island of hawaii 'r)tal 2431 mod hydrologic units

ISLAND OF HAWAII 'R)TAL s 2431 MOD

HYDROLOGIC UNITS SUstalnable ..... 1d I Aq ..... , CollI

Gudrun Well Well No. 3787-04

~ ,. ... -

-ISLAND OF HAWAII

roTAL • 2411 MOO HYDftOLOOIC UNI1'S

....... w.vt.kt lAq"'-rCodl

+

FROM: DEAN N.

TO:

BAUER, G. CHING, F. DANBARA, S.

~UII'N.

__ ODING, K. HARDY, R.

__ HIGA, D. ICE, C. -+- IMATA, R.

__ KUNIMURA, I.

INIT.

1 cOrJllvi'ISSION ON WATER RESOURCE MANAGEMENT (01/03)

DATE: MAR - 3 2003

TO:

MATHIAS, T. NAKAMA, L. NAKANO, D. OHYE, M. SAKODA, E. SUBIA, S. SWANSON, S. UYENO, D. YODA, K. YOSHINAGA, M.

INIT:

SUSPENSE DATE:

FOR: PLEASE:

Approvai See Me Signature Review & Comment Information~Take Action ~ Type Draft

Type Final

--1- File Xerox __ copies

o

February 27, 2003

Mr Gilbert S. Colana-Agaran, Chairperson Department of Land and Natural Resources Commission on Water Resources P.O. Box 621 Honolulu HI 96809

Re: GUDRUN WELL, WELL NO. 3787-04

Dear Mr Colana-Agaran;

Q

REC~D

n3 MAR 3 "m: 4 3

This is a request to install the permanent pump prior to final pump installation permit issuance in accordance with the Oommission's April 1 5, 1998 Declaratory Ruling No. DEC-ALM98-G5.

Aloha,

Mr. Kenneth Heinemann Gudrun and Valdis Maurins Family Trust

o WELL CONSTRUCTION PERMQ Gudrun Well, Well No. 3787-04

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

In accordance with Department of Land and Natural Resources, Commission on Water Resource Management's Administrative Rules, Section 13-168, entitled 'Water Use, Wells, and Stream Diversion Works", this document permits the construction and testing of Gudrun Well (Well No. 3787-04) at (8) Kiawe Street HPP, Hawaii, TMK 1-5-62: 96, subject to the Hawaii Well Construction & Pump Installation Standards (1/23/97) which include but are not limited to the following conditions:

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

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

The well construction permit shall be for construction and testing of the well only. A minimum 1114-inch diameter monitor tube shall be permanently installed, in a manner acceptable to the Chairperson, to accurately record water levels. The permittee, well operator, and/or well owner shall coordinate with the Chairperson and conduct a pumping test in accordance with the Standards (a pump testing worksheet is attached). The permittee, well operator, and/or well owner shall submit to the Chairperson the test results as a basis for supporting an application to install a permanent pump and withdraw water for use. No permanent pump may be installed until a pump installation permit is approved and issued by the Chairperson.

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

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

In the event that subsurface cultural remains such as artifacts, burials or concentrations of shells or charcoal are encountered during construction, the permittee, well operator, and/or well owner shall stop work and contact the Department's Historic Preservation immediately.

The proposed well construction shall not adversely affect existing or future legal uses of water in the area, including any surface water or established instream flow standards. This permit or the authorization to construct the well shall not constitute a determina1ion of correlative water rights.

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

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

The well construction permit application is incorporated into this permit by reference and is subject to the Hawaii Well Construction & Pump Installation Standards (January 23, 1997; HWCPIS). If the HWCPIS are not followed and as a consequence water is wasted or contaminated, a lien on the property may result.

The permit may be revoked by the Commission if work is not started within six (6) months after the date of aPl?roval or if work is suspended or abandoned for six (6) months, unless otherwise specified. The work proposed in the well construction permit application shall be completed within two (2) years from the date of permit approval, unless otherwise specified. The permit may be extended by the Chairperson upon a showing of good cause and good-faith performance. A request to extend the permit shall be submitted to the Chairperson no later than three (3) months prior to the date the permit expires. If the commencement date is not met, the Commission may revoke the permit after giving the permittee, well operator, and/or well owner notice of the proposed action and an opportunity to be heard.

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

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

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

Date of Approval: November 18, 2002 November 18, 2004

OLOMA-AGARAN, Chairp Commission on Water Resource Manage Expiration Date:

I have read the conditions and terms of this permit and understand them. I accept and agree to meet these conditiont::f a prerequisite and underlying condition of my ability to proceed and understand that I shall not commence work until I an~e driller h .. signed, dated, and returned the permit to the Commission. I also understand that non-compliance with any permit condition ~e grounds for revocation and fines of up to $1000 per day starting from the permit date of approval. ~ ~.f.. ~ ~

Permittee's Signature: ~ .. ..Y:. f?, ~te: ~; ... 4do Printed Name: ~/#,~!# #~Wd-~A~A/ Firm or Title: ~.s-r~~ ~u"e/A/'> ~A';;2;, /.i..,.,.p->_ .J .;A

Driller's Signature: ~~ G-57License#: C-16653 ~ite: ~5/03;:J Fred Page Firm or Title: Fred Page ~ming -mt I 1 Inc. Printed Name:

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

Attachment c: USGS

Department of Health! Safe Drinking Water, Wastewater, and Clean Water Branches Hawaii Department of Water Supply Fred Page Drilling

o Q / BENJAMIN J. CAYETANO GILBERT S. COLOMA-AGARAN

GOVERNOR OF HAWAII CHAIRPERSON

BRUCE S. ANDERSON MEREDITH J. CHING

CLAYTON W. DELA CRUZ BRIAN C. NISHIDA

HERBERT M. RICHARDS. JR.

LlNNEL T. NISHIOKA

STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES

COMMISSION ON WATER RESOURCE MANAGEMENT P.O. BOX 621

HONOLULU. HAWAII 96809

November 27, 2002

DEPUTY DIRECTOR

3787-04.wcp

Mr. Ken Heinemann Gudrun and Valdis Maurins Family Trust 507 Hop Ranch Circle Santa Rosa, CA 95403

Dear Mr. Heinemann:

Well Construction Permit Gudrun Well (Well No. 3787-04)

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

Special Conditions

1."- - -Attached for your information is a copy of the Department of Health's (DOH) review comments. Please note DOH's requirements related to discharge of effluent from well drilling and testing activities.

2. The annular space shall be 3" minimum.

This permit does not authorize work for your permanent pump installation. Approval and issuance of your pump installation permit is contingent upon completed application and information provided to and accepted by Commission staff as required in the Well Construction & Pump Installation Standards (1/23/97) and any special conditions performed under this

. permit. However, a permanent pump may be installed prior to the permanent pump installation permit issuance in accordance with the Commission's April 15, 1998 Declaratory Ruling No. DEC-ADM98-G5, which states that:

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

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

Mr. Ken Heinemann Page 2 November 27, 2002

o Q

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

IMPORTANT· Drilling work shall not commence until a fully signed permit is returned to the Commission. Please provide all the information in this packet to your well drilling contractor. The permittee, well operator, and/or well owner are responsible for all conditions of the permit. This includes ensuring that the well construction contractor, or other party who constructs the well(s), submits a completed Part I of the Well Completion Report form (enclosed) within sixty (60) days after the well construction work is completed. Be advised that you may be subject to fines of up to $1000 per day for any violations of your permit conditions starting from the permit approval date.

If you have any questions, please call Ryan Imata of the Commission staff at 587-0255 or toll-free at 974-4000 (Hawaii), 274-3141 (Kauai), 984-2400 (Maui), or 1-800-468-4644 (Lanai & Molokai) extension 70255.

Enclosures

c: Fred Page Drilling

~AI,O~~) rfV t (, VGJ· 0 /t .~ , ILBERT S. COLOMA-AGAl· N

Chairperson

OWEll CONSTRUCTION PERMIO Gudrun Well. Well No. 3787-04

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

In accordance with Department of Land and Natural Resources, Commission on Water Resource Management's Administrative Rules, Section 13-168, entitled 'Water Use, Wells, and Stream Diversion Works", this document permits the construction and testing of Gudrun Well (Well No. 3787-04) at (8) Kiawe Street HPP, Hawaii, TMK 1-5-62: 96, subject to the Hawaii Well Construction & Pump Installation Standards (1/23/97) which include but are not limited to the following conditions:

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

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

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

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

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

In the event that subsurface cultural remains such as artifacts, burials or concentrations of shells or charcoal are encountered during construction, the permittee, well operator, and/or well owner shall stop work and contact the Department's Historic Preservation immediately.

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

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

The per:mittee..Lwell op~rator, and/or well owner shall comply with all applicable laws, rules, and ordinances; non-compliance may be grounds for revocation of mlS permIt.

The well construction permit application is incorporated into this permit by reference and is subject to the Hawaii Well Construction & Pump Installation Standards (January 23, 1997; HWCPIS). If the HWCPIS are not followed and as a consequence water is wasted or contaminated, a lien on the property may result.

The permit may be revoked by the Commission if work is not started within six (6) months after the date of approval or if work is suspended or abandoned for six (6) months, unless otherwise specified. The work proposed in the well construction permIt application shall be completed within two (2) years from the date of permit approval, unless otherwise specified. The permit may be extended by the Chairperson upon a shOwing of goOd cause and good-faith performance. A request to extend the permit shall be submitted to the Chairperson no later than three (3) months prior to the date the permit expires. If the commencement date is not met, the Commission may revoke the permit after giving the permittee, well operator, and/or well owner notice of the proposed action and an opportunity to be heard.

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

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

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

Date of Approval: Novennber18,2002 Novennber 18, 2004

OLOMA-AGARAN, Chairp Commission on Water Resource Manage Expiration Date:

I have read the condItions and terms of this permit and understand tl1em. I accept and agree to meet these conditions as a prerequisite and underlying condition of my ability to proceed and understand that I shall not commence work until I and the driller have signed, dated, and returned the permit to the Commission. I also understand that non-compliance with any permit condition may be grounds for revocation and fines of up to $1000 per day starting from the permit date of approval.

Permittee's Signature: ______________ _ Date: ______ _

Printed Name: Firm or Title: ________________ _

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

Printed Name: Firm or Title: _______________ _

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

Attachment c: USGS

Department of Health! Safe Drinking Water, Wastewater, and Clean Water Branches Hawaii Department of Water Supply Fred Page Drilling

/

;MMISSION ON WATER RESOURCE MANAGEMg ROUTE SLIP FOR PERMIT ISSUANCE

FROM:..,;.R.:...;Y..:..A:.:.;N=----____ _ DATE: ! \ I 7--~ /01. SUSPENSE DATE:

BAUER, G. CHING, F. DANBARA, S.--

FUJII, N. GOODING, K.--

-1-HARDY, R. ~ HIGA,D. ~ HIRANO, E. --

ICE,C. -5-IMATA, R.

JINNAI, R.

WELL NUMBER

~ WELL CONSTRUCTION

KUNIMURA, I. MA AS, T.

MA,L. AKANO, D.

NISHIOKA, L...tI....- , . OHYE, M. .1tU 1 /, i.

--SAKODA, E. 16r -2-SUBIA, S.

SWANSON, S. --UYENO, D. --

YODA, K .

• WELL NAME

ATTACHMENTS FOR WELL CONSTRUCTION PERMIT: 1 COVER LETTER V 2 PERMIT (2x) ~

COMMENTS: 3 SDWB 4 WWB

3 3 4

Approval Signature Information

5 CWB TO BE SENT TO APPLICANT

6 HEER 7 LD 8 HP 9 PUMP TEST

10 WCR I FORM

D PUMP INSTALLATION

FOR OFFICE USE ONLY

ATTACHMENTS FOR PUMP INSTALLATION PERMIT: 1 COVER LETTER 2 PERMIT (2x)

COMMENTS: 3 SDWB 4 WWB 5 CWB 6 HEER 7 LD 8 HP 9 WCRII FORM

10 WURFORM

TO BE SENT TO APPLICANT

FOR OFFICE USE ONLY

•

PLEASE:

See Me Review & Comment Take Action Type Draft

-2-Type Final

5 File Xerox copies

BENJAMIN J. CAYETANO GOVERNOR OF HAWAII

TO:

o C)



HONOLULU, HAWAII 96809

October 28, 2002

Dede Mamiya, Administrator

... GILBERT S. COLOMA-AGARAN

CHAIRPERSON



HERBERT M. RICHARDS, JR.

LlNNEL T. NISHIOKA OEPUTY DIRECTOR

FROM: Land Division -,~: - l:--} j ift~ Linnel T. Nishioka, Deputy Director ~"W1'",--,: Commission on Water Resource ManagemeQVI'\.J\.../ '

SUBJECT: Well Construction/Pump Installation Permit Application Gudrun Well (Well No. 3787-04)

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 with regard to the programs, plans, and objectives specific to your division. Please respond by returning this cover memo form by November 27,2002. If we do not receive comments or a request for additional review time by this date, we will assume you have no comments.

Please find the attached maps to locate the proposed well. If you have any questions about this permit application, request additional information, or request additional review time, please contact Ryan Imata of the Commission staff at 587-0255.

RI:ss Attachment(s)

RESPONSE:

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

:;:)J: A water lease/permit is not required of this applicant.

[ 1

XX

[ 1

[ 1

2f~

A water lease/permit has been obtained by the applicant through lease no. :I. ::0("')

This well project [ 1 require~~ does not require a COUP. If a COUP is rMd it [.s ~ [ 1 has not been approved and [ 1 is [ 1 is not currently active. S ;:i ~ Vi!! Other relevant Land Division rules/regulations, information, or recommendations are~ed." ~

::c -:z:; ,--No objections E; ,~ .. ~

~;%: rf1 Other comments: Original source of private title occ~~d p~or 1:tSl'

statehood in 1959. :;:~ m.1'1' ~;;o

Phone: 587-0421 Contact Person: ____ G_a_r-'y=--M_a_r_t_l_· n _______ _

Signed: -b; ~ Oate:_N_O_V_1 _8 _2_00_'2_

o o BENJAMIN J. CAYETANO

GOVERNOR OF HAWAII GILBERT S. COLOMA-AGARAN

CHAIRPERSON

TO:

FROM:

SUBJECT:







LlNNEL T. NISHIOKA OEPUTY DIRECTOR

RECEIVED

October 28, 2002 SAFE DRINKING WA1ER Bf.:1!,i

Honorable Bruce S. Anderson, Director Department of Health Attention: Dennis Tulang, Wastewater Branch

William Wong, Safe Drinking Water Branch

0('..,- ~ (. r: II"J~ VV 4-

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

Gilbert S. Coloma-Agaran, Chairperson i A'A) j Commission on Water Resource Management ~V ' Well Construction/Pump Installation Permit Application Gudrun Well (Well No. 3787-04)


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 November 27,2002. If we do not receive comments or a request for additional review time by this date, we will assume that you have no comments.


RI:ss Attachment( s)

RESPONSE:

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

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

If the well is used to supply both potable and non-potable purposes in a single system, the user shall eliminate cross-connections and backflow connections by physically separating potable and non-potable systems by an air \lap or an approved backflow preventer, and by clearly labeling all non-potable spigots with waming 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.

An NPDES permit is required.

For the applicant's information, a source of possible wastewater contamination []Is [] is not located near the ~sed well 2 (informatIOn attached). rh n

(/)0 ' .. -.. ' --r % ::n =~ S! L--P1 ~~ - (")

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

No comments/objections 3:~ .CIt ~ eO <

Phone: 5 g, .-<f~~ :::, :--1

l ~~ .. 0

Contact Person: __ f71-L-'..!...U--,-, __ W_8'U_-I:6+'l ________ _

Signed:~1ai~t U,.---:..\JJ----'-,~~_-- Date: II'?(~ ~

o o OCT 30 2rl02


GILBERT S. COLOMA-AGARAN CHAIRPERSON

TO:

FROM:




October 28, 2002

Honorable Bruce S, Anderson, Director Department of Health Attention: Dennis Tulang, Wastewater Branch





lINNEL T. NISHIOKA DEPUTY DIRECTOR

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

Gilbert S. Coloma-Agaran, Chairperson t A"A) j ;r Commission on Water Resource Management~v ,U I



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 November 27.2002. If we do not receive comments or a request for additional review time by this date, we will assume tha~ you have no comments.



RESPONSE:

[ J

[ J

[ J

[ J

'" [ J

[ J

~

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

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

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

Contact Person: {AJVJ IV ~I ~ ~'I-~.~

Signed: __ ~ __ ----rr-----4+------------ Date:

'j

NOV-04-2002 08:43 FROM:DOH HEER hFFICE 8085867537 TO:~0!35870219

BE __ I· D'Y1ll.v4I.) ........ .w. __

..... __ ._.. ... TQ~_

FROM:

STATE OF HAWAII DEPARTAo£Nf OF LAND AND NATURAl" RESOURCES

COMMISSION ON WAT£R RESOURCE MANAGEMENT P.o. !lOX 621

HONOLULU. tfAWAI ..

October 281 2002

HonorabJeBruce S. Anderson, Director... . Department of Health

~UCE s. ANDeRSON ~/TH".CHING

ClAYTORw. ~LACRu! IRIAN C. NISHIlA

ttERIIEAT M. RICHARDS. JR.

LlNMEl T. NISHIOICII ---

Atlention: Dennis Tulang. Wastewater Branch William Wong, Safe Drinking Water Branch Dr. Keith Kawaoka, Hazardous Evaluation and Emergency Response Alec Wong, Clean Weter Branch ~

• GHbert S. Coloma-Agaran, Chairperson Commission on W_ Reo ....... uanagemfJlltcMJ j

SUBJECT: WeD Construction/Pump Installation Permit Applicetion Gudt"Un Well (.Well No. 3787-04)

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

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 res.e0nd by returning this cover memo form by November 27, 2002_ If we do not receive cOmments or a request for additional review time by this date, we will assume that you have no comments.

Please find the attached rm'ps to 10000te the proposed well. If you have any questions about this permit application, request additional infonnatlon, or request additional review time, please contact Ryan Imata of the Commission staff at 587-0255.

RI:ss Attachment(s)

RESPONSE: ( )

II

[ I

II

( J

t ) r I lJ4

llIi5 _U QIMIIfIes as • -...", which will _ 1111 II -'N:II tJA pOIabIoo -.fer to a JIUI!!ip water '~fIlIYI (defined as o;aMng 25 ... ""'"' people " 1eN1 00 day. PI!'" yaar or tin 1$ or IIIOAIIfIMCe conlllldiollallllCl mu ..... ve DINdot' til Hltellh ~ Ddar 10 III .,.10 ctJft\pIy wi'., HI_Ii ACI ..... iA1Ilivv Rllift (HAA), TIle 1 t. Chaplar 2O."UIeI ReIIIIing 10 PotaoIe W •• S,.."., 111~

TIliI WIllI does nGi qu.';1y •• a IiDUICe MIfuIna • public; ..... tAIm (1I8f\IU ... !han 25 IIIIODII Of "..... PI8GIIIa It _lOt tIO dIIyII PIlI' YNr or 15 .ervlc:e conMdions) snd • 'Ile well waIiIIr I' UAd far dr1nld"" lflii priva. owner • .,oi.Id"1e8I b blc:tertciloalc:alll'd ctlemical presence befo ... inijiMing -'ud1 UllIn IOUfin8Iy rnuntur the "I11III, IPIIiIY thel1llftel'. foIowMw. if fUture plaMlCl UIIIIftIm ChIs DIICa I~ 10 IM8l tile pUblic __ .,..... dIInIIIan UIItI ~ClfHNIIII ~ Is '"'*-d ~to III\~.

If the wall it liNd 10 IUE ....... nd ~1IIII~1n I ,I ... !iJIIIIm. Ihu ut« Iha' slmin"'~end baddIow COnnl.ll;lliunl tiY II IIY "piII1Iling ~ IIIIiI ~ .. ~1Imi by In lir IIIIP III' In IJlIWIVecI bIcUow p-...r. and by c:ltII!fIY Iatlerlflg III nOftoIlCl We ~ wilIlw.ning..,.1II IftV*Il .. VOdenl ....... ··~ QI notww.tablo ...... BaCkIlOw ~on devIeCs SI'IOIIId bII rouIin.-y inIPi=dICI ancIlIIIed. --' ........ ' .....

Il ~ nat aPPler"'l tnis _U wiU be -cd for COIIIUmptiva purpotel and is nat sublec:ll1O Sata 0rnIng w ... ReguI,liQns.

For the i1ppllcanr, InlotmatiOn, iI mun:e til po.-,Ie ....... COIIIIlltlllnalion [ lis II .. not IOcaIiIId ne ... ,he III'OIIOIC<I welllile (lnli:Jnnaticin BIIecIIecII.

An NPOES permit is '-'Iui~.

ov.r RIIe_, DOH nMIIMlJIIaIions.lnfarrnllIan, Of ~.IIon, ~ .nec:hed.

~unmM~M We defer to wastewater and drinking water concerns.

:~~KawaOka Phone: 586-4249

Fax to:Commission on Water Resources Manaoement: SR7-n~,q

, -r "NDV-01-2002 08:34am FrDm-DEPT OF HEA~,TH ENVIRONt.£NTAL t.f4GUT 8085864352 T-612 P.001/002 F-444

~~ . I'" '" I """ 'or, t.,~ " .• 'III~ .,' ttl I"'tt'l ", ,.,1, "'""""" 'III 1M! III' """,,"1 '1iI""" '.' ~ 'I' "t' N .. '; !.,. "0'.,. J,.!"., ... , '" , .. """ H''''I! "",·';'t .. I ,~_ II • .. . 1 . .• ... .. " I i:!"1""I ... '''''''lIr''' .... ~·, fl." H'M," \.~ .. '''' ....

The Department of Health, Clean Water Branch has the foll<!lwing comments: I

1. For Wen-Drilling Activities i

Any discharge to State waters of treated process wastewat,r effluent associated with well drilling activities is regulated by Hawaii Administrative Rules, Title 11, Chapter 155, Appendix I, effective Septef!1ber 22, 1997. Tr~ated process wastewater effluent covered by this. gene;rpermit .includes well drilling slurries, lubricating flUids wastewaters, and well purge wastewaters. ThiS gen ,.permlt does not cover well pump testing. The applicable Notice of Intent Forms and filing fee shall be sub itted at least thirty (30) days before the start of discharge to the' Department of Health, Clean Water Bran~at 919 Ala Moana Boulevard, Room 301, . Honolulu, Hawaii 96814-4920 or P.O. Box 3378, Honolulu, awaii 96801-3378. Inquiries may be directed to the Clean Water Branch at (808) 586-4309 or by fax at (80 ) 586-4352 .

.... . _2 ... _ .. _ ... FC)O'Yell Pump Testing --_._--_ .. - .---_ .. -_ ...• _ ......... _ ...... __ ._- --"."--' - -- --- -- -----. , . -- - -- ------_ ..... - ------- ------ -.--...

The discharger slJall take all measures necessary to preve t the discharge of pollutants from entering State waters. Such measures shall include, if necessary, contai ment of the initial discharg~ 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 fr m disturbing the darity of the receiving water. If the discharge is entering a storm drain, the dis~harger mu t obtain written pennission from the owner of that storm drain prior to discharge. Furthermore, best rna Clgement practices shall be_implemented to prevent the diScharge from collecting sediments and other pollutants prior to entering the stonn drain.

! .

. JS/cr

._. __ ---.---'-1--.-.-------

,. , Nov-Ol-ZDDZ 08:34am Froll-DEPT OF HE~I'1:~ ENVIRONt.£NTAL ~GUT 808586435Z T-61Z P.OOZ/DDZ F-444

< • ";_1/lI III, "'I tl "'~ Ii: ,- 1'- •• f II I!' !l<!!11 ,

TO:

• 2!I12 OCT 30 PH 2: 4D1I~

STATE OF HAWAII PEPARTM~NT OF LANO AND NAtURAl RESOURCES

COMMISSION ON WATER RESOURCE MANAGEMENT P.O.1IOX1I<l1

HONO~ULU. HAWAII lI6IIOII

October 28. 2002

Honorable Bruce S. Anderson, Director Department of Health

.. --_. ._- ·Attention-;····- .... -. Dennis Tulang. Wastewater Branch William Wong, Safe Drinking Water Branch Dr. Keith Kawaoka, Hazardous Evaluation and Emergency Response Alec Wong, Clean Water aranCJt&h • j .~

Gilbert S. Coloma-Agaran, Chairperson Commission on Water Resource Management .,

FROM:

SUBJECT: Well Construction/Pump Installation Permit Application Gudrun Well ewell No. 3787-04}


-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 November 27, 2002. If we dO not receive comments or a request for addftional review time by this date. we will assume that you have no comments.

Please find the attached mars to locate the proposed well. If you have any questions about this permit application. request additiona information, or request additional review time, please contact Ryan Imata of the Commission staff at 587-0255.

Ri:ss Attachment(s)

RESPONSE:

I)

11

[ I

[ l

[ I

[ ]

Jf

T1'\i& _II qualif.es as a soutee whiCh wi. &tiNe BCI a soutee Of potable Wlllef to a publiC walar &Vti'8m (defined a& 6IIrv;ng 2S or motA people illlea6t 60 days ~ year or has 15 Dr mare &ervice COtIneaion&) and mustl8CelYe DirECtor 01 HeaM apptova~l:r to lIS ule 10 ODmply witn Hawaii Admll1i&\lilliva Rulell (HAR). Tille 11. Cnaplar 20, Rulfl Relating 10 PoIaiJle Waler S)'SI8rn6. §"- .

This -'I doeli not qullliity as a source serving a public IAr8l8r sVSfllm [&a1V85 186& ttlen 2S people or mOl's ~ atlaa6t 80 deY' rr ~r or '6 service mnnec:tlonl) and if Ihe wall wator iii uI;od for Clririking. the prj_Ie owno, should to6t for bllCleriOiogiCal and chemica pra&encellllfore initialing such U58 and routillety monitOr lIIe willer quality tnereeflet. However. if future planned U&8 from IIlIs source Incraali85 10 meelllle pUblie water 5y&1am _Mion tllen Ditedor of Hlllllth 8ppt'OY81 is requirad prior 10 Implementation.

If I/le well is usalto &Upply both POtable and non-polilbla PUfII08eS In a lingle 5yd1m. 1J1e uiet shall eliminate c:rosl-<OMecIion& anel baCktlOw COnnactioll5 bY ph!r'llc:ally sepataling JXII8b1e ,tiel non1lOl8b1r: &y&tema b)' en aif Slap or iM1 IiIPPfOYeCI baclCftow pravenl8f. anc! by clearty Iilbaliflg •• noo-potable Spig01& witn wemillQ signs 10 pteYanl inBdll8ltenl consumpbOn of non-polable water. RlICkflOW prevention davic;al; IlholllCl be toUlinllly in5iJ8C*1 and ... feCI. -

II Claee flOl appear that tl1j& we" will be IIsecI Tot COft&Umptive pUrpOllel and is n~ IilolbjeGI to Safe Drinking W&ltef RegulaliClrn;.

For the applical11'1i infonnelion. a source 01 POIi&ible wellDW8ler contamination ( )11i [ ) Is nOilocatad l10ar 1he pmposad _. liite (il1fOtm8Ucn alladlad).

An NPOeS pennil iii raquilBll.

OIlIer /1Ilavilm DOH f\llesitegulaliOns. information. or rec:ornmendatiom; Bra ~chea.

No c:ommel1l&lobjec:tjon5

Phone: S"I1' - t+ 30 1 Date: l tJ ( 3 I ( 0 ~

W

DEPARTMENT OF LAND PnJ NATURAL RES~CES I ~ I: OCT 2 0 200'V OOClX'IlENT f'() •

SRCI COST F YR N>P D OBJ CTR PROJECT

S 03 ~26 ~ 1026 0752 - -- --- - ---- ---- ------- -- --- - ---- ---- ------- -- --- - ---- ---- ------- -- --- - ---- ---- ------

REMAAKS: LINE (1) Well No. LlNE (2)

LINE (3)

LINE (4)

---~~

Ken Heinemann 326-54-4828 Rayveen Ballard-Heinemann 576-74-8383 189 Iwalani Street Hilo, HI 96720 959-8525

-c:l uo.C OR ATTACHED WORKS~ET c::l - DATE:

PH ACT AI-'OlNT NAMEIDESCRIPTION "(WMKi INP\JT)

(1) 25.00 Ken Heinemann -- --- -----------------,

-- --- (2) -------------------, 0) -- --- ----------~-------.

(4) .--- --- ------------------_.

TOTAJ- 25 100

3787-04

2477

59·7869/3213

ACH ACCT: 7045

lEG fl FeU 375KEKUANAOASTREET HILO, HAWAII 96720

Independent EmplOyerS Group

MEMO _________ _

21.? ?


Mr. Ken Heinemann

o Q




October 28, 2002

Gudrun and Valdis Maurins Family Trust 507 Hop Ranch Circle Santa Rosa, CA 95403

Dear Mr, Heinemann:

GILBERT S. COLOMA-AGARAN CHAIRPERSON




LlNNEL T. NISHIOKA DEPUTY DIRECTOR

3787-04.ack,doc

Well Construction/Pump Installation Permit Application for Well No, 3787-04

We acknowledge receipt, on October 3, 2002, of your completed Well Construction/Pump Installation permit application and filing fee for the Gudrun Well (Well No, 3787-04). You can expect your application to be processed within ninety (90) days from this date,

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

If you have any questions about your permit application, please contact Ryan Imata of the Commission staff at 587-0255 or toll-free at 974-4000 (Hawaii), 274-3141 (Kauai), 984-2400 (Maui), or 1-800-468-4644 (Lanai & Molokai) extension 70255,

Sincerely,

~ U.,!\L '-E (=) A

OJ, ~'-_/ '!

U J / ) / ~<.J,

LlNNEL T. NISHIOKA Deputy Director

RI:ss

/

o o BENJAMIN J. CAYETANO GILBERT S. COLOMA-AGARAN

CHAIRPERSON GOVERNOR OF HAWAII

TO:

FROM:

SUBJECT:




October 28, 2002

Honorable Bruce S. Anderson, Director Department of Health Attention: Dennis Tulang, Wastewater Branch





LINNEL T. NISHIOKA DEPUTY DIRECTOR

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

Gilbert S. Coloma-Agaran, Chairperson i A'D j Commission on Water Resource Management ~V ' . . Well Construction/Pump Installation Permit Application Gudrun Well (Well No. 3787-04)


We would appreciate your comments on the captioned application for any conflicts or uloconsistencies withlhe programs,plans, and objectives specific to your department.~~ Please respond

by returning this cover memo form by November 27.2002. If we do not receive comments or a request for additional review time by this date, we will assume that you have no comments.



RESPONSE:

[ 1

[ 1

[ 1

[ 1

[ 1

[ 1

[ 1 [ 1

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

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

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

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

For the applicant's information, a source of possible wastewater contamination [ lis [lis not located near the proposed well site (information attached).

An NPDES permit is required.

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

No comments/objections

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

Signed: _________________________ _ Date: -------------------


GOVERNOR OF HAWAII GILBERT S. COLOMA·AGARAN

TO:




October 28, 2002

Dede Mamiya, Administrator

CtWRPERSON




lINNEL T. NISHIOKA OEPUTY DIRECTOR

FROM:

Land Division -f~; ".,...--.... , ,. ,.,~. i l. ; ~

Linnel T, Nishioka, Deputy Director '1, \.../ . Commission on Water Resource Managemedl1~V J. Ot



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 November 27! 2002. If we 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.

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

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

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

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

[ ] No objections

[ ] Other comments:

Contact Person: ________________ _ Phone: ________ _

Signed: ___________________ _ Oate: _______ _


GOVERNOR OF HAWAII GILBERT S. COLOMA-AGARAN

TO:



HONOLULU, HAWM 96809

October 28, 2002

Don Hibbard, Administrator

CHAIRPERSON




LlNNEL T. NISHIOKA DEPUTY DIRECTOR

Historic Preservation .."",~./ • /,..-, .. " . /'7 Linnel T. Nishioka, Deputy Director A/1AA-",/ -j AJ}f FROM: Commission on Water Resource Manageme.J1V;J',{ n ... J ,J, G fi \ )

-- ,_J ~ ~



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 November 27 ,2002. If we do not receive comments or a request for additional review time by this date, we will assume you have no comments.

Please find the attached maps to locate the proposed well. If you have any questions about this permit application, request additional information, or request additional review time, please contact Ryan Imata of the Commission staff at 587-0255,


RESPONSE:

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

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

[ ] No objections

[ ] Other comments:

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

Signed: ___________________ _ Date: --------

Search Results o o Page 1 of 1

.. action menu

NEW on this Action Menul

Copyright ©10/25/2002 by Hawaii Information Service

• PUBLIC RECORD DATA Property

TnrAddress F

Owner/ Lessee MAURINS, VALDIS & GUDRUN

Land Beds Baths area

21,780 sqft

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

Living area

http://webre2.hawaiiinformation.comlREsearchlAsplFunctionslProperty/search. asp 10/25/2002

Department of Commerce & caumer Affairs - State of Hawaii - PVLoarch Results

Department of Commerce and Consumer Affairs Professional and Vocational Licensing Division

Professional and \' ocational ticensing Search

LICENSE SCREEN

[ Look up License Type Codes-> ] Please click a link listed below to display the other screen.

***** GENERAL LICENSEE *****

LIC ID: CT-16653 Activellnactive: ACTIVE

NAME: FRED PAGE DRILLING INTERNATIONAL INC TRADE NAME: STATUS: CURRENT, VALID & IN GOOD STANDING ENTITY: CORPORATION BUSINESS CODE: ORIG LIC DATE: 4/25/91 CLASS PREFIX: C RESTRICTION:

EXPIRE DATE: 9/30/04 SPECIAL PRIVILEGE: EDUCATION CODE:

BUSINESS ADDR: 15-3105 HALELO PL PAHOA HI 96778 MAILING ADDR: POBOX 1434 PAHOA HI 96778

Click here to enter search criteria for prior complaints history ->

Page 1 of 1

For prior complaints and disciplinary history, contact licensing and business information center at (808)587-3295.

<-Back New Search->

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

Copyright 2002 Professional and Vocational Licensing Division

Hawaii State homepaae II DCCAII Professional and Vocational Licensina Division

http://www.ehawaiigov .org/serv/pvl? _ a=d& _ f=n&1ictp=CT &licno= 16653&off=&nm=F ... 10/25/2002

Well No.

Well Name

Applicant

3787-04

Gudrun

o

o

SECTION 1: WELL LOCATION INFORMATION

Island

Aquifer System

Aquifer Sector

HAWAII

#####

#####

data

Date of Review

Reviewer

Proposed Use

o

Proposed Withdrawal

System Sustainable Yield

#!!iUUNU] RRI

#VALUEI

o 17

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

Elevation at top of casing

Ground Elevation

Cement Grout

Rock Packing

Hole Diameter

Total Depth

Estimated Head

Calculated Aquifer Thickness

County Water Supply (YIN ?)

_ft.,m.s.1.

2050 ft.

-

Solid Casing

Material

Designation

Length

Diameter

Wall Thickness

Casing

Material

Designation

Length

Diameter

Wall Thickness

Openings

Open Hole

Length

Diameter

ft.

in.

SECTION 3: CHECKLIST (values to check are shaded)

Well Depth

Theoretical Thickness of Aquifer

1/4 Aquifer Thickness

Depth of Well below Sea Level

Well Casing

Minimum Wall Thickness

Material County or Non-County

Minimum Thickness per standards

Wall Thickness Provided Minimum Length of Solid Casing

90% of ground to top of aquifer

Length of solid casing Provided

Casing Material

Annular Space

Depth of Grouting

Calculated Depth of Grouting

Depth of Grouting provided

Thickness of Annular Space

Steel

2050 ft.

512.5 ft.

Oft.

non-county

#N/A in.

0.250 in.

9 ft. ------=6~0 ft.

ASTMA53

7 ft. ------=5~O ft.

o in.

okay (refer to HWCPIS Section 2.2)

(disregard if the well is not basal)

#N/A (refer to HWCPIS Section 2.4 c)

(disregard this if this is a non-county well)

okay (refer to HWCPIS Section 2.4 d)

okay (refer to HWCPIS Section 2.4 e)

If the cell above reads #NlA, reference HWCPIS)

okay

too small

Page 1

(refer to HWCPIS Section 2.6 c)

(refer to HWCPIS Section 2.6 d)

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State of Hawaii COMMISSICCbN-WATER RESOURCE MANA&:lv,ENT Department~ and Natural Resources APPLICATION FOR PERMIT IQ Well Construction and/or apump Installation

Instructions: Please print in ink or type and send completed application with attachments to the Commission

For Official Use Only: /

on Water Resource Management, P.O. Box 621, Honolulu, Hawaii 96809. Application must be accompanied by u-' 2 DC; 3 5 copies and a non-refundable filing fee of $25.00 payable to the Dept. of Land and Natural Resources. The

AID • ~ I 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 http://www.state.hi.usldlnr/cwrm.

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

1. (a) 0 WELL OWNER: Gudrun Maurins FamilYContactPerson: Ken HeinemanN 'Phone: l'J57//,f' . . vJUN!J Trus t

MaIling Address:

Fax: fi5 '':;If.30 . . E-mail: <4?YH~~"'41yr (b) 0 LANDOWNE~udrur:...Maurlns Famlly ContactPerson:Ken HeinemaIW Phone: p~S 7,>,z;o

,. VA&D7.S Trust Mailing Address: :::fO? "y'9P~#c!',..y ~&e,6- ..$AREALas.!'! CA·· '~2'03 Fax: E-mail: ((I<e?&WA?AU&-""~ @,vp;rn,A,>",- -~

(c) XJ CONTRACTORFred Page Drilling

Mailing Address: p" 0" Box 1 434

Int 'cl,ntactPerson: Fred Page PhonJ.808) 965-5339

Pahoa HI 96778

Fax: (808) 965-5339 E-mail: Lic#: C - 16653 (circle one@-57a, or A)

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

2. WELL NAME: (,uPAetl.Ml' Island:

Address

Hawaii

: ?t:. Zone Sec Plat Parcel

Attach: (a) portion of a 7.5-Minute Series USGS topographic map (scale 1 :24,000) with well location labeled and include the name of the quad map (b) a property tax map. showing well location referenced to established property boundaries

3. PROPOSED WORK: Xl Construct New Well IX Install New Pump" (check all that apply) o Modify Existing Well" o Modify Pump·

o Abandon/Seal"

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

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

Is this well part of a battery of wel!s? DYes C~~C (?i6Bsc aescriDe)

5. PROPOSED PUMPING RATE: __ --Il-;;JSL----__ _ gallons per minute

6. PROPOSED USE: 0 Municipal (including hotels. stores. etc.) o Industrial

(check a/l that apply) 00 Domestic (individual. noncommercial water system)

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

o Irrigation (crop)

o Military

7. (a) PROPOSED AMOUNT OF WITHDRAWAL:

(b) METHOD OF FLOW MEASUREMENT:

OTHER IMPORTANT INFORMATION:

o No. of Acres:

o Other (explain):

__ --'5~0~QL--______ gallons per day

KJ Flowmeter 0 Open-pipe 0 Weir o Orifice o Other(explain)

8. LEGAL REQUIREMENTS: If required. these permits must be obtained before the Commission can legally issue a permit.

Conservation District Use Penn It (COUP) To find out if a COUP is necessary. call DLNR Land Division at 587-0414

~ Not Required If required. date approved _____ _

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

~ Not Required If required. date published in OEQC bulletin _____ _

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

If required. date apllfoved _____ _

9. REMARKS, EXPLANATIONS:

(if more space is needed, please attach additional sheet)

NOTE: Signing below indicates the signatories understand and swear that the information provided on this application is accurate and true to the best of their knowledge. Further. the signatories understand that approval of this application attaches the following standard conditions: 1) the proposed work is to be completed within two (2) years of the approval date; 2) the contractor shall submit to the Commission a well completion/abandonment report within 60 days after the completion date of the permitted work; 3) monthly water use data shall be submitted to the CommiSSion; 4) such approval shall not constitute a determination of correlative water rights and shall not guarantee the pump capacity or future use up to the permitted pump capacity; 5) in the event that the application is not completed correctly. any permit may be suspended until the item is brought In to compliance, and any work done while the permit is in suspension may result in fines of up to $1000/day. Fred Page Dri llin

Well Owner 64'Atru#r~~/.5 Landowner q4!/~AZ4'.A/ t-~~S Contractor International Inl (print legibly) ~A~~AI".:s. (print legibly) /I-f.Au4:,v$ (print legibly) ~!~

Signature :$ ~ Signature ~~" Signature ~ uate $-",7-,pz- Date "j_.r7~P~~ Date 9/24/200

For official use only Latitude _______ Aquifer System No. Longit\Jde State Well No.

WCPIPA Form 8/21/01

10. PROPOSED WELL SECTION (Plea:>e attach schematic if different from diagram pro':;rfed below)

Hole mameter: ~ in.

Elevation at top of casing ..fA.- ft., msl* lr-[ ___ --I*-.---~ .-.-:~.

Minimum of 2' Radius & 4" Thick Concrete Pad (to contain benchml surveyed to nearest 0.01 ft.)

l'0:l~ G d EI a-A 1:-· ... ·: ,:,,', · .•• 1 .. :.:1 r roun evation: n..u I,. ::..:-.:.;.;; 'C:-' ·:..L-Y--~"/F,,,,,"-Fl //r,r""""",.

. , •.. =::.:: ...

ft., msl*

Please refer to the

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

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

: oil: ' •. , w with applicable standards.

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

/Annular space between I ~U: U ~ -- Solid Casing: (:<: 90% x (Ground Elev.-Water Level Elev»

hole and casinp (min,3"t . , Ii.l ;'.:.:': ~ Total Length: 6 0 ft.

I. 3 in. I V ~.:;; ~':;~I ~ . r '. . ... w ~ .. :.:' :~/:' §

Nominal Diameter: yt50 in.

Wall Thickness: in.

Bottom Elevation: 60 ft., msl*

Total Depth

60 ft.

Rock or G~:' :a<k;", :~ I:; ~I; ~ Material: G ,J 0 ~N

Open Casing: ~Perforated o Screen

o Crushed Basalt Total Length: rn ft.

~ Rounded Gravel [I ~~ ~~ V Estimated Water Level - -¥- ~~ 'j ~-:-;

Nominal Diameter: 6 in.

Wall Thickness: --'l'S0 in.

Bottom Elevation: 60 ft., msl* Elevation: ,:~ .. i

- @-i ~ -:-- r-note: Neither bentonite nor mud should be used in

_~5:11.10!...ft. msl* .<:RtllrRtRrl 70nR rlllrinn rlril/ion

Open Hole: Length: _____________ ft.

Diameter: _____________ in .

. -----,-------- Bottom Elevation: ft., msl*

* The approximate elevation must be referenced to mean sea level (msl) at the time of application filing. Final elevations of well components shall ~:s s\.!cmit'(:ri ;.., .!-.,. Wf'Ol! r."rnpl"l.ionl\l\lell Ah ~ndonment reports and referenced to a benchmark which has been eS(3blished by a surveyor licensed by the State.

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

Bottom Elevation of Well Limit = (Water Elevation. 41 x Water l~vel ElevatiOn)

Example: Estimated + 2 ft. Water Level Elev. -. Bottom Elevation orWell Limit = (2 - 41 ~ (2)) = -18,5 ft,

Solid Casing Material: Carbon Steel: compliant with (check one or mom): 0 ANSIIAWWA C200 0 API Spec. 5L ~ ASTM A53 0 ASTM A 139

And compliant with (check one or more): 0 ASTM A242 D 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 80

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

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

o Centrifugally Cast Res:n Pipe conforming to ASTM 02997

o Reinforced Plastic Mortar Pressure Pipe conforming to ASTM 03517

o Glass Fiber Reinforcec: Resin Pressure Pipe conforming to AWWA C950

o PTFE Fluorocarbon Tubing conforming to ASTM 03296

o FEP Fluorocarbon Tubing ;;onforming to ASTM 03296

Open ';asln9 Malaria;; Carbon Steel: compliant with (check one or more): 0 ANSI/AWWA C200 0 API Spec. 5L )fi ASTM A53 0 ASTM A 139

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

Stainless Steel: (check one): 0 ASTM A409 (production wells) 0 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): 0 Schedule 40 0 Schedule 80 0 Schedule 120

Thermoset Plastic: (check one) 0 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

o

.

_USGS science for a changing world

U.S. DEPARTMENT OF THE INTERIOR U.S. GEOLOGICAL SURVEY

155°00' '91""·E '92 '94 57'30" '95

U.S. DEPARTMENT OF DEFENSE NATIONAL IMAGERY AND MAPPING AGENCY

'96 '97 '98

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I-I

HanyKim Mayor

September 11, 2002

Mr. Kenneth Heinemann 189 Iwalani Street Hilo, HI 96720

Dear Mr. Heinemann:

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QIounfu of ~nfuaii PLANNING DEPARTMENT

25 Aupuni Street, Room 109 • Hila, Hawaii 96720-4252 (808) 961-8288 • Fax (808) 961-8742

Christopher 1. Yuen Director

Roy R. Takemoto A!D ~ I Deputy Director

SUBJECT: Special Management Area Use Permit Assessment Application (SMAA 02-38) SMA Minor Permit No. 125

Applicant: Kenneth Heinemann Request: Water well for a proposed single-family dwelling TMK: 1-5-62: 96, Keaau, Puna, Hawaii

This is to acknowledge receipt of your Special Management Area Use Permit Assessment Application for a water well to serve a proposed single-family dwelling.

According to your submittal, the activity will not exceed $125,000 in valuation and will not have a significant adverse impact to coastal resources. Special Management Area Minor Use Permit No. 125 (with conditions) is hereby issued for the construction of a water well within the County's Special Management Area.

Please comply with all of the terms and conditions of approval of SMA Minor Use Permit No. 125. Should you have any further questions, please contact us at 961-8288.

Sincerely,

CH(l6J.;;;: Planning Director

PF:pak p:\wpwin60\czm\SMAA\2002\SMAA02-38Heinemann.doc

Enclosure cc: Long Range Planning

Department of Public Works

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SPECIAL MANAGEMENT AREA MINOR USE PERMIT NO. 125

Approved Development:

Water well for a proposed single-family dwelling.

Applicant's Name: Kenneth Heinemann

TMK: 1-4-062: 096 Land Area: .50 acres

C'.llllle ......... CIInS 11 .... llcl •• IICllllllr 2.1-l .. 1111 ...... StIIIII. rlllrIIll."' ••• Clll._ ••••• lni

Check all objectives and policies found to be consistent with proposed development. Issuance of SMA Minor Use Permit requires that activity be consistent with all objectives & policies.

[&J Development will not have any significant adverse environmental or ecological effect, except as such adverse effect is minimized to the extent practicable and clearly outweighed by public health, safety, or compelling public interest. Such adverse effect shall include, but not be limited to, the potential cumulative impact of individual developments, each one of which taken in itself might not have a substantial adverse effect and the elimination of planning options.

[Bl The proposed development is consistent with the Hawaii County General Plan and Zoning Code.

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Check all objectives and policies found to be consistent with proposed development. Issuance of SMA Minor Use Permit requires that activity be consistent with all objectives & policies.

IXI The proposed development does not conflict with the following objectives of Chapter 205A, Hawaii Revised Statutes to: IXI Provide coastal recreational opportunities accessible to the public.

I&l Protect, preserve, and where desirable, restore those natural and man-made historic and pre-historic resources in the coastal zone management area that are significant in Hawaiian and American history and culture.

I&l Protect, preserve, and where desirable, restore or improve the quality of coastal scenic and open space resources.

I&l Protect valuable coastal ecosystems from disruption and minimize adverse impacts on all coastal ecosystems.

I&l Provide public or private facilities and improvements important to the State's economy in suitable locations.

I&l Reduce hazard to life and property from tsunami, storm waves, stream flooding, erosion, subsidence and pollution.

I&l Improve the development review process, communication, and public participation in the management of coastal resources and hazards.

I&l Stimulate public awareness, education, and participation in coastal management.

I&l Protect beaches for public use and recreation.

The proposed development is consistent with the following policies of Chapter 205A, Hawaii Revised Statutes relating to:

I&l Recreational resources I&l Historic resources IXI Scenic and Open Space resources I&l Coastal Ecosystems IXI Economic Uses IXI Coastal Hazards I&l Managing Development I&l Public Participation

I&l Beach Protection I&l The proposed development conforms with the requirements of Hawaii Revised Statutes

Chapter 343, Environmental Impact

- -

I. The applicant(s), its successors or assigns shall be responsible for complying with all stated conditions of approval.

2. SMA Minor Permit No. 125 is valid for a period of not more than three (3) years from the Planning Director's date of approval, indicated below.

3. The applicant(s), its successors or assigns shall comply with all other laws, rules, regulations and requirements, including the Department of Public Works.

4. Request(s) for an extension oftime shall be submitted to the Planning Director. Pursuant to SMA Rule 9-11E, written requests shall be filed sixty (60) days before the expiration of this permit. The request shall state the length of time requested and the reasons for the time extension.

5. The Planning Director may grant an extension of time upon the following circumstances:

a) non-performance is a result of unforeseen conditions or conditions beyond the control of the applicant, successors, assigns, and are not a result of their fault or negligence;

b) granting of the time extension would not be contrary to the original reasons for the granting of the permit; and

c) the time extension granted shall be for a period not to exceed the period originally granted for performance (i.e., a condition to be performed within one year may be extended for up to one additional year).

6. Should any of the conditions not be met or substantially complied with in a timely fashion, the Director may initiate procedures to revoke the permit.

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APPROVED:

Date Planning Director

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