memo and r~u~rllp (ver. q i wcr 1 check for well no. from ... · memo and r~u~rllp (ver. 09/09/08)...

· ,

MEMO and R~u~RLlP (ver. 09/09/08) Q 12/24/08

I WCR 1 Check for Well No. 5552-03 (regulation/survey route)

1. From Charley/Deni~Ryan:> (initial)

2. Pump Tests Check Diane England '<!:2bnitial)

Yes No

~pm no test required Step-Drawdown Test: followed WCPI Stds 0 0

analysis attached 0 0

Constant Rate Test.: followed WCPI Stds .A ,.\~ 0 analysis attached ~ I ~ 0

Potential Well Interference:

Potential Stream Impacts:

Additional Testing or Data Required:

Pump Test Comments Attached:

Proposed Pump Capacity is.OK.:

0<50 gpm no test required

3. Well Log Check Geology Code for Well Index: _[*. _ Fm Name:~:.u4-.,b.4~= z=t-_=initial) J

R. To/res (initial) 4. Construction Check Mitch Ohye ________ (initial) Yes No If no, describe deficiency / 2 rU-C" ~ L-H-H 5

\ , ""-;1 u--:49'O f~ l?~ .1.0~, '> 17,ot<> rl

data complete g i:l/ followed Special Cond & elevations /.. 0 well database updated .0" 0

NAD27

NAD83

Latitude

:... '. \. 'I.· \ \. '... j cJJ-.·t>f(.~ S ,

\ \\ / ~~ ---------~--~~~~-7~-----------------------------------~

----l,,='-...:.....-- (initial) take action based on above analysis e /~ 5. Charley/Den._........,._

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

2 COUNTY COMMENTS (DWS/SMA) 'I... 3 DOH COMMENTS ;(.

4 DLNR COMMENTS (LD/OCCUDHP) X 5 WCR 1 Accept

6 WELL CONST. COMPLETION CERTIFICATE

~rV~ /not necessary- onlyWCP or BOTH. r(lsidl

} To be sent to driller/pump installer

<------ To Landowner

} Staff internal chec s

6. Roy ~ (i check (Entered WCR 1IWCCC accept date into da 7. Sus~ (initial) finalize 8. Ken (in signature 9. Mitch initial) Entered PIP issue date if attached/required 10. Charley/De e/Ryan ile

o • ~ o LINDA LINGLE

GOVERNOR OF HAWAII

Mr. Bill Borkan 49 BSBHA

STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES

COMMISSION ON WATER RESOURCE MANAGEMENT P.O. BOX 621

HONOLULU, HAWAII 96809

May 19,2009 I

68-1107 Honokaope Place Kohala Coast, HI 96743

Dear Mr. Borkan:

Certificate of Pump Installation Completion for BSB Well, Well No. 5552-03 (TMK 6-8-033:053)

LAURA H. THIELEN CHAIRPERSON

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

CHIYOME L. FUKINO, M.D. DONNA FAY K. KIYOSAKI, P.E.

LAWRENCE H. MilKE, M.D., J.D.

KEN C. KAWAHARA, P.E. DEPUTY DIRECTOR

5552-03.cpi

We are pleased to inform you that the Pump Installation work permitted for the BSB Well (Well No. 5552-03) is complete and acceptable and welcome you as a new member to the community of well owners and ground water users in Hawaii. This certificate of pump installation completion allows you to commence pumping your well for reasonable & beneficial water use.

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

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

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

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

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

/

~Ar. Bill Borkan Page 2

o o May 19,2009

5. Your approved pump has a capacity of 50 gpm at a head of 390 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.

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

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

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

If you have any questions, please contact 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.

RI:ss Encl: Water y se Report Forms

c: Hawaii Department of Water Supply Derrick Moreira

Sincerely,

o o LINDA LINGLE

GOVERNOR OF HAWAII LAURA H. THIELEN

CHAIRPERSON




May 19,2009 I

MEREDITH J. CHING JAMES A FRAZIER NEAL S. FUJIWARA

CHIYOME L. FUKINO, M.D. DONNA FAY K. KIYOSAKI, P.E. LAWRENCE H. MilKE, M.D., J.D.


5552-03.cwc

Mr. Bill Borkan 49 BSBHA 68-1107 Honokaope Place Kohala Coast, HI 96743

Dear Mr. Borkan:

Certificate of Well Construction Completion for Well No. 5552-03 (TMK 6-8-033:053)

We are pleased to inform you that the Well Construction work permitted for the BSB Well (Well No. 5552-03) is complete and acceptable and welcome you as a new member to the community of well owners and ground water 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:

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

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

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

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

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

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

If you have any questions, please contact 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).

RI:ss

c: Hawaii Department of Water Supply Derrick Moreira

KE c.KAW~'~ De uty Direc:fARJ

LINDA LINGLE GOVERNOR OF HAWAII

Mr. Derrick Moreira

o o




May 19,2009

Derrick's Well Drilling and Pump Service P.O. Box 2187 Keeau, HI 96749

Dear Mr. Moreira:

Well Completion Report Parts I & II for Well No. 5552-03





LAWRENCE H MilKE, M.D., J.D.

We received youtfo'ell Completion Report Parts I & II for the BSB Well (Well No. 5552-03) on March 11, 2009 and acknowledge that they are complete.

This completes your obligation under the well construction and pump installation permits. Certificates of well construction completion and pump installation completion will be issued to the well operator/landowner and you will receive a copy. These certificates transfer responsibility of specific aspects of well usage and maintenance from you to the well operator/landowner.

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

Sincerely,

t 4L C. KA AHARA, P.E.

D puty Direc or

Rl:ss

c: 49BSBHA

'------------.. -,.-,~-~-••....

/

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

Well Number 5552-03 Well Name bsb Ground Elevation 58 Cement Grout 48 Grouting Method other Hole Diameter 12 Total Depth 68 Water Level 4 Depth to water 54 Public Water Supply Well? no Solid Casing Material I pvc plastic plastic Solid Casing Specification Schedule 4.0 Solid Casing Length 60 Solid Casing Diameter 6 Solid Casing Wall Thickness 0.280 Open Casing Length 8

Results

Well Depth Theoretical Thickness of Aquifer 164 1/4 Aquifer Thickness 41

\'DElptbdfWeJfbelow Sea Level .';. : '::. ';::':' ",.1.0' okay.'t:~."Y".l\;.,;? •.... (:Fi. :"< Secudnl\2 .. 2 Well Casing

Minimum Wall Thickness Material I pvc plastiC

Minimum Thickness per standards no requirement I:;, :~~iWa7/:ff:hickness provided !i '> .. :; "" .;::~:":!~; ;';;0728 nd:ata'oCla[d';: :'i:< . .; SeCtion;2.4{b ):. Minimum Length of Solid Casing

90% of ground to top of aquifer 48.6 ~:i.:"'!''§jfgtfto,solidcasing Provided , .. ::':: i.';<.<:0.'~};:~ ~aO. dkay::;~ ,;,:t:~.;".":ll,; •... ",~~s;·r;ll\;,;i~ S~idn2:lJ.(C) ...••.•• I 'e'aslng'Maferial Scheaull!'40 '.::' ·.)·:·;:,;·;'r,~r, ini:c.omp'laric.e;'J'.~(';''!.:l\~\~ ... ·l;:';j Si!Ctlbb':2:A( d) . .I(forcpilc only - 'check for 200' limit) dka~ SeCtlon2;!".(d) . Annular Space

Depth of Grouting Calculated Depth of Grouting 37.8

l:i;Oejith of Grouting provided . '.i 48 okay'·.: • .' .... Section·2.6(c) Minimum Annular Space required 2

' •. rhickness Of Annular Space " .. ,. ;;. i .. ;;:::;;·~3 dkay:; • . .... ; ..... ' .. : .. Section2.6( d) ...

Ryan,

o Derrick Moreira <[email protected]>

03/10/2009 08:54 AM Please respond to

moreira [email protected]

o To Ryan R Imata <Ryan.R.lmata@hawaiLgov>

cc

bcc

Subject State Well #5552-03

FYI, the chloride for this well was 4500ppm and temerature 74.2. Do you need me to send a revised completi reflecting this?

Cynthia

Cynthia Moreira Derrick's Well Drilling & Pump Services LLC P.O. Box 2187 Keaau, HI 96749 (808) 982-7627 Office (808) 982-7698 Fax e-mail: [email protected]

State of Ha£ii 0 COMMISSION ON WATER RESOURCE MANAGEMENT Deparbnent of Land and Natural Resources

WELL COMPLETION REPORT - PART I __________ ~VV_e~II_C~o~n~s~tru~ct~io~n ____________________________________ a

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

For Official Use Only:

DEC 23 A 9: 03 not accept incomplete reports. This form shall be submitted within 60 days of the completion of work. For c! " . , _. assistance, please consult the Hawaii Well Construdion and Pump Installation Standards or call the ,,' "'''lISS:UN n,i.J W to rl '" Regulation Bran~ at 587-0225. For updates to this form or additional information, please visit our website at 1\ ': C~~. ~,~ '. t, ':;~ 11 i-~ r \, httD:/Iwww.state.hl.usldlnr/cwnn! ";" f7 j:j, !

1. State Well No.: 5552-03 Well Name: BSB Well Island: Hawaii -'-'.;;.....;;....-.---

2. Address: 68-1107 Honokaope Place, Kohala Coast, Hl96743 Tax Map Key: _6_-_8-0_3_3_:0_5_3 _____ _

3. Drilling Company: Derrick's Well Drilling & pump Services, LLC

4. Drilling method used during contruction: 181 Rotary 0 Percussion 0 Other (describe)

5. Date Well Construction (drilled ,cased ,grouted) completed: 10/30/2008 Attach completed Drl118I'. Log monthldaytyear

6. VVas the subject well cored? 0 Yes 181 No

7. Step-Drawdown Test completed? 181 No 0 Yes Attach Step-Drawdown Test fonn (12117/97 SDPTD Fonn)

Constant uifer Test r~lmnIAt~~rI?

Infolrmallil:MtillobolJId be before any pump tests are installed) I '?

?' A.r'i't1U)5 • /

Temperature: 79.8 OF

referenced /0 mean sea depth /0 the water level.

12. As-built section filled in completely 0

CRPTD

13. Photograph of well and concrete pad showing benchmark on concrete pad attached 0

14. GPS coordinates provided in degrees, minutes, seconds 0

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. Rema~s: __________________________________________________________________ ___

Licensed Driller (print) Derrick Moreira ~~~-------------------------

D~~ C-57 Lie. No. C-28001 -----------------

Date December 9,2008 Signature

12. AS-BUILT V .. L SECTION (Please attach as-built if different fI liagram provided below) ~ ~

12 in. Elevation at top of casing ~ ft., msl*

;' Hole Diameter:

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

Bench mark elevation:

58.6 ft., msl* o {Survey to 0.01 ft.)

181 (Estimated)

Grouting method

o Positive Displacement (if annular space is less than two inches, attach photo of tremie)

181 Other

Total Depth

~ft.

Solid Casing Material:

Cement Grout: ...i!L- 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) -L.in.

Rock or Gravel Packing

20 ft

__ 4:L-_ ft. msl*

(item 11 from page 1)

*msl = mean sea level

..... ,.,...~.~.~-,.jir.-~~". Elevation: 58 ft., msl* OSurveyed I8IEstimated

Please refer to the HAWAll WELL CONSTRUCTION AND PUMP INSTALLATION STANDARDS

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

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

Length: 60 ft. Nominal Diameter: 6 in. Wall Thickness: .280 in.

Bottom Elevation: -2 ft., msl*

Open Casing: 0 Perforated 0 Screen

Length: 8 ft. Nominal Diameter: ___ -=.6=-=-_____ , in. Wall Thickness: ___ ~.2~8~0~---~ in. Bottom Elevation: -10 ft., msl*

Open Hole:

Length: ____ ......:n"'-/a=-_______ ft.

Diameter: _____________ in.

Bottom Elevation: ft., msl*

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

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

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

ASS Plastic conforming to ASTM F480 and ASTM D1527: (check one) 0 Schedule 40 0 Schedule 80

PVC Plastic conforming to ASTM F480 and (ASTM D1785 or ASTM D2241): (check one): 181 Schedule 40 0 Schedule 80 0 Schedule 120

Thermoset Plastic: (check one) 0 Filament Wound Resin Pipe conforming to ASTM D2996

o Centrifugally Cast Resin Pipe conforming to ASTM D2997

o Reinforced Plastic Mortar Pressure Pipe conforming to ASTM D3517

o Glass Fiber Reinforced Resin Pressure Pipe conforming to AINVVA C950

o PTFE Fluorocarbon Tubing conforming to ASTM D3296

o FEP Fluorocarbon Tubing conforming to ASTM D3296

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

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

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

ABS Plastic conforming to ASTM F480 and ASTM D1527: (check one) 0 Schedule 40 0 Schedule 80

PVC Plastic conforming to ASTM F480 and (ASTM D1785 or ASTM D2241): (check one): 181 Schedule 40 0 Schedule 80 0 Schedule 120

Thermoset Plastic: (check one) 0 Filament Wound Resin Pipe conforming to ASTM D2996

o Centrifugally Cast Resin Pipe conforming to ASTM D2997

o Reinforced Plastic Mortar Pressure Pipe conforming to ASTM D3517

o Glass Fiber Reinforced Resin Pressure Pipe conforming to AINVVA C950

o PTFE Fluorocarbon Tubing conforming to ASTM D3296

o FEP Fluorocarbon Tubing conforming to ASTM D3296

,.,"'" .. r" __ .. n, .. n,,,,. n ___ "" _,c r

o o DRILLER'S LOG

WELL NUMBER: 5552-03 - BSB Well In addition to the driller's log, if a geologic log was prepared, please submit with this form

Depths (II.) Rock Desaiption Water Level CI- Dates Depths (II.) Rock Desaiplion Water Level CI- Dates

_0_ to 10 Soft Cinders 0 10/27 to

0 10/27 __ to __

~ to ~ Soft to Medium 0 10/28 to

~to~ Medium 0 10/28 __ to __

~ to ~ Medium to Hard 0 ~ _to __

~ to 68 Soft Cinders 4 1000 10/28 to

to to -- --to to -- --to to

to to

to __ to_

to to

to to

to to

to __ to __

to to

to __ to __

to to

Remarks:

weR1 Form 6112107 Page 3 of 5

Attach photos of completed well and concrete pad

o o

I' NAD83: Latitwae: 155 degrees 52 min 24 sec ' "~

-I:eAgitu.de: 19 degrees 56 min 11 sec ;~"'\

EXAMPLE

Lat: 19"36'45" .................... -0: 154'"57'18"

------.---.. ----------------....L----------------'-----L..-_______ -I

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

Provide Latitude and Longitude of well referenced to NAD83 to nearest second

weR1 Form 6112107 Page 4 of 5

..

o

o

Well ID: Analysis Date: Geologist:

o Pump Test Analysis - Comments

5552-03 12/31108 Diane England

o

1. The database lists the well use as irrigation; however, the reported chlorides in the well are 48,000ppm. Such a high chloride content would correspond to supersaturated water. Is this value actually Total Dissolved Solids (TDS) or Total Salinity?

2. Such a high salinity or TDS value (48,000ppm) corresponds to sea water. What will be irrigated with this water? Or is the intended use something other than irrigation?

3. The operating conditions of the pump (50 gpm at a head of 390ft) are significantly higher than necessary based on the depth of the well (68ft). Please explain the need for the additional 310ft of head?

4. The proposed pump rate (50gpm) requires an 8hr constant rate test to be conducted. Given the capacity for the installed pump to produce significantly more water than 50gpm, it is especially important for the test to be conducted and the data submitted to CWRM for review.

Page 1 of 1

o MEMO and ROUTE SLIP (ver.9/09/2008)

o 12/24/08

WCR 2 Check for Well No. 5552-03 (survey to regulation memo)

1. ~ ___ (initial)

2. Pump Tests Check' special condition of PIP? Yes/No) D. England ___ (initial)

If no, describe deficiency

Step-Drawdown Test:

followed WCPI Stds 0 0 analysis attached 0 0 0<70 gpm no test required

Aquifer Pump Test:

followed WCPI Stds 0 0 T & S analysis attached 0 0 0<50 gpm no test required

Potential Well Interference: 0 0 Potential Stream Impacts: 0 0 stream names:

Additional Testing or Data Required: 0 0

Pump Test Comments Attached: 0 0

Proposed Pump Capacity is OK.: 0 0

',-

3. Pump Installation Check Mitch Ohye (initial) R. Torres ... ~.Jinitial) No If nOI describe deficiency

4.

data complete followed Special Cond & Elev.

well database updated

Charley/ Oeni@yan~

ATTACHMENTS FOR ACCEPTANCE: 1WCR2 ACCEPTANCE LETTER

2PUMP INST. COMPLETION CERTIFICATE

I

/0 0 0.· 0 '.-r'

0 0

(initial) take action based on above analysis

1" To be sent to driller

3METER INSTALL. REPORT (IF NECCESSSRY) __ _ J To be sent to landowner/operator 4WUR

} Staff internal checks

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

6. Susan Hoagbin (initial) finalize

7. Ken (initial) signature

8. Faith Ching (initial) enter into WUR database

9. Charley/ oeni@yanJ!;le

State of Ha~ii 0 COMMISSION ON WATER RESOURCE MANAGEMENT Department of Land and Natural Resources WELL COMPLETION REPORT - PART II

/ /

For Official Use Only.; , ,//

RECE1VED I

Pump Installation [B DEC 23 9 Instructions: Please print in ink or type and send completed report (with attachments, if applicable) to the A : 0 3 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 COHHISSIC'N ON WATLP, Regulation Branch at 587-0225. For updates to this form or additional information, please visit our website at )L"S(·')I'·~ IJ' \' . ~ r" ~JE1' http://www.state.hi.us/dlnr/cwrm/ \r" 'I" .l," ";";',)Cl"'l 'r1 T

1. State Well No.: 5552-03 Well Name:BSB Well Island:Hawaii

2. Address: 68-1107 HonokaoEe Place, Kohala Coast, HI 96743 Tax Map Key:6-8-033:053

3. Pump Installation Company:Derrick's Well Drillin~ & PumE Services, LLC

4. Date Pump Installed: 10/31/2008 monthlday/year

5. PERMANENT PUMP INFORMATION

Pump Type, Make, Serial No.: Franklin, FPS4400, 08E19155005

Rated Capacity: 50 gpm at head of: 390 ft.

Motor Type, H.P., Voltage, rpm: Franklin Submersible, 7.5HP, 230V, 3450RPM

Pump type (check one):

o Deep Well Turbine o Rotary o Propeller 181 Submersible o Rotary-Displacement o ReCiprocating o Centrifugal o Rotary-Gear o Impulse

6. Method of flow measurement:

181 Flowmeter Manufacturer Flow Solutions Model no. TM200-N Size 2"

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.

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

10. Well Owner Company 49 BSBHA Contact Bill Borkan

Address 68-1107 Honokaope, Kohala Coast, HI 96743

Phone 808-887-6442 Fax 808-887-0972

11. Land Owner Company Same Contact Same

Address Same

Phone Same Fax Same

12. Remarks TDH of 390' calculated due to friction loss and PSI at well head

Pump Installation Contractor (print) Derrick Moreira C-57/C-57a1A Lic. No. C-28001

Signature 0~~ Date December 21,2008

-. o o

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

Bench mark elevation surveyed to nearest 0.01 ft. =

59 ft. mean sea level

j

i

• ~ •. ~: : . .; ........... : . . ..; . . . .... . .... ·.A .• ·:.· .... ' .• ·;.

Elevation of top of chase tube n/a ft. mean sea level

-----,----

Pump intake depth = 60.6 ft. (referenced to bench mark)

Chase tube depth = n/a ft . .!;-_-I-_ (referenced to bench mark)

If airline installed, bottom of airline elevation =

58.6 ft. mean sea level

WCR2 Form 2126107 Page 2 of 2

o Q t!~ ~

'~"" 6" Submersible Pump

29

Well ID: Analysis Date: Geologist:

Step Drawdown Test

o Pump Test Analysis - Comments

5552-03 5/6/09 Diane England

Test Date: 3/4/09

Deviations From Pump Test Requirements

o

1. Step Drawdown Test not required. Proposed pump rate < 70gpm. 2. Water level measurements not collected at proscribed intervals. Water levels

collected at five minute intervals beginning ten minutes into test.

Other Comments 1. None.

Constant Rate Pumping Test

Deviations From Pump Test Requirements 1. No deviations from the "Aquifer Pump Test Procedures" guidance.

Drawdown Curve Comments 1. Given the location of the well within a few hundred feet inland from the coast,

and the brackish nature of the water, mild to moderate tidal influences are expected in the well. The constant rate test was begun two hours after high tide on 3/4/09 with falling tides during the duration of the test. The maximum drawdown measured in the well is close to, but less than, the maximum low tide change for the day. The aquifer response to pumping is likely masked in the constant rate data by tidal influence. For this reason, T&K analysis was not performed on the pump test data.

Based on the geology of the well site, and a maximum combined drawdown (pump effects and tidal influence) of one foot, T & K are assumed high and a 50gpm pump in the well is not anticipated to adversely impact the aquifer.

Well Interference & Stream Impacts

1. Based on preliminary analysis, no adverse stream or well impacts are expected.

Other Comments

1. Question 3 from Pump Test Analysis - Comments #1 has not been answered.

Proposed Pump Capacity OK? : YES

Page 1 of 1

o

o 100 o

0.5

i .... ~

~

c ~ 0

"C ~ e! c

1.5

2

120

100 -E c.. .2l 80 .... II) .. cu a:: 60 Cl c '0. 40 E j Il.

20

o o 100

Constant Rate Pump Test Well 5552-03 (3/4/09)

200

Time (min)

300

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

Pumping Rate Well 5552-03 (3/4/09)

....

200 300

Time (min)

o

400 500 600

.-.

....

400 500 600

o o Constant Rate Test (5552-03)

Elapsed Time Drawdown (ft)

Pump Rates (min) (gpm)

0 0 80 1 0.74 80 9 0.74 80 10 0.73 80 20 0.73 80 30 0.73 80 40 0.73 80 60 0.73 80 70 0.74 80 80 0.74 80 90 0.74 80 100 0.74 80 110 0.74 80 120 0.75 80 180 0.86 80 240 0.91 80 300 1.01 80 360 1.01 80 420 0.96 80 480 0.91 80

Average: 80.00

o

o 10 20 30 0

0.1

0.2 Z' CII ~ 0.3 c ~ 0.4 0

j 0.5 E

i..oc~ ............... ~ ~ ~ ~ ~

c 0.6

0.7

0.8

80

70

E 60 a.. 5 S 50 oS ~ 40 Cl c os.. 30 E ::s 20 D..

10

0 0 10 20 30

Step Drawdown Test Well 5552-03 (3/4/09)

Time (min)

40 50 60

'\ \ -

~ '--

Pumping Rate Well 5552-03 (3/4/09)

5

40 50 60

Time (min)

o

70 80 90 100

....... .. ..... ~ ~

70 80 90 100

o Step-Drawdown Test (5552-03) Pumping Rate (5552-03)

Time (min) Drawdown (ft) Time (min) Discharge (gpm) 0 0 0 50 1 0.45 30 50 2 0.45 31 60 4 0.45 60 60 6 0.45 61 70 8 0.45 90 70 10 0.45 15 0.45 20 0.45 25 0.45 30 0.45 35 0.45 40 0.6 45 0.6 50 0.6 Step Change 55 0.6 60 0.6 65 0.75 70 0.75 75 0.75 80 0.75 85 0.73 90 0.73

1.000 ,.., vl ~ 0.500 ..., 011

E 0.000 ::! t ..., -0.500 011 ;

-1.000

-1.500 03/04 00:00

o

03/04 08:00

Predicted WL --

NOAA/NOS/CO-OPS Verified Water Level vs. Predicted Plot

1617760 Hilo, HI fro~ 2009/03/04 - 2009/03/05

03/04 03/05 03/05 16:00 00:00 08:00

Date/Ti~e (GMT)

(obs-Pred) ><

o Page 1 of 1

03/05 03/06 16:00 00:00

Observed WL +

http://tidesandcurrents.noaa.gov 1 cgi -bin-mpl data ---'p1ot.cgi ?mins=&datum=4&unit= 1 &stn= 1... 5/6/2009

/ ;)ata Retrieval, ,

-.-

iIfii'CS, Htft Page

S1iatiollolQQ:i.1617760

Tide / Water Level Data

Tid~QfJ,;s Tide Data Station Date

CurOOE'iJata Units:

Me~i<lI~eal MSL Ob~~~~'?tI\lm : Coril:'lMtp-ltlj<lm:

------- --------

PORrr617760 20090304 1617760 20090304

OPer<e:!p?qI(f9re.a~ 90304 SYSi'm. 7 7 6 0 20090304 Be!1f~~.,~e'i6090304

1617760 20090304 Dat~'g17760 20090304

HarilnMit?60 20090304 conMit~Ei'rl1:yO 20090304

1617760 20090304 Sea1lG~eJ fg'6'd~ 0090304

1617760 20090304 1617760 20090304 1617760 20090304 1617760 20090304 1617760 20090304 1617760 20090304 1617760 20090304 1617760 20090304 1617760 20090304 1617760 20090304 1617760 20090304 1617760 20090304 1617760 20090304 1617760 20090305 1617760 20090305 1617760 20090305 1617760 20090305 1617760 20090305 1617760 20090305 1617760 20090305 1617760 20090305 1617760 20090305 1617760 20090305 1617760 20090305 1617760 20090305 1617760 20090305 1617760 20090305 1617760 20090305 1617760 20090305 1617760 20090305 1617760 20090305 1617760 20090305 1617760 20090305 1617760 20090305 1617760 20090305 1617760 20090305 1617760 20090305

Time

GMT

00:00 01:00 02:00 03:00 04:00 05:00 06:00 07:00 08:00 09:00 10:00 11:00 12:00 13:00 14:00 15:00 16:00 17:00 18:00 19:00 20:00 21:00 22:00 23:00 00:00 01:00 02:00 03:00 04:00 05:00 06:00 07:00 08:00 09:00 10:00 11:00 12:00 13: 00 14:00 15:00 16:00 17:00 18:00 19:00 20:00 21:00 22:00 23:00

o o Page 1 of2

Hilo, HI: Data Inventory

Page HeJp Historic Tide Data

Pred 6 Vrfy HH 1 1

Feet Feet 100.00 100.00

1.10 0.99 -1.16 -1.14

------- -------

-1.16 -0.63 -0.99 -0.48 -0.70 -0.28 -0.32 0.06 0.08 0.36 0.45 0.62 0.73 0.85 0.90 0.99 0.93 0.99 ~T 0.85 0.91

~ STA~\ C. \2 . Ie s..I-0.67 0.66 0.46 0.39 0.24 0.12 0.05 -0.05

-0.08 -0.12 -0.16 -0.28 -0.19 -0.34 -0.21 -0.28

c. f.<. Test--0.24 -0.3.§. -, ~f\Jb -0.31 -0.38 -0.44 -0.47 -0.61 -0.70 -0.80 -0.81 -0.98 -0.98 -1.10 -1.14 L( -1.13 -1.11 -1.04 -1.11 -0.81 -0.73 -0.47 -0.45 -0.06 -0.17 0.36 0.24 0.72 0.55 0.98 0.74 1.10 0.95 \1T 1. 06 0.91 0.88 0.71 0.61 0.61 0.30 0.34 0.00 0.05

-0.24 -0.22 -0.37 -0.34 -0.42 -0.46 -0.39 -0.46 -0.34 -0.48 -0.31 -0.40 -0.34 -0.35 -0.45 -0.55 -0.63 -0.63

http://tidesandcurrents.noaa.gov/ data _ menu.shtml ?bdate=20090304&edate=20090305&wl_... 5/6/2009

Data Retrieval

Begin Date: '-1 M-ar-3-, [4ii 12009 gm

Disclaimers ~ 1/23/2005

Contact Us

o Page 2 of2 ".

End Date: r-IM-ar-ii-·~ !5iikQ09:m

Interval: Datum: Data Units: & Feet

Time Zone: r Local

(LST/LDT)

I Hourly WL II I MSL iii r Meters

home I ~ I programs I partnerships I education I b@2 Privacy Policy About CO-OPS For CO-OPS Employees Only Revised

Ii GMT r LST

NOAA I National Ocean Service

http://tidesandcurrents.noaa.gov/data _menu. shtml ?bdate=200903 04&edate=200903 05&wl_... 5/6/2009

, "

FROM: ROY

TO:

CHENG, C. CHING, F. CHONG,R. DANBARA, S. ENGLAND, D. FUJII, N. HARDY,R. HOAGBIN, S. ICE, C.

-J- IMATA, R. _ KAWAHARA, K.

KIMURA, J.

p'

'-' COMMISSION ON WATER RESOURCE MANAGEMENT

DATE:

INIT. TO:

KUNIMURA.I. MILLS, D. OHYE, L. OHYE, M. OSHIRO, K. SAKODA, E. SWANSON, S. TORRES, R. UYENO, D. YODA,K. YOSHINAGA, M.

INIT:

SUSPENSE DATE:

FOR:

__ Approval Signature Information

(11/08)

PLEASE:

See Me Review & Comment Take Action Type Draft

__ Type Final File

__ Xerox _ copies

o o SDPTD Fonn 1012512004

STEP-DRAWDOWN PUMP TEST DATA / (not required for wells producing < 100,000 gpd or 70 gpm)

Pumped Well No. 0.55 ~ - 03 Observation Well No. _________ _

Pumped Well Name 4'1 (j1S<.f') Distance between Obs. & Pumped Well ft.

Target Q Yr gpm Reference pt. for depth to water 11'? ~ ft. msl

Static Water Level @ start of test - .}. t? ft. msl Water level measurements by: t3 electrical sounder 0 pressure transducer 0 airline

START TEST Date: (J lfil) l' Time of day: ?: t9 0 <"L--

Flow Meter Reading Start: ILl "'? 1.".{ gallons • c:J

':;G Iirlh UJ Suggested Actual Depth Drawdown Pumping ~. .. is tabl . for: :0

Elapsed Elapsed to S rate Temp. D~~ rn time Time water Q EC cr _oF o ObSJivation ~I 0

t t (unadjusted (at least 3 or : ;'0 -

~ (nearest to nearest steps) _oC ::. ':; -(min) (min} 0.1 ft) 0.1 ft) (gpm) (JUIIhOS) (rngll) 'c-: ;;iRemarks /'

-45 tJ71-f al.IPs- 0 · Start~ Step&:' - ..

-30 07 )tJ IPI,tpr; 0 --.~ -.. .. '- -~ ...

-15 tJZ4.s .Jd"~ 0 ~I"

-" /,-, -. ..-.

0 tJKO('/ (prJ.. I .$..5- .so 1 Start pump ..s % r::/;:;, - ·

+/ 1 IJ[tJJ itJJ-- () ·l(s l~··O v'

t). 1.5 tJro;;' fp)~tJ · '-IS ,t;72 · 1-4 2 1)~((4- 1/:;.0 .tls J"?J

Itl/ 2.5 tJftJt- it'1· 0 · 'Is .s-~ S:oJ.. 74.)... ..,8'" 3 on),f (P;.. ·0 ·'fs j-C?

If/12 4 CJlio trJ.O .~r- J, - c."

+/.7 5 tJtl.5 I/J.O - '-1.5- J-tJ if,s-tJtJ 611kU tj' d"/JJJ~ 1I11~u:,.v -I.5l.0 6 tJr~o if;" .U ·!i.e 13-' 0) 71./-:).

, ~-CJ

'+dS 7 OaJ-~~ 67J.o ''1,.5- ~.-~ · tLz; 8 ~f:j{) t, tl-. (? · ¥S· -.j-& ¥. 78' 11~p 7~-'J . 'I c/J.z)/.lJ 117 ",c~ 4-)j .... 10 LJtf:~5 IP.J./£ . ~b .1Lt2. te(5-h" .. ~ t".£luu", __ ~, ~ +40 15 ~t47J (p,').IS • {pI? IC'u ~·97 7c,.,. ' ~"0/~

+-1-8- 20 O!Z/:s-- {PJ./£ .~() 1//1 · "tSD 25 Oa3v (p~./z;- .c,t? £tJ >of%" 30

2 Od-~3" 0).. /e;- ·/?fJ vtl " /-[ d,~p~·1h nr/U< ~

+&0 of()o IPd./~ . ~(J I/(l '/-. fy 7 tr.j . Vaha 3 rJl.Il.n.N Hittj IPJ-.jo .7s 70 'f5/ltl

. 7&0/1"'" -+~S- o9a.)-

r7lJ c.'J'l/ t? bJ.}~t) ·7S- 70 4. ft- 7(,·0 •

, ' o SOPTO Fonn 1012512004 o

, . Suggested Actual Depth Drawdown Pumping Data in this table is for: Elapsed Elapsed to S rate Temp. o Pumped Well

time Time water Q EC cr _OF o Observation Well t t (unadjusted (at least 3 or

(nearest to nearest steps) _oC Remarks (min) (min) 0.1 ft) 0.1 ft) (gpm) (J.Lmhos) (mgII)

7-75 1J115 (P.J-~:30 . 7s- 70 .'i%P 07.HJ £.J-.J.JD .75 70 '-f60 OtjJ£:' 1RJ...,d . Aj 7() ">-. c)CJ 1s~ (, .

-r10 O;(}O ~J..J-f . "7.!J l.tk~ · Q ~1rtJ1M lit 1;?t~1P-L .... ,

·

·

·

·

·

·

· · ·

·

·

·

o Suggested Actual Depth Drawdown Pumping Elapsed Elapsed to S rate Temp.

time Time water Q EC cr _oF t t (unadjusted (at least 3 or

(nearest to nearest steps) _oC 0.1 ft) 0.1 ft) (gpm) (fJlTlhos) (mglI) (min) (min)

4

0

1 starting pumping rate Q 2 minimum length of step period of constant pumping rate 3 minimum mandatory Chloride (Cn measurement/sampling at end of every step 4 Use same ending drawdown figure as start for recovery

·

·

·

SDPTDFonn1~~

Data in this table is for: a Pumped Well a Observation Well

Remari<s

Max possible duration, water level or quality did not stabilize for any 24 period

Begin recovery data next page Flow meter reading at end of pumped period:

gals

o SDPTDFonn10n~ <-£ d ~w d-u tA.h1 e('l~

suggested Actual Depth Recovery elapsed elapsed To Drawdown Pumping Data in this table is for:

time time Water S rate Temp. o Pumped Well t t (unadjusted Q EC cr _oF o Observation Well (nearest to nearest or Remarks

(min) (min) 0.1 Il) 0.1 Il) (gpm) (l1'1lhos) mgII) °C

0 0 0 · Pump off, start recovery

+/ 1 0101 (p I. t..) • tYD 0

-t-J, 1.5 o'la.), kl. '70 . oS" 0 · +0 2 1)933 (Pl. {,9' . vi 0

1M; 2.5 £YiJ·l It; I. t.tJ « 1J.f 0

-II? 3 IJtJ:J~ I./.t.' .Oe/ 0

+(P 4 tY93b fp/.~ C; ,t?1 0

+7 5 Otl~7 Cd.~'l .04 0

-1-1 6 t>f'8rf 4-1. 4 9 . t.J¥ 0

It- Cj 7 LJ'lJ9 tf.1- f .01 0

-rIO 8 09~ kl.c,9 .04 0

10 0

15 0 · 20 0 · 25 0

30 0

40 0 · 50 0

60 0

70 0 · 80 0

90 0

100 0

150 0 · 200 0

250 0 ~80% recovery achieved o 80% recovery not achieved

END TEST Date: J 14/:2? Time of day: !.,4t:L ADDITIONAL REMARKS: ___________________ _

Person in charge of pu~ (Print)'; J),..yYe<.L IhfCk< I'lL •

Signature: ~~ ~ The signature above indicates that the data reported on this fonn is accurate and true to the best of the person's knowledge who operated this pump test.

, ' o o CONSTANT -RATE PUMP TEST DATA

(not required for wells producing < 50 gpm)

Observation Well No.

CRPTD Fonn 1012512004

Pumped Well No. 5S?,;J..-o.3

Pumped Well Name 4q [!)0 e Target Q ill gpm

Distance between Obs. & Pumped Well ___ ft.

Reference pt. for depth to water a. v ft. msl

Static Water Level @ start of test ·-d. 0 ft. msl Water level measurements by: ~ electrical sounder 0 pressure transducer 0 airline

START TEST Date: () - 4 -t? ., Time of day: f.' 4r !Z f

Flow Meter Reading Start: /~ 714-.3 gallons

Suggested Actual Depth Drawclown Data in this table is for: elapsed elapsed to S Pumping ~p. o Pumped Well

time time water rate _OF o Observation Well t t (unadjusted Q EC cr or

(nearest to nearest _oC (min} (min) 0.1 ft) 0.1 ft) (gpm) (J1mhos) (mgJI) Remarits

-45 ()f4o u/.bf Start test

-30 ~766 /,./. v'l -15 jO/O

0 0 0.00 1 Start pump/Cr taken

+--1 1 / tJ// b;, t/-J ,11- f7) 4. tj,;. SO"e> ·/10"" 111.1 . I d d/.'f?1h liT ~ OPV)

-11 1.5 {,J. J~ ·7'1 , (/

1 ~J.-o ,rl? -110 2 /cl.JO it:; rJ. '1.1 ·73 at) . .. 1)-0 2.5 /t?4tJ b-/').4J .. l..J f'(J 4.1Z :1L3· -f-.?/{i 3 Jo::tZ; ?J-. tid.. ·73 y~

+40 4 //~C' ? 1.4-.).. .?.J fl'J . +(;iJ 5 1/1 t? t>J.. 'f).. ; 7.3 cf-t2 tJ.9Q ~~ Z(p,,· !Ld14.J:b Jh ~ J1

'-110 6 (P.;...1/t3 .7f " v II.HJ Yo

-fro 7 /1,3lJ b d .t/-3 ·71 J7;J

'-I r Q 8 /1.jlJ /'.J...~ ·7'1- J"o £/. tjr 7(',(,.. " ... .L'( a ~-e~. Ti 'L. "'~.' '<\

+/~i? 10 IIsv "'.:J.."~ . 7 t./- /FL) /

-rift? 15 /~Ot'/ (pJ,.. t/ ~ ·7,/ 00 -II}..o 20 /diP t..J.44 ,7s- ~O 0; ()e? ~"o lJ..K· V rf),:l5 .J.h J~~1JU...~ i-If~ 25 lalo h;;'.53~ , tiP ro

--v

4·'i1 11ov~7 77·(" . 9 d"~/)~ Ih ~.h_U

-tJ..t/.tJ 30 1410 &1.&0 . " ot::J $Ot?tJ 77.3· ' 17

Iif", &/ / c) d W'!2;: I-h r.uFu"

+.3;,40 /.6{0 ?.l.7b /,01 ~;J I/.,? 71.'1· 0

SC>t?&' I tJ dh fl<, 11/.--" J.-...

fdlPt' 50 /&10 ?,A. 70 /.01 ?l---; S,c)J. 10$1)0 177. o. fj' 1I . d iAJ f') -< fh !?UU.;L

1-ri'.kI 60 1710 . 9~ g?> ¥S7J1.7 7..J.y· ,

CP~. (pS s--.c9~ I q"", ~ t1~ iJ-J -"'" ~ ,

o o CRPTDFonn1~2~~

Suggested Actual Depth Drawdown Data in this table is for: elapsed elapsed to S Pumping Temp. o Pumped Well

time time water rate _OF o Observation Well t t (unadjusted Q EC cr or

(nearest to nearest _oC (min) (min) 0.1 ft) 0.1 ft) (gpm) ijunhOS} (mgII) RemarKs

t-1fJJ 70 1"10 ~;-fLt7 ·91 Fv 15,,°1 ~qz;p 7<.5'-·L· . Cjfl J.<# P":' III ?~ -80 · 90 es-I-Iu 1:( DiY J'1 Viti - b ~/1>.. ~I<...t. :::C-&v'~ ::~cl

100 ,

150 · 200 250 · 300 400

1 cr sample taken

500 600 700 · 800

1 cr sample taken

900 1000 1 cr sample taken

1500 1 cr sample taken

2000 1 cr sample taken · 2500

1 cr sample taken

3000 1 cr sample taken ·


5000 1 cr sample taken ·





10000 Max possible duration, water level or quality did not stabilize for any 24 period

" Begin recovery data next page

0 Flow meter reading at end of pumped period:

~d;d:L9. ~- gals

1 Chloride sampling required 2 Use same ending drawdown figure as start for recovery

o o CRPTD Fonn 10/2Sf2004

Suggested Actual Depth Recovery Data in this table is for: elapsed elapsed to Drawdown Pumping Temp. o Pumped Well

time time water S rate _oF o Observation Well t t (unadjusted Q EC cr or Remart<s (nearest to nearest _oC

(min) (min} 0.1 ft) 0.1 ft) (gpm) (jIIllhos) (mgn)

0 0 0 · Start recovery

T 1 I fIt (PI. 70 0

1.5 0

+ 2 IfL).... (P/·7K" 0

2.5 0 · t 3 /t13 I.e!. 7 f' 0 · + 4 Ind (pl. 7'1 0

+ 5 I nz;- (PI- 7E' 0

+ 6 /8}fL ~/.7? 0 · 1- 7 / I'I7 t/.l~ 0

+ 8 /3'/~ /;/. III 0

10 0 · 15 0 · 20 0

25 0

30 0

40 0 · 50 0 · 60 0

70 0

80 0

90 0 · 100 0 · 150 0

200 0

250 0 o 80% recovery achieved o 80% recovery not achieved

END TEST Date: 0/ til) l' Time of day: 6: I CJ I , ADDITIONALREMARKS:~< C&Ld b.u&! 4~B&-d&d CS)vi-

Person in charge of pump)eSt)(print~: ;... ~ mv'>1!-eke-

Signature: U ~ ~ The signature above indicates that the date reported on this form is accurate and true to the best of the person's knowledge who operated this pump test.

AISSION ON WATER RESOURCE MANAGEMENQ ROUTE SLIP FOR PERMIT ISSUANCE 6/25/08. .

FROM: RYAN

CHENG, C. CHING, F. CHONG, R. DANBARA, S. ENGLAND, D. FUJII, N.

-1-HARDY, R. 1M -2-HOAGBIN, S.

ICE,C. IMATA, R.

-3-KAWAHARA, K.==

WELL NUMBER 5552-03

DATE: 8/25/08

KIMURA, J. KUNIMURA, I. LEROUX, E.

--MILLS,D. OHYE, L.

4 OHYE, M. --SAKOOA, E.

SWANSON, S. UYENO, D.

--YODA,K. YOSHINAGA, M.

WELL NAME

application type BOTH 1 WCP COVER LETTER )0 2 WCP 3 WELL CHECK PRINTOUT ~

proposed well section issu~

4 PIP COVER LETTER ~/ 5 PIP ../'

tJ

COMMENTS: date rec'd 6 SOWB @11 7 WWB 8 CWB 9 LO

10 HP 11 LUC ~CD 12 OCCL -~D 13 SMA in SMA 14 BWS

NOTES: ~

DRILLER Derrick Moreira

BSB

issues?

Derrick's Drilling and Pump Service 28002

TMK

phone fax cell

PUMP CAPACITY WELL OWNER LANDOWNER COMMENT DEADLINE

P.O. Box 2187 Keeau 982-7627

~ 6-8-033:053

100 49 BSBHA 49 BSBHA

HI

5/21/08

SUSPENSE DATE:

Approval -3-Signature -4-lnformation

96749

PLEASE:

See Me -1-Review & Comment

Take Action --Type Draft -2-Type Final --File

Xerox copies


Ref: 5552-03.pip

Mr. Derrick Moreira

o o




Derrick's Drilling and Pump Service P.O. Box 2187 Keeau, III 96749

Dear Mr. Moreira:

Pump Installation Permit BSB Well (Well No. 5552-03)





September 3, 2008

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

Special Conditions

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

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. Also, please contact the Noise Radiation and Indoor Air Quality Branch at 586-4700 to check compliance with construction noise permit requirements for this project.

3. The permittee shall conduct aquifer pump tests in accordance with the Hawaii Well Construction and Pump Installation Standards (revised February 2004) on the latest aquifer pump test data forms, which are available by contacting staff or on the web at www.hawaii.gov/dlnr/cwrm/forms.htm.

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

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

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

If you have any questions, please call Ryan Imata of the Commission staffat 587-0255.

c: 49 BSBHA (with applicable comments - DOH SDWB, WWB, CWB) USGS HawaiiDWS

_________ ._, _._. _~._ •• ____ .,. __ ... ,~"""I'·"W·''''''·

/

OPUMP INSTALLATION PERMI~ BSB Well. Well No. 5552-03

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

In accordance with Department of Land and Natural Resources, Commission on Water Resource Management's Administrative Rules, Section 13-168, entitled "Water Use, Wells, and Stream Diversion Works", this document permits the pump installation for BSB Well (Well No. 5552-03) at TMK 6-8-033:053, Hawaii, 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 100 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 Chairperson no later than the date the permit expires.

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

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

Date of Approval: Expiration Date:

August 19,2008 August 19,2010

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:

Printed Name: Derrick Moreira

C-57, C-57a, or A License #: C-28001 Date: -------Derrick's Drilling and Pump

Firm or Title: Service -------------Please sign both copies of this permit, return one to the Chairperson, and retain the other for your records.

Attachments

/

... LINDA LINGLE

GOVERNOR OF HAWAII

Ref: 5552-03.wcp

Mr. Derrick Moreira

o o




Derrick's Drilling and Pump Service P.O. Box 2187 Keeau, ill 96749

Dear Mr. Moreira:

Well Construction Permit BSB Well (Well No. 5552-03)





KEN C. KAWAHARA, P.E. DEPUTY DtRECTOR

September 4, 2008

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

1. Attached for your information are copies of the Department of Health's (DOH) review comments. Please note DOH's requirements related to discharge of effluent from well drilling and testing activities. Also, please contact the Noise Radiation and Indoor Air Quality Branch at 586-4700 to check compliance with construction noise permit requirements for this project.

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/cwnnlfonns.htm.

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 construction site during construction. Be advised that you may be subject to fines of up to $5,000 per day for any violations of your permit conditions starting from the permit approval date.·

If you have any questions, please call Ryan Imata of the Commission staff at 587-0255.

S~incew (L t~~ L ~A RA H. THIE EN \ Ch irperson

Enclosures

c: 49 BSBHA (with applicable comments - DOH SDWB, WWB, CWB) USGS Hawaii DWS

/

o o WELL CONSTRUCTION PERMIT

BSB Well, Well No. 5552-03 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 ofBSB Well (Well No. 5552-03) at TMK 6-8-033:053, Hawaii, subject to the Hawaii Well Construction & Pump Installation Standards (HWCPIS - February 2004) which include but are not limited to the following conditions:

I.

2.

3.

4.

5.

6.

7.

8.

9.

10.

II.

12.

13.

14.

IS.

The ChailJ2erson 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 apumping test in accordance with the HWCPIS (the latest rump test worksheet can be obtained by contacting Commission staff or at www.hawaii.gov/dlnr/cwrmlCorms.htm). The permittee shal submit 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 Charrperson. 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 (l/4) of the theoretical thickness (41 times initial head) of the basal ground water unless otherwise authorized by the Chairperson.

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

In the event that historically significant remains such as artifacts, burials or concentrations of shells or charcoal are encountered during construction, the permittee shall stop work and immediately contact the Department of Land and Natural Resources' State Historic Preservation DivIsion. Work may recommence only after written concurrence by the State Histonc Preservation Division.

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

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

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

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

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

If the well is not to be used it must be properly 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 § 13-168- 2(1) 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 m accordance with Hawaii Administrative Rules §13-168-12(1).

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

Date of Approval: August 19, 2008 Expiration Date: August 19,2010

C=LA \Co

I have read the conditions and terms ofthis permit and understand them. I accept and agree to meetthese 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:

Printed Name: Derrick Moreira

C-S7 License #: C-28001 ......:::::....=:::..::.c::..=.... ___ _ Date:

Derrick's Drilling and Finn or Title: Pump Service

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

Attachment

I

Results

Well Depth Theoretical Thickness of Aquifer 1/4 Aquifer Thickness

;!i!aep.tnj~fWellf6el~ . Well Casing

Minimum Wall Thickness

o

Material pvc plastic Minimum Thickness per standards no requirement

205 51.25

:.,~;WiilE:'lfhia 'i' '~ili rjj~i;~'ltU~'ii'~i::"lf~~~!;~i';i\;;~:',~~;~8 no:iiUlodard, I ...... Ii

Minimum Length of Solid Casing 90% of ground to top of aquifer 42.3

I Section 2.4(b)

';.I;:,';.tf;111WilbfsSblr(f'c;'asiilgU?i'b"Jdea. ?~;~~(: 1,6~~f;:~:i;;~i'ij:!fJ':\ iU;;l,R' ()J(ayi;,~'i. :5, ..... ' "', , ;"i, i Sectioh 2.4( c) !.~p"V"<" f1;':f~i;;'lf;~' ~i:4"i~i~Hi\)~I~i:~ ::~;:i SCfleQtlle;'~:i~11:ij:~j~i:i[r;~~:?1I<TI!f' iff c()mblian~Er" . '. i': Saplion 2.4( d)

)rrolpv~!ij'i1lr*icneckfQf:200~JimitJ;fJc:r··\'i i~.i::;;':':r.n·i!;!r'!~i},':pi;::n~~: QJ(ay·T.~ i, Section 2.4(d) Annular Space

Depth of Grouting Calculated Depth of Grouting

Minimum Annular Space required ;ThlcR1('4~fj(!d.ofitjlalSp·a:C91f::i\i;: :i;'f " ;~i.~i'i ';'."; "i, ~ :\'fi:

32.9 Section 2.6(c)

2 ~i!J:;i' okay;,} .', : ..•..... Section 2.6(d)

o LINDA LINGLE

GOVERNOR OF HAWAII

Q

RECf/VEe LAND DIVISION



1. JUt 30 p CHIYOME L. FUKINO, M.D. 14: 4" DONNA FAY K. KIYOSAKI, P.E.


f'E-Dr "\;" f

STATE OF HAWAII N}f'tLir; .tJ,.: l/"i\'D &: KEN C. KAWAHARA, P.E.

DEPUTY DIRECTOR

TO:

FROM:

SUBJECT:

DEPARTMENT OF LAND AND NATURAL RES06~f~ESL I;~- SOURer:-" COMMISSION ON WATER RESOURCE MANJAUEM'l::NTi A ¥.1 ~ 1,L: ~

P.O. BOX 621 ' • '''1 HONOLULU, HAWAII 96809

July 29, 2008

Morris Atta, Administrator

Land Division f 1 L Ken C. Kawahara, P.E., Deputy Director . e. IJ,tJAt Commission on Water Resource Management

Well ConstructionlPump Installation Permit Ap ication BSB Well (Well No. 5552-03) TMK 6-8-033:053

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 August 29, 2008. Ifwe do not receive comments or a request for additional review time by this date, we will assume you have no comments.

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

RESPONSE: G ~; ~ [ ] A water lease/permit is required of this applicant and an application for such will be i~~ted by our division.";; .~ ."

;-) '? tJ C~:~ •• .:_~ ~.kl

r';,"-: ... -:.~ IXX A water lease/permit is not required of this applicant.

!" Ci ,'-;1

.< ;11 C1

A water lease/permit has been obtained by the applicant through lease no. ____ ?:_,_'.-._': __ c:::J __ _ -

[ ]

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

[ ] No objections

OCX Other comments: Parcel 53 (well site) is a roadway parcel within the Black Sands Beach subdivision either owned by the county or is a private road.

Contact Person: ___ -'"GwaLLr-J'i----L.MwaLLr....l.t ...... i ..... oL-_______ _ Phone: 587-0421

Signed: ~~ Date: --------AUG 1 8 2008

08/21/2008 08:14 %18742

Mr. Chris Yuen, Director Planning Department County of Hawaii 10.1 Pauahi Street Hilo, HI 96720

Dear Mr. Yuen:

PLANNING

c

STATE OF HAWAII DEPAI~TMENT OF I.ANDAND NAtURAL RESOURCES

COMMISSIf)N ON WATER RESOURCE MANAGEMENT P.o, eO)(621

HONOLULU. HAWAII 96609

July 29, 2008

Special Management Area Use Pennit Requirements for Well Construc1iollIPump Installation Pennit Application

~m Well (Well No. 5552-03)

"",

PAGE 01

LAURA H, THlh5N CM.'.IRPf:1t80N

MEA~DITH J. CHING JAMES A. "f<AZleR NeAL S. FUJIWARA

CHtvOME L FUKINO. M.D. DONNA FAV I{ KIYOSAKI. P.e:. LAWReNce: H MIIK~, M.D .• J.D

'<EN C. KAWAHARA P.E. C!!'-UTYO~!:C:~

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

We would appreciate your comments on the captioned application with regard to the SMA permitting requirements specific to your division. .elease respond by retnrnin,Ltbis cover- memo form by AUll,llst 29. 2008. If we do llot receive comments or a request for additional review time by this date, we will assume you have 110

comments.

Please find the attached maps to loc!:ltc the proposed well. If you haVE: any questions Ilbout this pcnnit application, request additional information, or request additional re\'iew time, please contact Ryan Imata of the Commission staff at. 587-0255.

Sincerely.

SCANNED

BP.~~V~' IJ.r LA RA H TH~L "'r · Ch ir'persQn HIFLEN

RI:s5

RESPONSE:

~ This well project [X;1 req'lires [ ] does nCll require a SMA. If a SMA is required it &d has [ 1 ha$ not been approved

and iii is [ ] is not currently active. (RMA fib. :2 effective MarGh -4, 1976)

[ j Other relevant ruksiregularions, infonna1ion, or recommendations ate attached.

[ J No ()bje~tion5

[ ] Other (;ommcnt~:

Contact Person: 'E. Imanura PhQl1e: (808) 961-8:288

Signed: S0-~- Date: f:! !?J./O.8\-__ _

AUG-21-2008 08:24AM FAX: 9618742 ID:DLNR CWRM PAGE: 001 R=96%


c o RFf'Fl\'r-:- fJ

"-'-- -~

08 AUG II p2' 03 R£C[JVEl1

~~~~.:.",n:l MENT OF HEALTH

~"', ::-' ~\; .~.

AUG -4 A b: q' '. .-- • .'. ~>. : STATE OF HAWAallc-t:"D

; PEMRTMENT OF LAND AND NATURAL ~~fsF ICE "COMMISSION ON WATER RESOURCE MANAGEMENT

P.O. BOXS21 HONOLULU, HAWAII 96809

July 29, 2008






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

Tomas See, Chief, Wastewater Branch Stuart Yamada, Chief, Safe Drinking Water Branch Alec Wong, Chief, Clean Water Branch

vDr. Keith Kawaoka, Office of Hazarfld Eyaluation and Emer?ency Response

FROM: C~aura H. Thielen, Chairperson r!. .. ~~ 1....... Commission on Water Resource Management

SUBJECT: Well ConstructionlPump Installation Permit App cation BSB Well (Well No. 5552-03)


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 August 29, 2008. If we do not receive comments or a request for additional review time by this date, we will assume that you have no comments.

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

RI:ss Attachment(s)

RESPONSE: [ I

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

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

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

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

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

An NPDES permit is required.

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

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

kua-04-2008 08:39am From-DEPT OF HEAL~~NVIRONMENTAL MNGMT ~

8085864352 T-OOl P.004/004 F-780

tL¥.~

\JLh~' CtU LINDA LlNGLIO

IlO'olERNQJ.I OJ! rrllr.WA11 LAURA 11. THlE~EN

Cr1A~PIiRaQN

STATE OF HAWAII DEPARTME;NT OF LAND AND NATURAL RESOURCES

COMMISSION ON WATER RESOURCI: MANAGEMENT ".0.80X621


July 29, 2008

MEREDITIo! J. CHING JAMES A, FRAZIIOR NEA~ S. PUJIWARA

CHIYOME L. FI,lI<INO, M.D. OONNA FAY K KIYOSAKI P.E. LAWRENCE H. MIlKE. M.O~. J.D.

\

I<I!N C. KAWAHARA, ".E. \"tl De:!I'UTV ~1~iiCTOf; ~. w't

:"10 \. .,.4~

(fw ~~~~U\1

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

Tomas See, Chief, Wastewater Branch

l uan Yamada, Chief, Safe Drinking Water Branch lee Wong, Chief, Clean Water Branch

FROM: ~aura H. Thielen, Chairperson (;v ~

Dr. Keith Kawaoka, Office of Hazard alu~~on~and Emerjency Response

1"v" Commission on Water Resource Management

SUBJECT: Well Construction!Pump Installation Pennit App BSB Well (Well No. 5552-03)

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

We would appreciate your comments on the captioned application for any conflicts Or inconsistencies with the programs, plans, and objectives specific to your department. Please respond by returning this cover memo tonn by August 29, 2008. If we do not receive comments or a request for additional review time by miSdate, 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 Ryan Imata of the Commission staff at 587-0255.

Rl:ss Attaclunent(s)

RESPONSE: r 1

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[ 1

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r 1

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'to( ( I

This wl>ll Q~aht'it>~ ~, ~ ,ollr"" which willacrve as a &OW"C .. ()f paQble Willer to a pllbht Wlltlll' ~Y''''llI (defined as SQ'V'ng 25 Dr more people or Joa., 60 day. ""'Y.""""'" 15 <>r mOl''' •• rvi~e 00"""""iOn6) and ""~ _ci,," DirccI0l'01l:W,.lth ~ppr(>"~1 w:iw: to its l.ISe to comply with Hawaii Adl'llilli$Ir;)IIVC a."I.~ (NAA), TItle I I. Chapler 20.1l1..IM R..I!IIing 10 PotAble WIlIer SystelllS, §11-20-29,

This well dOili nOl qu.lify~.;\ 'QI\I1le seJVing a ,P!lblit wal~t ~y~bmi ~i~ I~ than 25 PdClpI. <>r !'IIQJ. people at least 60 l1"y~ per ~ar or 15 BBI'\Il~. c""""",i"n~) ~1I<1 ihh<o ,...",11 water IS used for dflllk.il1g, fha ]>I'iv"", owner .h .... ld ""St fa' ~acl.n"lol;!i".l and chellli ... 1 pJ1!Mn ... bofore initiatin& s~cb \lIe ;\nd routinely monitor lhe water qulity thl!lro..t\er. Howeva-. ifnllute plalUl..d u •• from 1I1i5 sOlltCC incroasas 10 m~llhc public Mle.' SySlalll .... fUlition Ilion Director c.fHcaldl approval is r~'lu1r.<I p.io" 'Q implr;meDtalion.

If 1M well is u.od Ie .lIPply both potable and OOll-pblilbl. PL1lP"~1O$ 111 a single S)'!I1eIll, 1M u,'" -hiall oliminate cr()8s-oon~".liQn. Wld bacl<flow eOlln .. ~tion. by physioally BcpilIBting pOlabl. 'IIl<lllon-potiWle 5)'Stema by so ait iI'IP or lII1 ;!pproy;d Qacldlo\¥ prevom=r, and by cltarly lab"hll! ilU 11011-pp,.bl. opigoQ; with wamilli. allin' to prevan! iO~Vl'""nt QOn,"mptiol1 ofllOIl-PDt.ble W~ter, RI,~kflow ptev~n!ion devices ,lIould ~ (oUlilloly ill>P""'od zmdte.st!!ld.

b QO"~ nOI ~ppl'nr lilat this well WIll be ~d for ~n~\lmptivo !-'urp<lses aad is not <ubjooct 11:> Snfe Drinking Willet aOg!lli1tlon5,

For the applicanrs illiotmouioll, II $(IUfge, of possible WilStcwalQt cont;mllnOltiOlJ I lis r I is 1I0t looato.J J1'~ lhe proposed wcll Silo (i"foflllAtioo nttachod).

M NPDIlS PClmlt is requited.

Othaf rel~vlinl POt! nll"vrcllllatJQns. infonnalicm. Of reUIlIIJll"ll<ia,ion6 ale attached

In !hi> evon' thai Ill_ IOD~hDn of <I" ",oil ,,~an8~a but i •• till Within ,ll. p~l de,ol'ib.d Oil ,hi. applicalloll, o~r divisio,l COn.ida ... the ccmmcnli to slill be i\.pp14a~blc, ~)d 'wI;! 00 u.~\ IlIiiGd to n:;view the nnv JQC~[ion,

L 1 No commclllsio11ie.:,io ... , ,

Contact Person: vD4VlVt~ S'etn Phone: b~b-l.hlt1 Date: ~Il) 0« Signed: \\b uta r'1~ fry g-

RUG-04-2008 08:21RM FRX:8085854352 IO:OLNR CWRM PRGE: 004 R =9T~


o OEPARTMEQf HEALTH WASTEWATER BRANCH

J!P:.'\::;.-'-';': "I-;:!<..'

dUL 32 AM 8 28 AU6 0\




July 29, 2008







Jomas See, Chief, Wastewater Branch Stuart Yamada, Chief, Safe Drinking Water Branch Alec Wong, Chief, Clean Water Branch Dr. Keith Kawaoka, Office of Haz:fard Eyaluation and Emer,ency Response

FROM: C.~aura H. Thielen, Chairperson 1(2.., ~~ '-.... Commission on Water Resource Management

SUBJECT: Well ConstructionlPump Installation Permit App cation BSB Well (Well No. 5552-03)


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 August 29, 2008. 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 Ryan Imata ofthe Commission staffat 587-0255.

RI:ss Attachment(s)

RESPONSE:

[ I

[ I

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




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




X Contact Person: ----,, ___ ---:-D_a_n_e_H_i_ro_m_a_s_a_in_K_o_n_a ___ 322-1963 _____ _

Signed:~ ~. Of} Oo..hcA Date:.---=e;_ ..... _O-'-I_·~O--'-e?_

No comments/objections

cr I c , "

8

• AUG~-'2008 12:44 From:DOWSAFE WATER BRANH 8085854351 To:808 587 0219 P.1"1

.-.J

RECCIVED SAfE DRINKING WATER BRANCH

LINDA LINGLE AUG -1

LAURA H THlli:LEN (;l1AlrtP .. ,U,CN QOVIi:RNOR Q~ H'-WAil

STATE OF HAWAII DE~ARTM~Nl OF LAND AND NATlJRAL R.ESOURCI:S

COMMISSION ON WATER RSSOURCE MANAGEMENT ~.O 1l0)(621

"IONOLULU, >lAWArr 96e09

july 29, 2008

ME~eDITH J. CHING JAME5 A. FI!AZI~R NEAL S F UJIWAR.A

CHlYO"''' L FUKINO, M,D. DONNA FAY K. KIYOSAKI, PE LA~EN(;e: 11. MrrK;€:, M 0, J D.

K;EN C KAWAHAflA. p.t C~Il"J'lV aJ~E(!T'~

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

lomas See, Chief, Wastewater Branch ..gtuart Yamada, Chief, Safe Drinking Water Branch Alec W ong, Chi~f, Clean Water Brancb Dr. Keith Kawaoka, Offiw of HaZ:f:aTd Eyaluation and Emt:rljency Response

FROM: ~ura H. Thielen, Chairperson l:2... ~L..---> 'r· Commission on Water Resource Management

SUBJECT: Well Constmction/Pump Installation Permit App cation BSB Well (Well No. 5552-03)

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

We would appreciate your comments on the captioned application for any conflicts or inconsistencies with the programs, plans, and objectives specific to your department. Please r9Pl)nd by retu,-ning thi:s cover memo fonn by August 29,2008_ 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 a.ttached 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 Commissjon staffal 587-0255,

Rhs Attachment(s)

RESPONSE: (JIG: [ J

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lJ

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I;

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[ )

( J

n" well qWlhlio, a. a 'c", ... whicb will ~JVe QS _ sour~e ofpolabl~ wale.- te a pUbll, "'iltcr system (dcfjll~d .. ~.{vlnB;15 Qr IDQrc peopl~ at I~ait 60 days per )'I!'ZI" or h;a~ 15 cw mQf!! ;ervjcll!: conneet~{ft).S.) md ftIolU!!t reutvt DU'utbl' tJfB~idth apprCtval ~ to 14 u~ ~ cl)~pJy with HawaiI Admi.tl'$tr~t:jVC Itul.~ (HAR), Tido II, Chp(o, 20. Rulos ReJaim@toPoI"leWllle,Sy.t.m5,§II-lQ-lP.

TIus: W(!u doll!!~ not qllilhfy :J$ ~ soW"t!t!! ~s:vj,(l.e: ~ plI.blic water gystem (~et\'t:II~;;, tb:m ~5 p.eopte (6 mot'1! J>e~le ~ leAst 60 dR.Y,. ~ Y'8r or'S 5Ctvl~C <onn.clioJlO) ~nd ;f the w.ll water ;, .Wllld for dnnklng, the privat~ OWIICr .b.QI4 te.I for b.otcriolagi",,1 znd oh.rn",.1 p",.ence before inll1Atifte such us~ ond ...,,,linely ",.oollor ,h. water qu.hty (hereafter. However, if f .. \ufe pl~lWod uso from !h,s $0 .... 0. Incr~~~ to m~~t the public w!!t;r sYSIe1J\ d;fiDltion t.h.~tJ. DI"«'tor of Ht:$lth .:I.pprovaJ is. r.e:qujroed .2!!!.! 10 implcmerltanon

Ifill. well i, U~.~ to $\lJ)ply botl1 potable and lIOI1-potJlble purpO$'~ I~ a slnl!l~ system, tho \1ScT $h"ll .h1J1i/)~t" oross-cOOllt:Ctiol1ll and blCkflow coon."tio",s by phy",ooUy ""parotlng potabl~ and non,,?(>I;I\>le s)'stems by an air Sap Of .., .pp~ ~d<flow pTOlI\lnteJ, BIId by ekMly labeling all nonPQtable apigol.'i willl warnLng fiSJU 10 prevenl in~vL>l1Qnl ~Dn.umpllo. of noo'lJQ\llblg watL:'f llaGkflow pn:ventioll deVices sbould bo routi~ely inspected ond tested

II do~~ n~1 ~-pp.~r Ib .. thlE woll will be us.d rot t(]oo.rumptlv. purpo.e, ond i~ not subject to Safe Dronlc,n5 W"t<f Regulat'on •.

fo: (be ",pli~ant'. ""OrmalLOn, 3 source ofpo.otblt "'lSI .... "Ior oontaonmatlOn Iii. (I •• nollooe!.d ,,"III' th'proposed ",til.,,,, ('niQrmiLlIOLI atta.;h.d)

Oth ... «I.van! DOJj ruI.si"8\lI.tkm,. i .. rorm.lion. or fOoommend!tlotl< = il.tloohod

In 0.< ."",,1 thol tho l"""toon cor tho ",,,n ct."'!",," ht IS still within lb. p""",1 d.:~<rib.d O~ Ih's OJpph~ati.m, 0\1' diV~,on <olWdcrs Ille G"lDm.nt~ to still b. l<IPpb030lo_ '1.110 w< do MI need 10 reVIew the new lOUt'Dt!

1'10 ccmmellt;.!objtcllons

Contact Person: MI~ MI'4AJJJ~ Phone: ____________ _

Date; fR/7 /~ Signed: "-:;Ac7~ ) I

AUG-07-2008 01:02PM FAX: 8085854351 ID:OLNR CWRM PRGE: 001 R=94~:

12. AS-BUILT WECiECTION (Please et.tech a!)-lxJflt if diffemnt from O'am provided below)

Hole Diameter; .11 in. Elevation at top Of caGIng ill ft, 1llS1" (to nearest 0.01 ft) Minimum of 2' Radius & 4" Thick Concrete Pad

Bendlmark elevation:

~ft .• msl· t:BI (Su ..... eyto 0.01 ft.)

o (Estimated)

Grouting method

o Positive Displacement (If a.nnular space is 1888 than two inCneS, attach photo of tremie)

~ other

Total Depth

~ft.

S21id Casing Material:

C~rnlilnt Grout: 30 ft. (min. 70% of distance from ground elev<J,lon to top of water 8ulface or 500 ft .• whichever is IEIss.)

Annular space between

hole and easing (1.5" for positive disphacem"nt., 5" for other methods) ~~3_in.

Rock or Gravel Packing

10 ft Materiel:

0.3 ft. msl·

(item 11 from page 1)

"lTI$1 = ml!tan :!;ea level

.................

Please refer to the BAWAUWELL CONsm!.!!;:DON ANP lllMl INIDI,I4lJON SI,ANDARDS

to en5\1fe that your as-built \$ in ~ompliUlcc wllb applicable: standlIrds.

Sold Casing; (01: 90% X (Ground EIeV.-Water L~81 Elev»

Length: 33' 6" ft. Nominal Oiamett!:r: e in. Wall Thidtnes&: 2aP in. Bottom Elevation - l.§ ft., msl~

Open Casing: 0 Perforated 0 Screen

Length: 8 ft. Nominlill ~l11E!ter; __ ~§o!""",.",."._~_~_ln. Wall Thickness: .280 in. Bottom Elevation -Q.§ ft., I'MI"

Open Hole:

Length; ____ --JDl.wIliL-______ ft

Diameter: In .

Bottom Elevatioll; • ft .• msl*

Carbon Steel: CQrTlpliant with (Checl< one ormore): 0 ANSIIAVtNVA C200 D API Spec. 5L 0 ASTM A53 0 ASTMA139

And compliant witll (check 0118 or more): D ASTM A242 or ASoo 0 Type E D Type S 0 Grade B 0 Other

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

ABS Plaatlc conforming to ASTM F480 and ASTM D1527; (check one) 0 Sohf!ldul. 40 0 Schedule 80 pvc Plastic conforming to ASTM F-teO and (ASTM 01765 or ASTM O~~41): (~k one): 18! Schedule 40 D Schedule SO D Schedule 120

ThQrmoset Plastlc: (check onE!) D Filament Wound Resin pipe cenfonning to ASTM 02996

o Centrifugally Cast Resin Pipe c;onfo!l'l')ll'lg to ASTM 02~7 o Reinforced Plastic Mortar PreiSSl.lte Pipe conforming to ASTM D3517 o Glalils Fiber Reinforced Resin PreAure p~ conforming to AWWA CMO

o PTfE Fluorocarbon Tubing conforming to ASTM 00296

o FEP Fluorocarbon Tubing conforming to ASnn 03296

Oeen Casing Material: Carbon Steel: compliant with (check one ormore): 0 ANSI/A'MNA C200 0 API S~c, 5L 0 ASTM A53 0 ASTM.A139 And compliant with (Check one or more): 0 ASTM A242 or ASOe CJ Type E 0 Type S 0 Grade B 0 other

StainleSS StHl: (check one): 0 ASTM M09 (production well5) 0 ASTM A312 (monltof wells)

ABS Plastic ronforming to A$TM F480 and ASTM 01527: (check one) 0 Schedule 40 0 Schedule 80 PVC Plastic confonnlng to ASTM F480 and (ASTM 01785 or ASTM 02241): (check one): 1'81 Schedule 40 0 SChedule 80 0 Schedule 120

Thermoset Plastic: (check one) 0 Filament Woul'l(! Resin Pipe conforming to ASTM 02996

AUG-07-200801:12PM

o Centrifugally Caet ReSin j;lipe conforming to ASTM 02997

o RBinforced Plastic Mortar Pressure Pi~ CQoformlng to ASTM 03517 o Glass Fiber Reinforced Resin Pressure Pipe conforming to AINWA eS50 D PTFE f"luorocarbon Tubing conforming to ASTM 03296

[J FEOP Fluorocarbon Tubing confon"rling to ASTM 03296

FAX: ID:DLNR CWRM

I.""'"", r--.~ .. ", ... n,,, .. r"'I.,.. __ ., _Jt ~

PAGE: 001 R=100%

. .: ~

...

RUG-07-200801:13PM FRX: ID:DLNR CWRM PRGE:002 R=100%

COQSSION ON WATER RESOURCE MANAGEMENT Q ROUTE SLIP FOR NEW APPLICATIONS

FROM: RYAN -----------------

CHING, F. FUJII, N. GOODING, K.

-1-=,~R ,., -2-HOAGBIN, S.

ICE, C. -5-IMATA,R. -3-KAWAHARA,K.==

DATE: 29-May-08

KUNIMURA,I. NAKAMA,L.

-4-0HYE,M. SAKODA, E. SWANSON, S. UYENO, D. YODA, K. YOSHINAGA, M.-

WELL NAME asa

SUSPENSE DATE:

1 Approval -3-Signature -4-lnformation

5-Jun-08

PLEASE:

See Me -1-Review & Comment

Take Action Type Draft acknow letter

-2-Type Final, label file folder, update People.db -5-File

Xerox copies

WUP Number WELL NUMBER S~{' -z.,. - 0 ~

~WELL CONSTRUCTION

---------------------~UMP INSTALLATION

ATIACHMENTS FOR APPLICATION PR9CESSING - Both applicant & staff generated 1 TRANS. LETTER V 2 PERMIT PROCESS TABLE ~ 3 CWRMMAP

4 APPL. FORM (11 COPIES)

5 USGS MAPS (11 COPIES)

6 TAX MAPS (11 COPIES)

-f. t -(, It.-- \ a(Df

7 PARCEL OWNER VERIF.

8 CONTRACTOR VERIF.

9 ALL INFO FILLED IN --::r-LS PRINTOUT

DCCA LICENSE SCREEN PRINTOUT

~ \ 1/1 S oj/\;Y'\ - J,.) I V\' ~~ 11 $25 FEE DEPOSIT SLIP v' . ,- I' n I Y ....... • 12 DHP/CDUP/SMA pre·screen ~ (SMA map printout http://gis.~icentral.com/website/parcezoning/viewer.htm.,or INGRID'S SMA/CD MAP)

10 BACKGROUND CHECK

~ --(LUC map printout http://luc.state.hLuslluc_maps.htm., or INGRID'S SMA/CD MAP)

FOLDER: MADE NEW FILE FOLDER, ATIACHED o FILE FOLDER ALREADY MADE, IN FILE CABINET

INCOMPLETE ACTION DATES:

DATE ACTION


Mr. Derrick Moreira

o o




July 29,2008

Derrick's Well Drilling and Pump Service P.O. Box 2187 Keeau, HI 96749

Dear Mr. Moreira:




KEN C. KAWAHARA, P.E. OEPUTY DIRECTOR

5552-03.ack

Well ConstructionlPump Installation Permit Application for Well No. 5552-03

We acknowledge receipt, on July 21, 2008, of your completed Well ConstructionlPump Installation permit application and filing fee for the BSB Well (Well No. 5552-03). 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 Ryan Imata of the Commission staff at 587-0255.

RI:ss Attachment

c: Bill Borkan

Sincerely,

~~ rJ:Ut~·&e'j:;H


o o




July 29, 2008

LAURA H. THiElEN CHAIRPERSON


CHIYOME l. FUKINO, M.D. DONNA FAY K. KIYOSAKI, P.E.




Tomas See, Chief, Wastewater Branch Stuart Yamada, Chief, Safe Drinking Water Branch Alec Wong, Chief, Clean Water Branch

FROM: ~~aura H. Thielen, Chairperson r! .. ~~ Dr. Keith Kawaoka, Office OfHaz~ard Eyaluation and Emer,ency Response

\Y. Commission on Water Resource Management 1 SUBJECT: Well Construction/Pump Installation Permit App cation

BSB Well (Well No. 5552-03)


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 August 29, 2008. Ifwe 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

[ 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 11, Chapter 20, Rules Relating to Potable Water Systems, §II-20-29.




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




No comments/objections

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


TO:

FROM:

SUBJECT:

o o




July 29, 2008

~~ib~:~~dministrator f 1 L Ken C. Kawahara, P.E., Deputy Director . (}" 1JAJA/ Commission on Water Resource Management

Well ConstructionlPump Installation Permit Ap ication BSB Well (Well No. 5552-03) TMK 6-8-033:053



CHIYOME L. FUKINO, M.D. DONNA FAY K KIYOSAKI, P.E. LAWRENCE H. MilKE, M.D., J.D.


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



RI: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:

o o




July 29, 2008

Dr. Puaalaokalani Aiu, Administrator Historic Preservation

Morgan Davis Historic Preservation

Ken C. Kawahara, P.E., Deputy Director ft'!, t~) Commission on Water Resource Management V Well ConstructionlPump Installation Permit Ap ication BSB Well (Well No. 5552-03) TMK: 6-8-033:053





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


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 Ryan Imata of the Commission staff at 587-0255. 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.

RI:ss Attachment(s )

RESPONSE:

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

[ ] We concur that the work described under this 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. Chris Yuen, Director Planning Department County of Hawaii 101 Pauahi Street HHo, HI 96720

Dear Mr. Yuen:

c o


COMMISSION ON WATER RESOURCE MANAGEMENT P.o. BOX 621


July 29,2008

Special Management Area Use Permit Requirements for Well ConstructioniPump Installation Permit Application

ESE Well (Well No. 5552-03)





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

We would appreciate your comments on the captioned application with regard to the SMA permitting requirements specific to your division. Please respond by returning this cover memo form by August 29, 2008. Ifwe do not receive comments or a request for additional review time by this date, we will assume you have no comments.

Please fmd 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.

Sincerely,

~C~~rovL flr LA . RA H. THI LEN \'" Ch rrperson

RI:ss

RESPONSE:

[ ] 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: --------

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

Professional and V ocational Li~Sing (PVL) - powered by eHawaii.goo Page 1 of 1

GENERAL LICENSEE

LIC ID: CT-28001 Active/Inactive: ACTIVE

NAME: DERRICK'S WELL DRILLING & PUMP SERVICES LLC

TRADE NAME:

STATUS: VALID THRU EXPIRATION DATE, RENEWAL NOTICE SENT

ENTITY: ORGANIZATION (LIMITED LlABILIlY COMPANY) BUSINESS CODE:

ORIG LIC DATE: 06/19/2007 EXPIRE DATE: 09/30/2008

CLASS PREFIX: C SPECIAL PRIVILEGE:

RESTRICTION: EDUCATION CODE:

CONDITIONS AND LIMITATIONS:

BUSINESS ADDR: 15-2005 29TH AVE KEAAU HI 96749

MAILING ADDR: POBOX 2187 KEAAU HI 96749

http://pvl.ehawaii.gov/pvlsearch/app? _a=d& _ f=n&lictp=CT &licno=2800 1 &off=&nm=DE... 7122/2008

••

Hi Ryan,

o Derrick Moreira <[email protected]>

07/21/200808:07 AM Please respond to

moreira [email protected]

o To Ryan R Imata <Ryan.R.lmata@hawaiLgov>

cc

bcc

Subject Applications

Thank you for working on our applications. I know you're swamped and have alot of applications & permits t

As far as the BSB Wells, I looked on the County Real Property Site, the owner I have on the application is co we are looking at different sites? The Newman Nursery, I'm sorry I should have been explained myself better yes there was a pump already installed previously to ours. We just replaced it with the same type of pump (GJ sorry .. this one was sort of confusing for me.

Do you have any word on State Well 5552-02 and also Pahinahina Property Wells 1 & 2? Is Mauna Lani (BS recieved acknowledgements on BSB & Pahinahina. Thanks again.

Cynthia

Hawaii County - Profile o o Page 1 of 1

RECORD DETAILS

.. Parcel Data

Sales

Permits

Land

Residential

Commercial

Del. Structu res

Sketch

Values

Map

Tax Bill

Tax Details 2008

Tax Details 2007

Tax Details 2006

Tax Details 2005

Tax Details 2004

Tax Details 2003

HELP CONTACT US

County> State> State Bureau of Conveyances

680330530000

NA

Parcel Data Site Address Unit No. Property Class Zoning

Owner

Home Property Search

Address Parcel Number Advanced

49 BLACK SAND BEACH AT MA

APARTMENT Call the Planning Department at (808) 961-8288.

Owner Address City State Country Zip Code

49 BLACK SAND BEACH AT MAUNA LANI SR ROADWAY

Data Copyright Hawaii County [Disclaimer] Last Updated: 7 /18/2008 Site Design Copyright 1999-2004 Akanda Group LLC. All rights reserved.

CURRENT RECORD

RKI 1of1 i'. I Return To Search Results I

~PrintThis

!S2I Email This

II Generate Permit Report

http://www.hawaiipropertytax.com!Datalets.asp?mnu=PSearch&submnu=Profile&pin=68 ... 7/22/2008

Search Results o Page 1 of 1

I I

I I

o Owner: MLRO & SEA CLIFF DEVEL LLC

Tax Payer: MLRO & SEA CLIFF DEVEL LLC Tenure: Fee Simple Tax Bill: 810 RICHARDS ST #900, HONOLULU, HI 96813 USA Annual Tax: $100.00

Assessed Value Exemption Size Buildings: 0 Zoning: (road)

Land: $100 $100 7.45 ac Dwellings: 0 PITT Code: 200 -Apartment

Total $0 o sq ft Subdivision: 49 Black Sand Land Use: Buildings: $7,400 Beach

Total: $7,500 $100 Project: Census Tract: 217.01 Bedrooms/Baths: 0/0 Lot#: 1

SALES 10/25/2001 TRANSD-M $0 DOC 01-168814

MLRO & SEA CLIFF DEVELOPMENT LLC, A Company or Corporation

3/16/2005 DEED-M $2,543,900 DOC 05-051914 BOC ROADWAY LOTS 54 & 55 49 BLACK BEACH AT MAUNA LANI OWNERS ASSN, A Company or Corporation

OTHER BUILDING IMPROVEMENTS

Type I Description I Quantity Year Area Grade Condition

RS1 I FR UT SHD I 1 2001 176 Normal

BUILDING PERMITS FROM REAL PROPERTY TAX

Date I Number I Amount I Status Purpose

3/13/2000 I 000383 I $84,560 I Complete

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

Copyright '97/18/2008 by Hawaii Information Service

http://webre2.hawaiiinformation.comIREsearchIHIS/Searchisearch _PUB.asp?SRC=LNK&... 7/18/2008

CARTMENT OF LAND AND NATURAL RESOQES DOCUMENT NO.: UA RA A H W SH C 0 TT C ED ORK EET TE DA 2 : May 2 ,2008

SRC/ COST F YR APP D OBJ CTR PROJECT PH ACT AMOUNT NAME/DESCRIPTION 0NANG INPUT)

S 08 326 C 1026 0752 (1 ) $25.00 Derrick's Well Drilling

" " " " " " (2) $25.00 Derrick's Well Drilling

" " " " " " (3) $25.00 George Edgar

" " " " " " (4) $25.00 Waimea Water Services

" " " " " " (5) $25.00 Sumiko Besser

" " " " " " (6) $25.00 Carolyn Sue Brown

" " " " " " (7) $25.00 Nadiya Hrach

" " " " " " (8) $25.00 Joseph Orlikowski

" " " " " " (9) $25.00 Lori Diamond

" " " " " " (10) $25.00 Avery Freed

TOTAL $ 250.00

REMARKS: LINE (1) Well #1, TMK: 6-8-34:4 LINE (2) Bi&Well LINE (3 Tufty #1 LINE (4) Kohanaiki #8 LINE (5) Besser Well LINE (6) Daisy Well LINE (7) KalapikWell LINE (8) Menehune Wishing Well LINE (9) Pohaku Well LINE (10) MOWell

STATE OF HAW"JI 0" For Official Use Only: DEPARTMENT OMND A~D NATURAL RESOURCES COMMISSION ON WATER RESbuRCE 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 CommiSSlAlon Water Resource Management, P.O. Box 621, Honolulu, Hawaii 96809. Application must be accompanied by 6 copies and a non-refundable filing fee of $25.00 payable to the Dept of Land and Natural Resources. The

A 8: 35

Commission may not incomplete applications. For assistance, can the Regulation Branch at 587-0225. F~r further information to this form, visit C!. ' :L.._-...,.. ....... -"lli"'''-~---------'

. ;~";- .. ; '.;·LliL_l';

WELL LOCATION INFORMATION 1. STATE WELL NO. (if already assigned) 2. WELL NAME

BSBWell 3. ISLAND

Hawaii

following be attached before this application is accepted as complete (check off if attached):

4.TMK 6 8 - 33 53 --- --- ---

Portion of7.5-Minute Series USGS topographic map (scale 1:24,000) with well location labeled and include the name of the quad map Properly tax map, showing well location referenced to established property boundaries Photograph of the proposed well site ./"" $ ." [ c· , , J \ ... l' r7( t/\ . .....r--A schematiC diagram showing the well site, access road and proposed well infrastructure ./

Well Operator's Mailing Address / 68-1107 Honokaope Place/ Kohala Coast, HI 96743

Well Operator's Phone Well Operator's Fax

887~42 887-0972

6. LANDOWNER'S NAME/COMPANY Landowner's Con1act Same Same Landowner's Mailing Address Same

Landowner's Phone

same

PROPOSED WELL CONSTRUCTION PROPOSED PUMP INST 7. Proposed Wor!< Construction Type

~ Drilled 10. Proposed Wor!< 11. Proposed Pumping Rate, gpm 13. Method of flow measurement

~ Flowmeter 181 Construct New Well ~ Install New Pump (gallons per minute) o Modify Existing Well DOug o Replace Pump 100 o Other (explain) o Abandon/Seal Well o Shaft r---------------~ 12. Proposed Amount of o Tunnel Withdrawal, gpd (gallons per day)

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

21. o Well is in Conservation District o Required, COUP # date approved __ _

o Not Required (attach documentation from OCCL) o 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.

181 Well is not in Conservation District o I have not checked if well is in or out Conservation District. I understand that checking if the well is in a Conservation District may expedite my review.

I

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. 181 I have not consulted with the HPD regarding potential impacts of weD construction adivities on historic sites. I understand that checking with the HPD

prior to making this application may expedite my review. I further understand that issues raised by this may delay or result In denial of the

Additional remarks, explanations, etc. (attach additional sheet if more space is needed) 49 BSB falls under the Mauna Lani Resort's Master SMA

NOTE: Signing below indicates that the signatories understand and swear that the information provided is accurate and true to the best of their knowledge. C:urther, the signatories understand that upon permit approval: 1) the proposed wor!< is to be completed within two (2) years of the approval date; 2) the

~ctor shall submit to the Commission a well completion/abandonment report within 60 days after the completion date of the permitted wor!<; 3) in the 'qt the application is not completed correctly, permit may be suspended until the item is brought in to compliance, and any wor!< done while the

(Must be Mad out if application is for Well Construction)

·'Iing & Pump Svc C..".-__ 2 __ 8..,...,00-1'--...,..,.---C-57 Ucense No.

~errick Moreira 5116/08 Print Date

25. PUMP INSTALLER (Must be filled out if application is for Pump Installation)

Derrick's Well Drilling & Pump Svc .."C...,.-2=8=-OO-==1~~_~ ~-: b~i~ =- ~ I'/i C-57/C-57a1A License No. U~ /'~ Derrick Moreira 5116/08 Signature Print Date

e o PROPOSED WELL SITE

Proposed Well Site Map

---.~. > / .

. " ~ .. /,-,", i

TMK Map of 6-8-033-053

f

/

I ~-;:;.q'

/

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

Hole Diameter: 12 in.

Elevation at top of casing: _ .... 5=3_ Minimum of 2' Radius & 4" Thick Concrete Pad (to contain

.. "n,I>",'" to nearest 0.01 ft.) benchmark

Grouting method

o Positive displacement

~ Other

Total Depth

60 ft

Cement Grout: 40 ft. (min. 70% of distance from ground elevation to top of water surface or 500 ft., whichever is less.)

Annular space between

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

in.

Estimated Water Level

Elevation:

5 ft. msl*

"""'f"-'-'----Ir--L'JiMSlaand Elevation: ~ ft., rnsr

Please refer to the HAWAII WELL CONSTRUCTION AND PUMP INSTALLATION STANDARDS

to ensure 1hat your as-built is in compliance with applicable standards.

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

Total Length: 54 ft. Nominal ~iameter: 6 in. Wall Thickness: .280 schedule 40 pvc in. Bottom Elevation: -2 ft., msl*

Open Casing: Iii!J Perforated 0 Screen

Total Length: 6 ft. Nominal Diameter: ~~-:--7L6-:--=-___ in. Wall Thickness: .280 schedule 40 pvc in. Bottom Elevation: -8 ft., msl*

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

Open Hole:

Length: _____ -'nI....,a"-______ ft.

Diameter: ____________ in.

Bottom Elevation: ft., msl*

* The approximate elevation mtJSt be referenced to mean sea level (msl) at the time of application filing. Final elevations of well components shall be submitted in the WeH Completion/Well 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 weI should not be deeper than 1/4 of aquifer thickness or,

Bottom 8evation of Well Limit = (Water Elevation _ 41 "Wm 1&:1 Eln'a!ign )

Example: Esllmated +2ft. Water L_IElev. - Bottom Elevation of Well Limit = (2- ~) = -13.Sfl

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

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

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

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

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

Thermoset Plastic: (check one) 0 Filament Wound Resin Pipe conforming to ASTNI 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 ASTNI 03296

o FEP Fluorocarbon Tubing conforming to ASTM 03296

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

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

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

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

WCPI App. Form 10/05/04

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