, the private owner should test for bacteriological and chemical presence before initiating such use and routinely monitor the water quality thereafter. However, if future planned use from this source increases to meet the public water system definition then Director of Health approval is required prior to implementation.

'fthe well is used to supply both potable and non-potable purposes in a single system, the user shall eliminate cross-connections and backflow connections by physically separating potable and non-potable systems by an air gap or an approved backflow preventer, and by clearly labeling all nonpotable spigots with warning signs to prevent inadvertent consumption of non-potable water. Backflow prevention devices should be routinely inspected and tested.

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

For the applicant's information, a source of possible wastewater contaminatio~is I J is not located near the proposed well site (information attached).

An NPDES permit is required.

Other relevant DOH rules/regulations, information, or recommendations are attached. ~() ~ ~ ~tf ..::l..t!'ftJ In the event that the location of the well changes but is still within the parcel described on this application, our division considers the comments to still be applicable, and we do not need to review the new location.

~ No comments/objections •

Contact~n: ~UJv) !"Wvl t1=Vl11 Phone: ~L0St4: Signed:~~ Date: 1\- p{-oS

,~ . ...,

c o UNOAUNOLE GOIIEIIHOII Of'_ CHlYOIE L I'UICIIIO, lUI.

0IIIEC10R OF tEALlH

STATE OF HAWAII DEPARTMENT OF HEALTH In NpIy, ,.... .... to:

P.O. BOX 3378 HONOLUlU, HAWAII 88801

Wastewater Branch 919 Ala Moana Blvd, Room 309 Honolulu, Hawaii 96814-4920

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

EMD/WB

A septic tank file has been found and the following information is provided. In general, the Department of Health has reviewed and approved of the plans based on the information submitted as verification that a treatment individual wastewater system (IWS) such as a septic tank was constructed and authorized to be used for wastewater disposal from a building/dwelling,

Tax Map Key number

Address

Septic Tank File #

Applicant Name

Submit Plan Date

Plan Approval Date

Inspection Date

System Approved for Use Date

BPA Date

System / Disposal Via

Use For

Designed By

Percolation Rate / Capacity

(i) J:l-iL- 0 12- 01 S 4-3<0 1- tqm~ Rd

----------/------~/-------------------------~/ /----------------

--------~/ /----------------

n -------------min/in / \ 'LSD gallons

For further information, you may call the Wastewater Branch engineer as listed:

Mr. Johnny Ong at the Wastewater Branch office on Oahu at (808) 586-4294

Mr. Dane Hiromasa at the Kealakekua Health Center in Kona at (808)322-1507

] Mr. Jerry Nunogawa at the Hawaii District Health Office in Hilo at (808)933-0401

~ Mr. Joe Tateyama at the Kauai District Health Office at (808)241-3323

[ ] Mr. Roland Tejano at the Maui District Health Office at (808)984-8232

cesspool faxes.wpd sam revised February 24, 2005

" No~-2005 - r.1":;9pm From-DEPT OF HEALr~ ENVIRONMENTAL MNGMT 8085864352 T-838 p.002/aoz F-193

LINDA ~INGLE G~V"RNCI'I: Of' r1A-.rIAI~

TO:

FROM:

STATE OF HAWAII OEPARTMENT OF LANOAND NATURAL RESOURCES

COMMISSION ON WATER RESOURCE MANAGEMENT PO.60XB21


November 8, 2005

Honorable Chiyome 1. Fukino, M.D., Director Depanmem of Health Anention: Director's Office

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

Peter 1. Young~ Chairperson 1 Commission on Water Resource Management

PETER 'f, YOUNG (\. ." C""RP,RSON ~

MEREDITH J. CHING JAMI'SA FflAZIEA n. NEAL S. FUJIWARA l.."

CHIYOME L. FUKINO, M.O LAWRENCE H. MilKS, M.D., J.D.

STEPHANIE A. WHA~EN

DEAN A. NAKANO ",C;'I'Iffi) OEPuTY (J,R&CTQR

SUBJECT: Well Construction/Pump Installation Permit Application MilIer.Ol Well (Wet] No. 0519-(17)

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

We would appreciate your comments on the captioned application for any conflicts or inconsistencies with the programs, plans, and objectives specific to your department. Please respond ~y returnin this cover memo form b December 8 2005. If we do not receive comments or a request lor

mona review tUlle y this date, we will assume t at you have no comments,

Please find the attached maps to locate the proposed well. If you haw any questions about this permit application, request additional infonnation, or request additional review time, please contact Lenore y, Nakama of the Commission staff at 587 M0218.

LYN:ss Attachment(sl

RESPONSE: [ l

[ I

[ I

[ 1

11

[ 1

~

Thi~ ",,~11 qLlalifics as a ~(lIlI'C\I which ",ill s~rv~ :\.~ a sO'.lce ofpotabl~ water h) a p~blie wlll~r ~ystem (dellm:d l\.~ serving 2~ or morcpCOpl~ all~sl60 day~ p;r y~~t ,11113,S 15 or mL'r¢ ~e'vi<c <0111100tlOn.) ,,11(1 "''''1 (ecei"" Dir~olor of I-Idllh apl'fOysl ru:ilu: 10 iI> u$O In colllJlly wirh Hllwnli fldmmi~ltalive R~le. (HAR). TlIle II, Chapter 20. l~ul~$ Relating ro Po{"bl~ W~I¢f $y<Tellls. ~ 11-20·29.

Tbi6 w~l\ d\)e~ 001 qualify 1,. a ~~~rcc sc.'VlI1g Il public Willet S)SICIU (serves I.,; Ih~n 25 p.Opk Of mor< p.opl~ .1 .lea~{ 60 .:jays p~r l'~ar or 15 ."""'C~ connectiOn,) aHd Ifrhe ",dl wilter IS uSCQ for drmkm~. Ih~ P,'lv.le OwllN should {~'l lOr U;,el",.ololl.Cal nnd chemlc .. l prose.,.e befme mln.lIng .".h ••• a.la ,oUliliely mOnlt~t lhe waltr q"~lily Ih~Naf[.f. However. ifti't"r~ rl~llIl"d usc ITom Ihis ,Ol1TCO in<.:r;lascs to m~e[ tho; pllbl.;> "alJ!t system ddinition th~TI P'I'<lCIOr of Health aj)jll'oval is required I!.!:i!!.!; 10 implel\\~mation.

Ifille w...,U is used to ,upply bolh p')!ilbl~ a~d .,Iln-potable pllrpo~~~ 111 n ~i'I!llc sys!(In, the usor "hill I ~li.ni.atc cro5S-i:onn~cli.)lI~ ana backflow con~e¢lio'l~ by physicillly ,epalllring pombl~ ~n<lII'ill.p()\abk 'YS!C'IIlS by. iln ~ir g~p 01 an approved bacl;fIow PICvcIIlcr, and by ~I~arly lapelill!; .. l1 non· JX'1i1~1~ SPill"lS "Ilh "uml~~ SIil'lS to pr~v.nllm\lJ,eflelll ~0.5I1mptiOll or n{ln'I'QI~~I~ .. arcl. Backflo,~ prev.,,'"'''' dc~,ces shollld be routinely Illopac[cd i.md L(:!!~~4.

It d0~; 1I0T appear that thi;:; ;v.1I will be 1I •• d ior ",,,,~,,,nplivt pUrpOSes and i~ 1101 subj~1 10 Silf. Drinkill!! Wilt.f RugulQ[iol1 •.

for [he applicam'~ inflltl1l8tioll. a .our~< "t'pClssiblc wasrtwnt~ o;'nlillmn~lioll Iii. ( I is not !oQltt~d !1~at Ihe propos~d w~1I ~il.li"roru\alioll attached).

An Nl'DES permil lS [<'luil'<ld.

Other r~l~v;ml DOH '1tltSIr.:~ulali~'lg, illfonuation, or ,.c.l •• nl~.ldaliOlls art mm~h~d,

1t1 Ih. <wnlll~llhc lorarion 0l'tll. wdl change.; but is ~[ill wllJ.illlhc pafctl de6crib~lj ~n Ih" ~pplicalioll, ollrdivi~jol1 cOlUidcls the comm.:nts TO ~tllll)¢ i$pphc.i!lb)c:~ IJI1Q Y¥t; do 1101 nOrJd 10 rt;:'IIicw Tht: new lOili\tlun.

Phone:

NDV-14-2005 03:45PM FRX:8085864352 ID : DL~-lR CWRM PRGE:044 R=97%

B085864352 T-838 P.001/OOl F-194

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

1. For Well-Drilling Activities

Any discharge to State waters of treated process wastewater effluent associated with well drilling activities is reguiated by Hawaii Administrative Rules, Title 11, Chapter 55, Appendix I, effective September 22, 1997. Treated process wastewater effluent covered by this general permit includes well drilling slurries, lubricating fluids wastewaters, and well purge wastewaters, This general·permit does not cover well pump testing. The applicable Notice of Intent Forms and filing fee shall be submitted at least thirty (30) days before the start of discharge to the' Department of Health, Clean Water Branch at 919 Ala Moana BoUlevard, Room 301, Honolulu, Hawaii 96814-4920 or P.O. Box 3378, Honolulu, Hawaii 96801·3378. Inquiries may be directed to the Clean Water Branch at (808) 586-4309 or by fax at (80S) 586-4352.

2. For Well Pump Testing

The discharger shall take all measures necessary to prevent the discharge of pollutants from entering State waters. Such measures shall include, i! necessary, containment of the initial discharge until the discharge is essentially free of pollutants. If the dIscharge is entering a stream or river bed, best management practices shall be implemented to prevent the discharge from disturbing the clarity of the receiving water. If the discharge is entering a storm drain, the discharger must obtain written permission from the owner of that storm drain prior to discharge. Furthermore, best management practices shall be implemented to prevent the discharge from collecting sediments and other pollutants prior to entering the stoll!' drain.

, JS/cr

'.

_.-.---.---------------------

~~m) -14-2005 03: 46PI1 FAX: 8085864352 ID:DLNR CWRM

PAGE: 045 R=9T:

---- o o LINDA LINGLE

GOVERNOR OF HAWAII PETER 1. YOUNG

CHAIRPERSON

TO:

FROM:

SUBJECT:




November 8, 2005

Russell Tsuji, Administrator Land Division

Dean Nakano," Acting Deputy Director 11 Commission on Water Resource Management

Well Construction/Pump Installation Permit Application MiIler-Ol Well (Well No. 0519-07)


CHIYOME l. FUKINO, M.D. LAWRENCE H. MilKE, M.D., JD.

STEPHANIE A. WHALEN


C"~'C=' i ... --4 c: '2~ :z » :::0 :~:~-;: ;-'; :a a~ '':'>'. r, , '':::::>rr1 -'l(-~r:~ ..D « :x: <F' ~ " Ui_rr10 p.G~;· -0 ~C:~ 0 '1;>:::0 - ~ u ..., =-(J P.o 'n'" ....

Transmitted for your review and comment is a copy of the captioned Well Cot@uction~mp 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 8, 2005. Ifwe do not receive comments or a request for additional review time by this date, we will assume you have no comments.



RESPONSE:

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

~:;

[ ]

~:;

[ ]

kt

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. : The subject well site is not located in the conservation district. No oD]ections

Other comments: Original source of private title was issueq prifr to stathood.

Contact Person: _..::G:...:a::..:r::...y-<---.::..M::..:a::..:r::.....=t..=i:..::.n=--________ _ Phone: 587-0421

~~ --r. Signed:_--I~'--__ +-_"_ "_~---,,,---,,-,,-==---______ _ Date: --------

NOV 1 4 2005-~





Dear Mr. Sober:


November 8, 2005




STEPHANIE A. WHALEN


OSJ9-07.rev

Well ConstructionlPump Installation Permit Application for Well No. 0519-07

We acknowledge receipt, on October 11,2005, of your completed Well Construction/Pump Installation permit application and filing fee for the Miller-Ol Well (Well No. 0519-07). You can expect your application to be processed within ninety (90) days from this date.

For your information, the attached table describes the process, responsible parties, and deadline requirements for drilling or modifying a well and installing, modifying, or replacing a pump.

By this acceptance letter, we are also notifying the well operator/landowner that water may not be pumped for purposes other than testing until the certificate of well construction/pump installation completion letter is issued to the well operator and landowner. Additionally, the permitted pump capacity described on the pump installation permit may be reduced in the event that the pump test does not support the capacity. No certificate of pump installation will be issued until the Commission has determined that the pump capacity will not have adverse effects on the aquifer, other nearby wells, or streams. In other words, you may need to remove the pump and install a smaller pump at the Commission's discretion before you can withdraw water for purposes other than testing.

If you have any questions about your permit application, please contact Lenore Y. Nakama of the Commission staff at 587-0218 or toll-free at 974-4000 (Hawaii), 274-3141 (Kauai), 984-2400 (Maui), or 1-800-468-4644 (Lanai & Molokai) extension 70218.

LYN:ss Attachment

c: Robert J. Miller

Sincerely,

Wf7H 1't


LINDA LINGLE PETER T. YOUNG GOVERNOR OF HAWAII CHAIRPERSON

TO:

FROM:




November 8, 2005

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

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

Peter T. Young, Chairperson 1 Commission on Water Resource Management



STEPHANIE A. WHALEN

DEAN A. NAKANO ACTING OEPUTY DIRECTOR

SUBJECT: Well Construction/Pump Installation Permit Application Miller-OJ Well (Well No. 0519-07)


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 8, 2005. If we do not receive comments or a request for additional review time by this date, we will assume that you have no comments.


LYN:ss Attachment(s)

RESPONSE:

[ I

[ I

[ I

[ I

[ I

[ I

[ I

[ I

[ I

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

This well does not qualiry as a source serving a public water system (serves less than 25 people or more people at least 60 days per year or 15 service connections) and if the well water is used for drinking, the private owner should test for bacteriological and chemical presence before initiating such use and routinely monitor the water quality thereafter. However, if future planned use from this source increases to meet the public water system definition then Director of Health approval is required prior to implementation.

If the well is used to supply both potable and non-potable purposes in a single system, the user shall eliminate cross-connections and backflow connections by physically separating potable and non-potable systems by an air gap or an approved backflow preventer, and by clearly labeling all nonpotable spigots with warning signs to prevent inadvertent consumption of non-potable water. Backflow prevention devices should be routinely inspected and tested.

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

For the applicant's information, a source of possible wastewater contamination I Jis II is not located near the proposed well site (infonnation attached).

An NPDES pennit is required.

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

In the event that the location of the well changes but is still within the parcel described on this application, our division considers the comments to still be applicable, and we do not need to review the new location.

No comments/objections

Contact Person: Phone: -------------------------------------------- ------------------Signed: __________________ _ Date: --------------------





TO:

FROM:

SUBJECT:




November 8, 2005

Russell Tsuji, Administrator Land Division

Dean Nakano, Acting Deputy Director 11 Commission on Water Resource Management

Well Construction/Pump Installation Permit Application Miller-OJ Well (Well No. 0519-07)

STEPHANIE A. WHALEN



We would appreciate your comments on the captioned application with regard to the programs, plans, and objectives specific to your division. Please respond by returning this cover memo form by December 8, 2005. Ifwe do not receive comments or a request for additional review time by this date, we will assume you have no comments.


LYN:ss Attachment(s)

RESPONSE:

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

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

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

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

[ ] No objections

[ ] Other comments:

Contact Person: Phone: -------------------------------- --------

Signed: _____________________________________ __ Date: _______ _


TO:

FROM:

SUBJECT:




November 8, 2005

Melanie Chinen, Administrator Historic Preservation

Dean Nakano, Acting Deputy Director '11 Commission on Water Resource Management

Well Construction/Pump Installation Permit Application Miller-Ol Well (Well No. 0519-07)




STEPHANIE A. WHALEN


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

We would appreciate your comments on the captioned application with regard to the programs, plans, and objectives specific to your division. Please respond by returning this cover memo form by December 8, 2005. If we do not receive comments or a request for additional review time by this date, we will assume you have no comments.

Please find the attached maps to locate the proposed well. If you have any questions about this permit application or request additional review time, please contact Lenore Y. Nakama of the Commission staff at 587-0218. If you require additional information regarding specific information that can be provided by the applicant, please contact the applicant directly at the contact information provided on the application form.


RESPONSE:

[ ] This is a [ ] public (county or state) project [ ] private project and [ ] will [ ] may disturb historic sites,

[ ] We concur that the work described under this permit will not disturb historic sites,

[ ] We do not concur that the work described under this permit will not disturb historic sites. We require the following for our concurrence:

Contact Person: _________________ _ Phone:

Signed: ____________________ __ Date: ---------


Mr. Ian Costa, Director Planning Department County of Kauai 4396 Rice Street Lihue, Hawaii 96766

Dear Mr. Costa:




November 8, 2005

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

Miller-Ol Well (Well No. 0519-07)



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

STEPHANIE A. WHALEN



We would appreciate your comments on the captioned application with regard to the SMA permitting requirements specific to your division. Please respond by returning this cover memo form by December 8, 2005. If we do not receive comments or a request for additional review time by this date, we will assume you have no comments.


LYN:ss

RESPONSE:

Sincerely,

WfiH ~


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

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

[ ] No objections

[ ] Other comments:

Contact Person: ___________________ _ Phone: ---------

Signed: _____________________ _ Date: ____________ _

c Date: 10/6/05

To: Lenore-CWRM OS GCT II A 8: ~ D From: Tracie Sober

.( ',' , ~" t,;· 'l" ,-:.~ "-".'

Attached are copies for the Miller Well. Please note that we have corrected the estimated water level at +30 msl and the proposed gallons per day as 500.

o o .. - DEPARTMENT OF LAND AND NATURAL RESOURCES

•

STATE OF HAWAII

•

COMMISSION ON WA'.TE~ RESOURCE MANAGEME. NT APPLICATION FOR A WELL CONSTRUCTION I PUMP INSTALLATION PERMIT '.,.,;;~

For Official Use Only:

:--"0'".

Instructions: Please print In ink or type and send completed appUcatIon with attachments to the Commlssion on . Water Reaource Management, P.O. Box 621, Honolulu, Hawaii 96809. ApplIcation must be accompanied by 10

copies and a norH'8I\mdable tiling fee Of $26.00 payable to \he Dept. of Land and Natural ReaoIllC'88. The Commission may not accepIlncomplete appllcaUons. For assistance, caU the Regulation BranCh at IINI22&. For further Information and updates to thlll appHcalion fonn, vI&It http://ovww.hawaD.govldlnrlcwnn.

~--------------------------------------------------------------~----~~-WELL LOCATION INFORMATION /4.TMK a.ISLAND

KAM/ltl The -!Ill mull be attached beIorelllla IIPIIIicaIion is accepIed as ~

.PortIon of 7.5-Minule SerIes USGSIrlpograp/1Ic map (1CIIIe 1:24,000) with WIllI ICIC8IIon libeled and Indude the name oflhe quad map • Property tax map, showing WIIIIIocaUon _10 utailIIsiled PfIII*IY boUndarIes • PhoIOgraph of the prDp08IId won ..... . A_-'" ~ IheWIIII._roadandprDp08lldWIIII~ 4~~N~Elk ~. ~WMai~"t,I~t\?- g.t·.

t<APAA HI "11v~ V-.kft-.A til -'1'{i-T 1.:rt:,

PROPOSED WELL CONSTRUCTION PROPO$ED puMP INSTALLATION 7. Pp!lP0S8d Work

l!I COnstruct New WeD 8. Construction Type ~Propoaad Work 11. Proposed Pumpl/lg Rate, gpm 13,.MethOd of flow measurement

III Drilled LeI Install New Pump (ganona per minute) c;r Flowmeler o Modify Eldatlng WeD o AbandonlSeal Well

o Dug 0 Replace Pump .' 40 0 Open PIpe

00 Shaft 1-,""2'"". :"Pro-P-osad"":':;:"Amou=---n-:t-o"'"f ----/ 0 WaJr

Tunnel lMthdrai~al' gpdi an,~per day) 0 OrIfIce 1----------1.------1 00 0 Other(expIaJn) 9. Is this well part of a battery ofwells? 0 Yes ~ No • 14. Proposed Surwyor name and 1Ican .. number (a a_yor Is required for all Well Construction Pennlts and may be required for __ Pump

Installation PermIta)

PROPOSED USE

o 15. Municipal (wafer systems serving greater than 25 lndMduafll 01' 15 service connections)

12' 18. Domestic Number of units to be served: I

o 17. Industrial (desafbe)

o 18. Irrigation (desatbe crop and no. of acre~)

o 19. Military (describe)

o 20. Other (descrtbe)

OTHER LEGAL REQUIREMENTS If required, items 21. and 22. must be obtained befOre ths Commission can legally lssufJ II pennlt

21. Conservation DistrIct Use PennI! (COUP) o Required, COUP fI. '. date approved __ _ Q Not Required (attaCh documentation from PCCl) . . ~ I have not Checked with OCCL about whether or not a COUP Is required. I understand that chackIng with OCCL prior to making this application wiD

expedite my nIIIiew. I further understand that iSsues flIi&ad by this agency may delay or /8SuIt In denial of the permit issuance, or reIIOCaIilln of the pefmlt after It Is Issued.

22. Special Management Area PennI! (SMAP) o Required, SMA:II date approved ___ ...... . o Not Required (attaCh documentation from applicable County agency) 171 have not checked with the county about whather or not an SMA Penni! Is required. I undelstand that Checking with the County priorto making this

application wUl ~~my revfew. I further understand that Issues rai&ed by this agency may delay,Onesult in denial of the pennI! Issuance, or revocation ofthe.pennnaftarltis.iSsuad.

23. Historic Preservation DMs/on(HPO) of the Department of Land and Natural Resources o I havo conaulted With the HPD regarding potential Impacts Of well construClion aCllVtll85 on historic sites. I have attaChed applicable documentation

from the HPD. iii' I have not consulted with the HPD regarding potentiallmpacls of well constlUClion actMties on historic aItes. I understand that checking with the HPD

~~?" toit

. making this appUca!~ofwWthe~~it a1lemyrellieWl iSs' I adfurth~~ltIonanderatandl~·. thethaL~ ~~ by this agency may '!.!'Iay_ 0Ullllult In denl,.laIOf the ""nn ISsuance orrevocs ..... , ,,"'fT"" rlt s u • """ .ny, h .... nvof""stlanduseisattached. K~·n~~

Additional remarks, explanations, etc. (attaCh additional sheat If more space Is needed)

NOTE: Signing below indicates that the signatories understand and swear that the information providad Is' accurate and true to the best of their knOWladge • . Further, the signatories undeniIand that upon pennlt apprOval: 1) the proposed work Is to be completad within two (2) years of \he approval date; 2) the . contractor shall submit to the Commission a well compltitlonlabandonment report within 60 days after the completion date of the pennitted work; 3) In·tha event that the appllcatlon Is not cornpletad correctly, any pennlt may be suspendad until the item is brought In to compUance, and any work done WhIle the Pllnnlt Is In susoenslon may result.1n fines Of UD to $6000lday. . 24. WEU DRillER (Must be1lUed OUIif 8pflI1C8Uon i. for Well ConIIruction) 25. PUMP·1N:sT ALLER (Must be ftIIed out if appllcaHon Is for Pump In_aJion}

Valley Well. Drilling, LLC 24941 Valley Well Drilling, LLC 24947 I ,,{censee busi~me C-57 license No. ~1JcensII8 busIn~ma C-57JC..57a1A Ucense No.

~~ Mike Sober &illS/OS ~ -~~ Mike Sober 9/12loS ~r Print Date .~?::' Print Date

91-235A Oihal'la st. Kapolei, HI 96707 91-235A Oihana.st. Kapolei, HI 96707 Address Address ." . .l

682-1767 682-1768 vwdhi@la~net 682-1767 "F;;:ax=:=-' ....:...;c=~ __

68 'i;'::,:2:...:'..;..11;..;6;..;;8 ___ [email protected] Fax e-mail Phone E-mail Phone

INePI App. Fonn 05112105

c o PROPOSED WELL SECTION (Please attach schematic If different from diagram provided below)

Hole Diameter: I z. in,

Elevation at top of casing 2£:1.. ft, msl' - r-t _-l" , ---, .....'L '--:--1.'-- Minimum of 2' Radius & 4" Thick Concrete Pad (to contain benchmark

,,;; ',,"'~, J surveyed to nearest 0.01 ft.) ~ " • ,rAt;, ,,:d2' r Ground Elevation; ~ft" mal .:;",r:;r::Iff:: ~= ,----....,rt'"-..., ,',:' , ',;::

Please refer to the Cement Grout ~ft. (min. 70% of distance from ground elevation to top of water surface or 500 ft" whichever is less.)

HAWAII WELL CONSTRUCTION AND PUMP INSTALLATION STANDARDS to ensure that your as-built is in compliance with

applicable standsrds.

Grouting method:

OPositive displacement

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

Solid Casing: ~ 90% x (Ground Elev.-Water level Elev»

Total length; '/1..,"::' ft.

o Other ~in.

Nominal Diameter: _-:(.;;;.'-::-:::-:-______ in.

WaD Thickness: _-:,,(\ __ , ,':'l:::.-~::..()L' ______ in, :.",,". Bottom Elevation: f;- ft., msl'*

Rock or Gravel Packing:

00 Total Depth

"~\~Jft. :-;-:-:...,....,._ft. Material: I Open Casing: riPerforated o Screen

!i'Crushed Basalt

o Rounded Gravel

Estimated W r level

, /

/

Total Length:

Nominal Diameter:

Wali Thickness:

Bottom Elevation:

1)0 ft. l' in.

0. l~(\ in.

''\C ft.,msl"

note: Neither bentonite nor mud should b& used in saturated zone during drilling

Open Hole:

length: ____ --,\~:...:JH~::r.,....-----ft. Oiameter: ____ ' __ ' ______ in.

--- ._,-_. __ ._- . ,,--- _ ... ------- - ~ Bottom Elevation: ft., msl·

• The approximate elevation muat be referenced to mean sea level (msl) at the time of application filing. Final elevations of well components shall be submitted in the Well CompletionlWeD 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 XW8!erL7 Elmtjon )

Example: Estimated +211. WBterLeliel Elev. _ Bottom ElevaIionofWelI Umlt= (2- ~) = -18.511.

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

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

Stainless Steel: (check one): 0 ASTM A409 (production wells) 0 ASTM A312 (monitor wells) ABS Plastic conforming to ASTM F480 and ASTM 01527; (check one) 0 Schedule 40 0 Schedule 60

PVC Plastic conforming to ASTM F460 and (ASTM 01765 orASTM 02241); (check one); riVSchedule40 0 Schedule 60 0 Schedule 120

Thermoset Plastic; (check one) 0 Filament Wound Resin Pipe conforming to ASTM 02996


o Reinforced Plastic Mortar Prassure Pipe conforming to ASTM 03517

o Glass Fiber Reinforced Resin Pressure Pipe conforming to AWNA C950



Open Casing Material: Carbon Steel: compliant with (check one or more); 0 ANSIIAWNAC200 0 API Spec. 5l 0 ASTM ASJ 0 ASTM A139


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


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




o Glass Fiber Reinforced Resin Pressure Pipe conforming to AWNA C950



WCPI App. Form 05112/05

f I

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09

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.-.- .. -.------.--~~.t:-~----II-~---------~<::::J~------.. -~---~~----"~::;:~---g o

--l---t:.c;=;::-. ________ ... ___ _

_ .... -

Tracie,

c Lenore Y Nakama/DLNRIStateHiUS

"'* 1 0105/2005 02:01 PM

To Tracie Sober

cc

bcc

o

Subject Well Permit Applications for Kauai Wells

Thanks for faxing in corrected water levels. Please provide 10 copies of the applications including attachments for the Miller-01, Kaala Farms, NSLF-023 & 015 wells. Thanks, Lenore

09/30/2005 15:14 8085821758 VI;.ID HI PAGE m/m

Valley Well Drilling , LLC

To: Lenore From= Tracie Sober

Fax: 587-0219 Pages: 1

CompanY".oLNR-CWRM Date: 9/30/2005

Re: A few well permit applications cc:

o Urgent o For Review 0 Please Comment D Please Reply 0 Please Recycle

Lenore,

Can you please do me a favor and change the estimated water levels for the following well permit applications we recently turned in? All msl estimated water levels are + not minus.

Well Name E~timated Water Level-msl

Miller-01

NSLF-023

NSLF-015

Ka'ono'ulu V Well

Thanks,

Tracie

30msl

20msl sent in 9120/05 ~~~"'\. ~ ~ ~-"-20msl sent in 9/20/05

5msl sent in 9/30/06 ~\

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

SEP-30-200S 03:10PM FRX:8086821768 ID:OLNR CWRM PRGE:001 R=9S%

Department of Commerce & C~umer Affairs - State of Hawaii - PVL LICENSE CLAS... Page 1 of 1 '-" (:J

Department of Commefte'and Consumer Affairs ProfeSSional dnd V<w::ation~ licensing OIVI~lon

Professional and Vocaijonal IJcensing Search

CLASS CODE C57

LICENSE CLASS SCREEN

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

There was 1 specific license class on this licensee!

***~* LICENSE CLASS FOR THIS LICENSEE ***** LIC: CT -24947 VALLEY WELL DRILLING LLC

CLASS TYPE WELL

EFFECTIVE 02112/04

<-Back New Search->

RESTRICTED STATUS

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

Copyright 2002 Professional and Vocational Licensing Division

Hawaii State homepage II DCCAII Professional and Vocational Licensing Division

http://pahoehoe.ehawaii.gov/pvl/app? _ f=n& _ a=LC&licno=2494 7 &lictp=CT &off=O&nm=... 9/30/2005

Search Results o o Page 1 of 1

Copyright ©9/30/200S by Hawaii Information Service

Assessed Values reflect tax year 2005.

Search criteria: TMK Taxkey 4-4-6-12-75

• PUBLIC RECORD DATA Taxkey Subdiv /Condo Tnr Address Owner {Lessee Bds Bths Land area Liv area Last Sale Instr

r .4-4-6-12-75 Laipo{Kanaele/Kaehulua F 4362 MILLER, 2 1 2.40 ac 915 4/3/2003 DEED KANAELE ROBERT & GINA RD

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

http://webrel.hawaiiinformation.comlREsearchIHIS/Searchlsearch _ PUB.asp?NOCACHE... 9/30/2005

Well Background Check

Approved Well No. Well Name Applicant

Miller 01 Robert J. Miller

7/8/2005 0421-04 Szeton Derk Norton

o

o

Friday, September 23, 2005

Well Construction Driller Pump Inst. Type Issued Signed WCR1 Accept

24947 24947 BOTH

24947 24947 BOTH 7/12/2005 7/21/2005

Pump Installation Issued Signed WCR2 Accept

7/1212005 7/21/2005

Page 1 of 1

o o STATE OF HAWAII For OffIcial Use Only: DEPARTMENT OF LAND AND NATURAL RESOURCES COMMISSION ON WATER RESOURCE MANAGEMENT APPLICATION FOR A WELL CONSTRUCTION I PUMP INSTALLATION PERMIT

Instructions: Please print in ink or type and send completed application with attachments to the Commission on . Water Resource Management, P.O. Box 621, Honolulu, Hawaii 96809. Application must be accompanied by 10

copies and a non-refundable filing fee of~25.~O payable t~ the Dept. of Land an~ Natural Resources. The Commission may not accept incomplete applications. For aSSIstance, call the Regulation Branch at 587-0225. For further information and updates to this application form, visit htlp:/Iwww.hawaii.gov/dlnr/cwrm. .

WELL LOCATION INFORMATION 1. STATE WELL NO. (if already assigned) 12. WELL NAME 3. ISLAND 14. TMK -±-DSlQ--01 MiLLER -01 KA\APtI zone

The following must be attached before this application is accepted as complete: • Portion of 7.S-Minute Series USGS topographic map (scale 1 :24,000) with well location labeled and include the name of the quad map • Property tax map, showing well location referenced to established property boundaries • Photograph of the proposed well site • A schematiC diagram showing the weil site, access road and proposed weil infrastructure

5. WELL OPERATOR'S NAME/COMPANY I Well Operator's Contact 6. LANDOWNER'S NAME/COMPANY

~e~T J. MI LLE\Z.- (l.OB~~T J. M \ LL -erz. f«)eRR, J. M Ill.ii~ Weil Operator's Mailing Address Lan~~ MK~~?l£ R.D. 4310 7.. KA.-NI\ E l£- ~D.

I<APAA H\ "I~1"4(o KA.PA.A 1-\1 <4loq~ Weil Op'erator's Phone I Well Operator's Fax l~tll Operat0'1:-

mail Landowne/'s Phone -, Landowner's Fax

<gl~ -~" "313 -~'K I' im b I bbfwvefittm rtJ lZ~- ~~'I ~13-~'g1' ~

PROPOSED WELL CONSTRUCTION PROPOSED PUMP INSTALLATION

7. ~osed Work 8. Construction Type 10 Proposed Work 11. Proposed Pumping Rate, gpm

Construct New Well iii Drilled i!?'instali New Pump (gallons per minute)

o Modify EXisting Well DOug o Replace Pump 40 o Abandon/Seal Well o Shaft 12. Proposed Amount of o Tunnel IlVithdrawal, gpd (gallons per day)

9. Is this well part of a battery of wells? 0 Yes Ilf No I~ ~()D *-

--.k.- -Oil 01-5 : sec plat ~rc

I Landowner's Contact

p,oeef4' :J. M, ll:n~-

I, Landowner's E-mail

iqirY:{ L()Ii\K~r~.o6

~MethOd of flow measurement Flowmeter

o Open Pipe o Weir o Orifice o Other (explain)

14. Proposed Surveyor name and license number (a surveyor is required for all Wen Construction Permits and may be required for some Pump Installation Permits)

(fCFtRReD PROPOSED USE

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

12' 16. Domestic Number of units to be served: I

o 17. Industrial (describe)

o 18. irrigation (describe crop and no. of acre!?)

o 19. Military (describe)

o 20. Other (describe)

OTHER LEGAL REQUIREMENTS If reqUired, items 21. and 22. must be obtained before the Commission can legally issue a permit:

21. Conservation District Use Permit (COUP) o Required, COUP # date approved Ii 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 of the permit after it is issued.

22. Special Management Area Permit (SMAP) o Required, SMA # date approved o Not Required (attach documentation from applicable County agency) . II( 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 will expedite ·my review. I further understand that issues raised by this agency may delay .or result in denial of the permit issuance, or revocation of the permit after it is issued.

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

from the HPD. [if 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 will expedite my review. I further understand that issues raised by this agency may ~Iay or result in denial of the permit issuance or revocation ofthe Dermit after it is issued. Additionallv. the historv of Dast land use is attached. ip:',<\ln~ ·""'11, I..

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

NOTE: Signing below indicates that the signatories understand and swear that the information provided is accurate and true to the best of their knowledge . . Further, the signatories understand that upon permit approval: 1) the proposed work is to be completed within two (2) years of the approval date; 2) the contractor shall submit to the Commission a well completion/abandonment report within 60 days after the completion date of the permitted work; 3) in the event that the application is not completed correctly, any permit may be suspended until the item is brought in to compliance, and any work done while the permit is in suspension mav result In fines of up to $5000/dav. 24. WELL DRILLER (Must be filled out if application is for Well Construction) 25. PUMP INSTALLER (Must be filled out if application is for Pump Installation)

Valley Well Drillingl, LLC 24947 Valley Well Drilling, LLC 24947

~e C-57 License No. ~seeb~me C-57/C-57a1A License No.

Mike Sober &fIlS/oS - -""./ Mike Sober 8L''2Jo~ -.- ~)" -Si~ure / Print Date • 1i-~re ~ Print Date

91-235A Oihana st. Kapolei, HI 96707 1-235A Oihana st. Kapolei, HI 96707 Address Address

682-1767 682-1768 [email protected] 682-1767 682~1768 [email protected] Phone Fax E-mail Phone Fax E-mail

i) WCPI App. Form 05/12/05

/

c

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

Hole Diameter: I Z- in.

EI . t t f . ') (rl ft 1* ,! I evatlon a op 0 casing _'-'__ ., ms - ~-..t-~--1 ,'_ Minimum of 2' Radius & 4" Thick Concrete Pad (to contain benchmark

_.l __ ~__ :-r~ surveyed to nearest 0.01 ft.)

/~·L:-:· .,:'):!>..1 - Ground Elevation: 100 ft msl*

"~('It @j'i .--k-=" HAWAUWE~~~~;"~CTIQN AND

1,~Vt V{:I !~=e ~!~!~~~~~t~;;n~!!~i?n~~!

-r------· .-.--.. --..

Cement Grout: lId ft. (min. 70% of distance from ground elevation to top of

I::(~ :«1 applicable standards. water surface or 500 ft., whichever is less.)

Grouting method:

r;(Positive displacement

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

i·:.::j. ~":;::I /:!::·l. ~::< ~/ rr

!+-----I Solid Casing: (~ 90% x (Ground Elev.-Water Level Elev»

Total Length: 1C<J ft.

methods): r·:::

Nominal Diameter: _....:V7::..-________ in.

[~/ o Other ?J in. v Wall Thickness: _--->.Q'--'. t;....~_O"--______ in.

-r: ~II Bottom Elevation: __ -,\1t:,....· ______ ft., msl*

Rock or Gravel Packing: --,

1 ~, S'~~~I , I ~s~ q~! I

Total Depth

l.Wft. Open Casing: r:I Perforated o Screen

Total Length: ~O ft.

/" Nominal Diameter: fIJ in.

"gO __ -,-,--_ ft. Material:

crt Crushed Basalt

Wall Thickness: 0.1'&0 in. :f::d

:::, 1'1, 11 Bottom Elevation: -~ ft., msl* ,

3Q ft. msl* I I note: Neither bentonite nor mud should be used in

I I 1 I I I I '

saturated zone during drilling

~

Open Hole:

Length: ~~ ft.

Diameter: in. __ ~.~~_ .... _ ~_._~_______ L_J _~~ Bottom Elevation: ft., msl*

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

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

Bottom Elevation of Well Limit = (water Elevation _ 41 x Water Le:el Elevation )

. E ---.. . W .. ( 41 x (2) ) 5 Example: Estimated + 2 ft. Water Level lev. -- Bottom Elevation of ell limit = 2 - 4 = -18. ft.

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




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







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




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







WCPI App. Form 05/12/05

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QRTMENT OF LAND AND NATURAL RESOIQ'CS DOCUMENT NO.: UAC OR ATTACHED WORKSHEET DATE: Septembe 21,2005

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

S 06 326 C 1026 0752 (1 ) $25.00 Gina Miller

(2)

(3)

(4)

(5)

(6)

(7)

(8)

(9)

(10)

TOTAL $ 25.00

REMARKS: LINE (1) Miller- 01 Well LINE (2) LINE (3 LINE (4) LINE (5) LINE (6) LINE (7) LINE (8) LINE (9) LINE (10)

1'. · memo and routjiup (ver.1110107) q 03/22/07 wcr 2 check for well no. 0519-07 (survey to...

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