wcr 2 check for well no. of pip? yes@g) d. englan~ wcr 2 check for well no. 3688-24 (survey to...

MEMO and ROUTE sSp (ver.07/17/2008)

Q

I WCR 2 Check for Well No. 3688-24 (survey to regulation memo)

1. Pump Tests Check( special condition of PIP? Yes@g) D. Englan~ Yes No If no. describe deficiency

Step-Drawdown Test:

followed WCPI Stds analysis attached

Aquifer Pump Test:

o o

followed WCPI Stds 0 T & S analysis attached 0

Potential Well Interference:

Potential Stream Impacts:

Additional Testing or Data Required:

Pump Test Comments Attached:

Proposed Pump Capacity is OK.:

o o

o o

~ gpm no test required

~o gpm no test required

stream names:

07/30108

2. Pump Installation Check Mitch Ohye I \) (initial) R. Torres __ (initial) V,s No If no. describe deficiency

data complete followed Special Cond & Elev.

well database updated

i

·0 0 [] / 0 9/ 0

3. Charley/ Denis +--~ __ (initial) take action based on above analysis

ATTACHMENTS FOR ACCEPTANCE: ~ 1WCR2 ACCEPTANCE LETTER •

2PUMP INST. COMPLETION CERTIFICATE

3METER INSTALL. REPORT (IF NECCESSSRy) -1./ 4WUR \/

l' To be sent to driller

J To be sent to landowner/operator

} Staff internal checks

4. ROY+ (i~ check(Entered WCR 2/PICC accept date into database)

5. Susan Hoagbin (initial) finalize

6. Ken (imtial) signature

7. Faith Ching (initial) enter into WUR database

8. Charley/ DeneRY~ile

LINDA LINGLE GOVERNOR OF HAWAII

Mr. Robert Anderson P.O. Box 665

o o

STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES

COMMISSION ON WATER RESOURCE MANAGEMENT P.O. BOX 621

HONOLULU, HAWAII 96809

February 9,2009

Mountain View, HI 96771

Dear Mr. Anderson:

Certificate of Pump Installation Completion for Pattycake Well (Well No. 3686-20) (TMK 1-5-052:076)

LAURA H. THIELEN CHAIRPERSON

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

CHIYOME L. FUKINO, M.D. DONNA FAY K. KIYOSAKI, PE.

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

KEN C. KAWAHARA, P.E DEPUTY DIRECTOR

3688-24.cwc

Weare pleased to inform you that the Pump Installation work permitted for the Pattycake Well (Well No. 3686-20) is complete and acceptable and welcome you as a new member to the community of well owners and groundwater users in Hawaii. This certificate of pump installation completion allows you to commence pumping your well for reasonable & beneficial water use.

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

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

2. If the well is to be abandoned then the landowner must cause a licensed contractor to apply for a well abandonment permit in accordance with §13-168-12(f) 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.

/

... o o Mr. Robert Anderson Page 2 February 9, 2009

5. Your approved pump has a capacity of 16 gpm at a head of 95 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 monthly 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/dlnr/cwrmlresources .....Permits.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.

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

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

If you have any questions, please contact 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,

i~t~ Deputy Director

RI:ss Encl: Water Use Report Forms

c: Hawaii Department of Water Supply Diamond Construction and Water Well Drilling

o o LINDA LINGLE

GOVERNOR OF HAWAII LAURA H. THIELEN

CHAIRPERSON




February 9, 2009


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


KEN C. KAWAHARA, PE. DEPUTY DIRECTOR

3688-24.cwc

Mr. Robert Anderson P.O. Box 665 Mountain View, HI 96771

Dear Mr. Anderson:

Certificate of Well Construction Completion for Well No. 3688-24 (TMK 1-5-052:076)

We are pleased to inform you that the Well Construction work permitted for the Pattycake Well (Well No. 3688-24) is complete and acceptable and welcome you as a new member to the community of well owners and groundwater users in Hawaii.

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

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

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

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

4. In the event that the well operator and/or landowner changes, the Commission shall be notified 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 www.hawaii.gov/dlnr/cwrmlforms.htm.

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

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

Sincerely,

~~t~ tty Director

RI:ss

c: Hawaii Department of Water Supply Diamond Construction and Water Well Drilling

I


Mr. Rod Diamond

o o




February 9,2009

Diamond Construction and Water Well Drilling HC#3 Box 14073 Keeau, HI 96749

Dear Mr. Diamond:

Well Completion Report Parts I & II for Well No. 3688-24


KEN C. KAWAHARA, P.E. OEPUTY DIRECTOR




We received your Well Completion Report Parts I & II for the Pattycake Well (Well No. 3688-24) on July 24, 2008 and acknowledge that they are complete.

This completes your obligation under the well construction and pump installation permits. Certificates of well construction and pump installation completion will be issued to the well operator/landowner and you will receive a copy of each. 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,

r:wt::: Deputy Director

RI:ss

c: Robert Anderson

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

Well Number 3688-24 Well Name Pattycake 1 Ground Elevation 97.67 Cement Grout 75 Grouting Method 'positive disj>lacement Hole Diameter 8 Total Depth 107 Water Level 2 Depth to water 95.67 Public Water Supply Well? no Solid Casing Material pvc plastic plastic Solid Casing Specification Schedule 40 Solid Casing Length 95.67 Solid Casing Diameter 4.5 Solid Casing Wall Thickness 0.000 Open Casing Length 11

Results

Well Depth Theoretical Thickness of Aquifer 82 1/4 Aquifer Thickness 20.5 Dej:Jtn o'f Well below Sea Level ~9;'S3 okay Section 2.2

lWell Casing Minimum Wall Thickness

Material pvc plastic Minimum Thickness per standards no requirement Wall Thickness Provided 4" " \,0 no standard Section 2.4(b)

Minimum Length of Solid Casing 90% of ground to top of aquifer 86.103

",Lerifjth"ofsolid,casing'Provided", ,,' , ,7 ,95;137 okay ( Section2.4(c) CS'siQil'MaierlsJ ' 5, :" Schedule 40 " : '\1", "::,:: ill compliance , Section 2.4( d) , (forp'lc0otlly - cnee/ffor 200' limit) ',: ;:', ':,," okay Section 2.4(d)

Annular Space Depth of Grouting

Calculated Depth of Grouting 66.969 Depth,~of Grouting provided 75 okay Section 2.6(c)

Minimum Annular Space required 1.5 Thioknes'sof Annular Spaee ":, "',: ' 1.75 okay Section 2.6(d)

,. +-

State of Hawa9 0 COMMISSION ON WATER RESOURCE MANAGEMENT Department of Land and Natural Resources WELL COMPLETION REPORT - PART II

For Official Use Only:

Pump Installation 6 -!"'In-st-ruction~· -S:~P~Iease--pn~·nt~in""'!'ink";-or-type-and~-send~-com-plet~ed~~-epo!~rt~(with~·~attach~-ments~-,~if-appl~ica-ble~)"!"to""'!the!""-Com~-m~issIon""'!'·"'" DB JJL 2'-1 A B: 3

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 com~ of wort<. For assistance, please consult the Hawaii Well Construction and Pump Installation Standards or call the Regulation Branch at 587-0225. For updates to this form or additional information, please visit our website at http://www.state.hi.usldlnr/cwnnl

Hawaii 1. State Well No.: 3688-24 Well Name: Pa cake #1 Island: ~========================-------=====~~==~ 2. Address: PO Box 665, Mt. View, ill 96771 Tax Map Key: 1-5-052-076

3. Pump Installation Company: Diamond Drillin ~~======~==~-----------------------j

4. Date Pump Installed: 7-17-08 Month ldaylyear

5. PERMANENT PUMP INFORMATION

6.

7.

8.

9.

lO.

11.

--------------------------------------------------------Pump Type, Make, Serial No.: SUB 1 GOULDS 11OGS07

Rated Capacity: XL \ l,P gpm at head of: 95

Motor Type, H.P., Voltage, rpm: ITT 1 % lIP 1230 V 13450 RPM Pump type (check one):

o Deep Well Turbine

X Submersible

o Centrifugal

Method of flow measurement:

o Rotary o Propeller

o Rotary-Displacement o Reciprocating

o Rotary-Gear o Impulse

Manufacturer Master Model no. PT92194 Size

ft.

% in. X Flowmeter

o Weir ---------- ----------~

o Open Pipe 0 Orifice* 0 Other*, explain below

*attach schematic

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

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 method of flow measurement.

Well Owner: same

Land Owner: Robert Anderson Po Box 665

Mt. View, ill 96771

Pump Installation Contractor (print) Rod Diamond C-S7/C-S7a/A Lic. No. Be 23379

Signature Date 7-21-08 WCR2 Form 2/2,l105 Page 1 of 2

"

7. AS-BUIL T PUMP QTlON (Please attach as-built if different from diagOProvided below)

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

~11II_11II-11l1=11II .~---........ --.

8evation of top of chase tube NI A ft. mean sea level

... _ .. 1.

Pump intake depth = 100 ft. (referenced to bench mark)

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

If airline installed, bottom of airline elevation =

NI A ft. mean sea level

WCR2 Form 2123m5 Page 2 of 2

METERS FEET

360 1200---- __

!'1GS30_

1100[_ 320

1000 --- ---280 900 7GS20

~ :c 240 800

I 100~ .. -- -'''-: 200 i-ZGSl$-

600

~ e 160 500-;6510 -120 400'"'------

~ 7GS07

80 3OO'-7G~~~--

40 100

, 0 °0

Model5GS

4 6

.5

o

1.5

CAPACITY

8 10

METERS

350

325

300

275

250

~ 225 :I:

!.! 200 ~ ~ 175

~ ISO

125

100

75

50

25

0

12

2.5

Mf11:RS

FEET 1200,

1100 ______

5GS20 1000

900

800~~5_

700 ........ _-- .. 600

5GSl0

~~-----500 SGS07

400----- __ f:sGSoS ..

200~

,00r ____

i=-~=-' 0 0

0

~::!

-I 14GPM

mllhr

400 f-tllG550'

1300:1""" .. ----- ... -

350

300

~ :t: 250 !.!

I 200 ..... j! 0 0-

150

100

50

10

4

.5

o GOULDS PUMPS Residential Water Systems

_ --r---------;-

I RECOMMENDED RANGE 1--"= [J 1.2 - 7;5.GPM I:' . . -,

"" - ~~ - ~ '.

1.0 C/INaN

1.5

Model7GS

RPM 3450 60Hz

_.I

8 9GPM

2.0 m'Jhr

~ ,"', \

---~T --------+----~-_1--,----. --.,.-.. --, - --

-- on, I REC~or~ 1_'-'-----~~-, _3450 I 60Hz I

6 8 10 • GPM

m'Jhr CAPACI1Y

o o

.. ...." .. ~ ."..

,_v ........... ~ .... "'~',

!

" ~MP INSTALLATION PERMIT Pattycake 1 Well, Well No. 3688-24

o 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 Pattycake 1 Well (Well No. 3688-24) at TMK 1-5-052:076, 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 16 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.

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

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

Date of Approval: Expiration Date:

June 13, 2008 June 13,2010

, Chairperson Resource Management

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

Installer's Signature:

Printed Name: Rod Diamond

BeC-57, C-57a, or A License #: 23379 Date: 7 /!sID g / ,

Diamond Construction and Firm or Title: ......:W.:...:a=t=er:....W..:..:....::e~ll~D:::.:r~il:::lin=g ___ _

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

Attachments

(

o 0 MEMO and ROUTE SLIP (ver. 07/03/2008) 07/30/08

I WCR 1 Check for Well No. 3688-24 (survey to regulation memo)

1. Pump Tests Check Diane England, ___ _

Step-Drawdown Test: followed WCPI Stds analysis attached

Constant Rate Test: followed WCPI Stds analysis attached

Potential Well Interference:

Potential Stream Impacts:

Additional Testing or Data Required:

Pump Test Comments Attached:

Proposed Pump Capacity is OK.:

(initial)

Yes

0 0

0 0

0

0

0

0

y

No

0 c6"0 gpm no test required 0

0 ~o gpm no test required 0

/ ~

y 0

2. Well Log Check Geology Code for Well In.dex'-'If-I---=--Fm Name:

3. Construction Check Mitch Ohye --"r17"-

NAD27

NAD83 \ 1

Ct

!

o o o

R. Torres .IV"" (initial) If no, describe deficiency ~

. ;

(' V' 108\...A...- 1'1..01 S A f.,'.,()v ... )C (,it.:,;~

SA VV\ E; LO(...1\ -(r c.~) 4).

'~(c<r;-L:'"

Latitude Longitude

? (0 t( .J

~o 1--7

____ (initial) take action based on above analysis

ATIACHMENTS FOR PUMP INSTALLATION PERMIT (2x):

1 COVER LETTER

2COUNTY COMMENTS (DWS/SMA)

3DOH COMMENTS

4DLNR COMMENTS (LD/OCCUDHP)

5WCR 1 Accept

SWELL CONST. COMPLETION CERTIFICATE

__ not necessary - only WCP or BOTH.

} To be sent to driller/pump installer

<------ To Landowner

} Staff internal checks

5. Roy (initial) check (Entered WCR 1IWCCC accept date into database) 6. Susan Hoagbin (initial) finalize 7. Ken (initial) signature 8. Mitch . . ial) signature (Entered PIP issue date if attached/required) 9. Charley/De 'se/Rya ile

'. State of Hawa9 0 COMMISSION ON WATER RESOURCE MANAGEMENT Department of Land and Natural Resources WELL COMPLETION REPORT - PART I Well Construction

Instructions: Please print in ink or type and send completed report (with attachments, if applicable) to the Commission on Water Resource Management, P.O. Box 621, Honolulu, Hawaii 96809. The Commission may not accept incomplete reports. This form shall be submitted within 60 ~ of the completion of wort<. For assistance, please consult the Hawaii WeN Construction and Pump Installation standards or caR the Regulation Branch at 587-0226. For updates to this form or additional information, please visit our website at http://www.sIate.hi.usldlnr/cwrml


DB Jl ,4 A 8: 3

, __ i 'f' '" ..... ~ .

1. State Well No.: 3688-24 Well Name: Pattycake #1 Island: Hawaii 2. Address: PO Box 665, Mt. View, HI 96771 Tax Map Key: 1-5-052-076 3. Drilling Company: Diamond Drilling and Pump

4. Drilling method used during construction: ~ Rotary 5. Date Well Construction (drilled, cased, grouted) completed: 7 -18-08 Fill out attached Driller's Log

MonthIDayIYear In addition to the driller's log. if a geoIogk log was prepared. please submit with this form.

6. Was the subject well cored? DYes • No

7. Step-Drawdown Test completed? • No DYes

S. Constant Rate Aquifer Test completed? • No D Yes

Attach step-Drawdown Test Form (12117197 SDPTD Form)

Attach Constant Rate Aquifer Test Form (12117197 CRPTD Form)

Water Level Data:

9. Initial encountered during drilling (this should also be filled in on the dtiller's log)

10. Just prior to casing installation After casing installation (this information should be before any pump tests are performed with casing installed)

Reference Point Elevation

Ground= ftmsl

Ground= 97'8" ftmsl

If this reference point is not the bencbmark, the difference between the benchmark and this

Depth to Water (ft.)

95'S"

Water Level Date /Time of ft. above msI Measurement

= 2 7-17-08 am

11. Chloride: 46 ppm. Temperature: 67 *F point is: 4in. 96' 2 7-17-08 am 12. As-built section filled in completely 13. Attach photograph of well and concrete pad showing benchmark on concrete pad. 14. GPS coordinates provided in degrees, minutes, seconds

If a pump is not planned to be installed, please describe (below in the remarks section) how well is secured to prevent 15. unauthorized access (example: lockable cover, threaded coupling, etc.) 16. Remarks:

Licensed Driller Rod Diamond C-57 Lic. No. Be 23379 -------------------------------------- -------------------

Signature ___ --"p __ ~ __ ~_L~ __ ' ____ _ Date: =================== 7-21-08

WCR1 Form 6112107 Page 1 of 5

o o 13. A8-8UIL T WELL SECTION (Pleae aftac:It aa-buiIt if diIfetent tom diagnrm ptOVIded below)

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

8 in.

M~m of 'Z Radius & 4' Thick Concrete Pad

Groood Elevation: 97' 8" fl. mel Bend1mark elevation:

98 __ ft.,msI* (Survey to neaf8St 0.01 ft.)

Grouting method: Positive

"5( displacement

o Other

Total Depth

107 ft.

Solid Casing Material:

Cement Grout ft. (100. 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):

1.5 in.

Rock or Gravel Packing:

32 fl Material: N Crushed Basalt

o Rounded Gravel

Water Level Elevation: _2 ___ ft., msI*

"mSI = mean sea level

,&,---1 Solid Casing: (~ 90% x (Ground EIev.-W81er Level EIev))

Length: 9 5 ' 8" ft.

Nominal DIameter: 4 . 5 inches in.

wall ThicIuless: Schedule 40 in.

Bottom Elevation; -0- ft., msI

Open C8sing: /LPerforated Length; ____ --'l~l'__ ____ ft.

o Saeen

Nominal Diameter:

wan Thickness:

Bottom Elevation:

Open Hole:

4 .:; inches in.

Schedule 40 in.

-11 ft.. mal

Length: _____ NUL.I/A~ ___ fl rnamemr. ______________________ in .

. Bottom EIeYation:. ________ ft.. msI

Carbon Steel: compliant with (check one orrnore): 0 ANSI/AWWA C200 0 API Spec. 5L 0 ASTM A53 0 ASTM A139 And compliant with (check one or more): 0 ASTM A242 or A606 0 Type E 0 Type S 0 Grade B 0 Other

Stainless Steel: (check one): 0 ASTM A409 (production wells) 0 ASTM A312 (monitor wells) ASS Plastic conforming to ASTM F480 and ASTM 01527: (check one) 0 Schedule 40 0 Schedule 80

PVC Plastic conforming to ASTM F480 and (ASTM 01785 or ASTM 02241): (check one): _ 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

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

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

Stainless Steel: (check one): 0 ASTM A409 (production wells) 0 ASTM A312 (monitor wells) ABS Plastic conforming to ASTM F480 and ASTM 01527: (checIc one) 0 Schedule 40 0 Schedule 80

PVC Plastic conforming to ASTM F480 and (ASTM 01785 or ASTM 02241): (checIc 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

weR1 Form 10118104 Page 2 of 5

.. - ._--_.- .~-----------

o DRILLER'S LOG o WELL NUMBER: 3688-24

Depths (ft.) s Rock Description, Water Level, Chlorides PPM Dates

0 to 107 Basalt, Water @95'8"; End @107 ft., 46 PPM 7-17-08

to

to

to

to

to

to

to

to

to

to

to

to

to

to

to

to

Remarks:

weR1 Form 10118104 Page 3 of 5

Latitude:N 19 degrees 36 min. (.280)x60=16 sec I /

! Longitude: W154 degrees 58 min. (.182)x60=10 sec.

Well 0 +- 60,_' __

House

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

weR1 Fonn 10118104 Page 4 of 5

Well Elevation

Benchmark Elevation est. 98

I cert~· that the eleyation shown aboye: I) Was done in accordance with acceptable slllTeying practices 2) Is accurate to the nearest 0.0 1ft. 3 ) Is referenced to mean sea leyel

Surveyor

Site Photo

License No. Date

WCR1 Form 10118104 Page 5 of 5

C 0 WELL CONSTRUCTION PERMIT ,

Pattycake 1 Well, Well No. 3688-24 ____ -'-~1 -,1

MAILED 7 j'RvJo¥

1 'y completed

In accordance with Department 0:

o~ hJJJ.6 lent's Administrative Rules, construction and testing of uction & Pump Installation

Section 13-168, entitled "Water Pattycake 1 Well (Well No. 368 Standards (HWCPIS - February 2

UlJAtjIo(.pI~' (/XI U) I.

2.

3.

4.

5.

6.

7.

8.

9.

10.

II.

12.

13.

14.

IS.

The Chai'Eerson of the Commis least two (2) weeks before any v § 13-168-15, Hawaii Administra

This pennit shall be prominentl)

The well construction permit sha test in accordance with til www.hawaii.gov/dlnr/cwrmlfor pennanent pump. No permanent shall be made for purposes otheJ installation pennit may be redu

In basal ground water, the depth otherwise authorized by the ChaiJ

The pennittee shall incorporate n high rainfall, and to revegetate an

In the event that historically sig pennittee shall stop work and recommence only after written cc

The proposed well construction s flow standards. This pennit or th

The Well Completion Report P; www.hawaii.gov/dlnr/cwrmlfor

The pennittee shall comply with i

aJyKMMJ

1» ~ <fWI. Ot \

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shall be notified, in writing, at I activities in accordance with

haiJrperson and conduct a pumping ling Commission staff or at Dporting an application to install a luperson. No withdrawal of water , capacity described on the pump

:I) of the basal ground water unless

schedule work to avoid periods of

:ountered during construction, the ~eservation DiVIsion. Work may

rface water or established instream ights.

vork (please contact staff or visit

'this pennit.

The well construction pennit application and any related staff submittal approved by the Commission are incorporated into this pennit by reference. This pennit 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 pennit application shall be completed within two (2) years from the date of pennit approval, unless otherwise specified. The pennit may be extended by the Chairperson upon a showing of good cause and good-faith perfonnance. A request to extend the pennit shall be submitted to the Chairperson no later than the date the permit expires.

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

The pennittee, 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 pennit or relating to or connected with the granting of this pennit.

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

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

Date of Approval: June 13, 2008 Expiration Date: June 13,2010

N, Chairperson ssion on Water Resource Management

I have read the conditions and terms of this permit and understand them. I accept and agree to meet these conditions as a prerequisite and unde~lying conditio~ o! my ability to proceed a~d unde.rs~and that I shall not commence work u~til I hav~ .. s.igned, dat~nd returne~ the permit to the Commission. I understand that thiS permit IS not to be transferred to any other entity. I alsodb~stand 8li\ non-comphance with any permit condition may be grounds for revocation and fines of up to $5,000 per day starting from the per~it date pf ~pprov~l.

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Driller's Signature: £fez&, d: d .... L C-S7 License #: BC-23379 ; :1ate: i /J611f / , .~ ~ Djamond ~nstructi12n and

Printed Name: Rod Diamond Firm or Title: ~. Water WdbDrilling;-J ,.. CJ"


Attachment

CRoSION ON WATER RESOURCE MANAGEMENT 0

ROUTE SLIP FOR PERMIT ISSUANCE 6/25/08

FROM: RYAN DATE: 6/26/08 .-=..:.;== ______ SUSPENSE DATE:

TO: INIT. TO:

CHENG, C. CHING, F. CHONG,R. DANBARA, S. ENGLAND, D. FUJII, N. -4-

-1-HARDY, R. til -2-HOAGBIN, S. ICE,C. IMATA, R. ---3-KAWAHARA, K. --

WELL NUMBER 3688-24

application type BOTH 1 WCP COVER lETTER ./ 2WCP ~ 3 WEll CHECK PRINTOUT -;:r

proposed well section issues?'

4 PIP COVER lETTER 5 PIP

;/

KIMURA, J. KUNIMURA, I. LEROUX, E. MILLS, D. OHYE,L. OHYE, M. SAKODA, E. SWANSON, S. UYENO, D. YODA, K. YOSHINAGA, M.

WELL NAME

COMMENTS: date rec'd 6 SOWB 7 WWB 8 CWB 9 lO

10 HP

S\~

INIT.

~ ~

.'

Approval -3-Signature -4-lnformation

Pattycake 1

issues?

i

11 lUC 12 OCCl

not in CD ,;,X;...-_______________ _ not in CD '""X;...-_______________ _

13 SMA 14 BWS

not in SMA-=:X~----------------5<:

NOTES: DRILLER

TMK

phone fax cell

PUMP CAPACITY WELL OWNER LANDOWNER COMMENT DEADLINE

Rod Diamond Diamond Construction and Water Well Drilling 23379 HCR#3 Box 14073 Keeau 966-4129 966-4129 987-8100

1-5-052:076 16

Robert Anderson Robert Anderson

6/13/08

HI 96749

PLEASE:

See Me -1-Review & Comment

Take Action Type Draft

-2-Type Final File Xerox copies

if checked, send to applicant

~

"-LINDA LINGLE

GOVERNOR OF HAWAII

Ref: 3688-24.pip

Mr. Rod Diamond

o c




Diamond Construction and Water Well Drilling HCR #3 Box 14073 Keeau, HI 96749

Dear Mr. Diamond:

Pump Installation Permit Pattycake 1 Well (Well No. 3688-24)





KEN C. KAWAHARA, P.E. DEPUTY DIRECTOR

July 10, 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 weH resurveyed) and documentation of the new benchmark shaH 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.

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.

Sincerely,

.~ItL-WLA RA H. T~~EN

,. \ - Ch irperson

Enclosure

c: Robert Anderson (with applicable comments - DOH SDWB, WWB, CWB) USGS HawaiiDWS

/

I Q,UMP INSTALLATION PERMIT

Pattycake 1 Well, Well No. 3688-24

o Note: This permit shall be prominentlv displaved 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 Pattycake 1 Well (Well No. 3688-24) at TMK 1-5-052:076, 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 16 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/cwrrn.

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.

II. 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 und"er 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:

June 13, 2008 June 13,2010

~L

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:


BeC-57, C-57a, or A License #: 23379 Date:

Diamond Construction and Firm or Title: Water Well Drilling


Attachments

J


Ref: 3688-24,wcp

Mr. Rod Diamond

o





Dear Mr. Diamond:

Well Construction Permit Pattycake 1 Well (Well No. 3688-24)



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


July 10, 2008

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

Special Conditions

1. Attached for your information are copies of the Department of Health's (DOH) review comments. Please note DOH's requirements related to discharge of 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/cwrmlfonns.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 staffat 587-0255.

S:t£incerely. (:!... ~ Gv""LA H. T~fE~ 1 Ch irperson

Enclosures

c: Robert Anderson (with applicable comments - DOH SDWB, WWB, CWB) USGS HawaiiDWS

-J o

WELL CONSTRUCTION PERMIT

Pattycake 1 Well, Well No. 3688-24 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 U se, Wells, and Stream Diversion Works", this document permits the construction and testing of Pattycake 1 Well (Well No. 3688-24) at TMK 1-5-052:076, Hawaii, subject to the Hawaii Well Construction & Pump Installation Standards (HWCPIS - February 2004) which include but are not limited to the following conditions:

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

II.

12.

13.

14.

15.

The Chai'Eerson 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/cwrmlforms.htm). The permittee shal sutimit to the Chairperson the test results as a basis for supporting an application to install a permanent pump. No permanent pump may be Installed until a pump installation permit is approved and issued by the Ch!l1rperson. 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 (114) 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 sto!, work and immediately contact the Department of Land and Natural Resources' State Historic Preservation DiVIsion. Work may recommence only after written concurrence by the State Histonc Preservation Division.

The proposed well construction shall not adversely affect existing or future legal uses of water in the area, including any surface water or established instremn flow standards. This permit or the 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 contmninated, a lien on the property may result. Any variances from the HWCPIS shall be approved by the Chairperson prior to invoking the variance.

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

If the well is not to be used it must be prorerly capped. If the well is to be abandoned during the course of the project then the permittee must apply for a well abandonment permit in accordance with § 3-168-12(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 dmnage, personal injury, or death arising out of any act or omission of the applicant, assigns, officers, employees, contractors, and agents under this permit or relating to or connected with the granting of this permit.

This permit shall apply to the location shown on the application only. If the well is to be relocated, the permittee shall apply for a new well construction/pump installation permit In accordance with Hawaii Administrative Rules 913-168-12(1).

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

Date of Approval: June 13, 2008 Expiration Date: June 13,2010

N, Chairperson er Resource Management

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

Driller's Signature:


C-S7 License #: BC-23379 Date:

Diamond Construction and Firm or Title: Water Well Drilling


Attachment

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Results

LINDA LINGLE GOVERNOR OF HAW All

o

DB MAY 23 A 8' ~ 7

r; ,. ':':- ';;STATE OF HAWAII I -'; . ~ ,

o

i\t .~ .•. \c. ~ErA~!~~TIOF LAND AND NATURAL RESOURCES

STATE HISTORIC PRESERVATION DIVISION 601 KAMOKILA BOULEVARD, ROOM 555

KAPOLEI, HAWAII 96707

May 12,2008

Ken C. Kawahara, P.E., Deputy Director Commission on Water Resource Management State of Hawaii P.O. Box 621 Honolulu, Hawaii 96809

Dear Mr. Kawahara:

SUBJECT: Chapter 6E-8 Historic Preservation Review -


BOARD OF LAND AND NATIJRAL RESOURCES COMMISSION QN WAlER RESOURCE MANAGEMENT

RUSSELL Y. TSUJI FIRST DEPUIT

KEN C. KAWAHARA DEPUTY DIRECTOR - WATER

AQUATIC RESOURCES BOATING AND OCEAN RECREATION

BUREAU OF CONVEYANCES COMMISSION ON WAlER RESOURCE MANAGEMENT

CONSERVATION AND COASTAL LANDS CONSERVATION AND RESOURCES ENFORCEMENT

ENGINEERING FORESlRY AND WilDLIFE HISlURIC PRESERVATION

KAHDOLAWE ISLAND RESERVE COMMISSION LAND

STATE PARKS

LOG NO: 2008.1352 DOC NO: 0805TS08 Archaeology

Request for Comment on a Well Construction/Pump Installation Permit Application, Pattycake 1 Well (No. 3688-24) Keaau Ahupua' a, Puna District, Island of Hawafi TMK: (3) 1-5-052:076

Thank you for the opportunity to comment on your project.

We determine that no historic properties will be affected by this undertaking because: D Intensive cultivation has altered the land D Residential development/urbanization has altered the land IZI Previous grubbing/grading has altered the land D An accepted archaeological inventory survey (AIS) found no historic properties D SHPD previously reviewed this project and mitigation has been completed D Other:

In the event that historic resources, including human skeletal remains, lava tubes, and lava blisterslbubbles are identified during the construction activities, all work needs to cease in the immediate vicinity of the find, the find needs to be protected from additional disturbance, and the State Historic Preservation Division, Hawaii Island Section, needs to be contacted immediately at (808) 981-2979.

Please contact Timothy Scheffler (808) 981-2979 if you have any questions or concerns regarding this letter.

Aloha,

Nancy McMahon, Acting Archaeology Branch Chief State Historic Preservation Division

------------_. ----~ .. ~ ........ ".---------------------.

-+ ~'lA'/-21-2008 14:52 From:DOWSAFE NOT~R BRAHH 8085854351 To:80P -:)7 0219 P.7"18 ".

RECEIVED srJE DRINKli~G WATt:R 3RANCH

LINDA ~INGLE MAY - 8 200a LAURA H THIH~N (lO\p'l:~~O"O' Y,A,W'\!I

STATE OF HAWAII oePARTMENT OF lANO AND NATURAL RESOURCES

COMMISSION ON WATER RESOURCE MANAGEMENT PO. 60)(621

HONOLULU HAWAII 96309

May 5, 2008

MEREDITH J CHING J>W1:3" FRAZIER NEAL S FUJIWARA

CHIYOME l. I=UI(INO, M 0 DONNA FAY ~.I(IY06AKI, P.E LAW~ENCE H MIlKE, M.O, J,t)

KEN C. I<AWAHAAA, p.E. "II!"'~'N I)lrI,I:C:10n

t11. ~.~!1C ml: {t:- c " 00 - Z4 ()" ZhD(;lrd

\l~C :: P'Oh'le-;h'(.-,

TO: Honorable Chiyome L. Fukino, M.D.~ Director Department of Health

Im:ation = H f~ ~i.hl (ahove)(tg· • lie line grd, \.:lev. '= q(P I well dia. = 4.0'1 Attention: Director's Office

Tomas See, Chief. Wastewater Branch well depth == I ~I' .fituart Yamada, Chief, Safe Drinking Water Branch

Alec Wong, Chief, ct~n Water Bra ch

FROM: Q.v'Laura H. Thielen, Chairperson 1 '1~ \" Commission on Water Resource Management'

SUBJECT: Well ConstructionJPump Installation Permit App ication Pattycake 1 Well (Well No. 3688-24) ll'l'\ K; l~) I·r;. rJZ: 7(P

Oi lIe,.-: -p~ d¥'letr f) k;;J WlDfld

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 returnnDf this cover memo form by June 13, 2008. If we do not receive comments or a request for addition a fCview 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 addjtional review time, please contact Ryau lmata of the Commission staff at 587 ~0255.

R155 Attachment(s)

RESPONSE: 11

11

II

11

II

II { I

{ I

rhj~ well qllahlit, as a so~e which will s~rve as a soutce of potaille wat~r t" , pllbh< wJ1er sy!I'm [d~fj~.d QS 3~"'lOg 25 OJ more people at leasl60 d:a}"ll per )car or,~s. I S or more ~ttvl-tC It:QnncotlQnti):md must Tt'!1I::'!!lYe Plt'~ctor ofHeiilllth ~pp:ro .... Q) ~ Co it.:; uSc:: .0 wmply -.,vit}, Haw::l1I Admmim;;:a1Jvc Rulc5 (HAR), Tltl" \I, Cha\lt~r 20. Rules Rclatlllg to Potable Water Sy,tetns. §11·Z0·29

fhl5 w.U do •• n,,1 qualIfy as • ~."."" $",v,ng • pu.ht w.t.r $y.tom (.erves I ••• I"'~ 2, poopl. QI" more p~opl~ atlea~t ~O days ptt ye ... or IS "I"IIC. oonnocllC:ul,$) and ift •• w.lI water ... used for drilllonS, lhe priv.t. owner .hould tes! fr:rr bl~teriolol!'csl OJId ch.mll:al prese!let before Inib"''''a su<h .... v<d ,c>uIIO\.I.y IM!litoo: lb. w~t.f <\Mlity th"r.~ft.r HowovOf •• f N:tw<> pl~ .... e~ ,,$¢ /'r">;n. Ihi. '''''..,0 ;no",,,;o. to mee! the public waler 'YStom ~cfimtlOn th~D DieGtar Df H~lth iIIlfIlroY'Zlll5 reQuned ~ lo 11Dplenu:ntillhon

Iftbe well i •. u,ed 10 ,upply botb pol.bl •• "d non1'm.bl. ,urpo, •• 10 • 'lngle !!),s\em, the u,'" shall.li.rn, .. al< .ro~s·~onnectloDS and bacldlow .Qn,n.~.,,~, by p~yo;.,.U} •• p .... ting "",_bl • ..,d "",,·p~I .. \JI ... yolom. t,oy on ." gop Q' ..... ""rQv..o b.okfuw prevent"r, and b~ cl<arly 14bolin8 ~II non-1>ot~bl~ s";'g()t$: with ~ll'\in8 signs to pre .... ent. ttlIill4ver1;ent: cQn~l)b'l.:pho. of "'Q"'l"~:j.bll; ....... ::a.1,:::1: 8.:J.r;.kflo'W ~1:QVI;n.t'on d,=viec!:- !On.Duld be: routInely mr;.pc.;:tcO ... dt.,I.d.

It (\~es not app03I that thIS \.Yell Will tie USM [or OOllsumptive PUI1>O!lel aM II not ,uoJctt to 5al'e Dnnking Water Rcgulatioft5

An I'lFD.ES penni! i, "'qu"ed

In the I!vl!!nt tlm.t th~ 100.llt!0Jl of the well chlUlae~ out 1" :;1111 wlth.ln UK! ~rol;t.] d"s.erlbe-d Ott thu apph~alion_ out dn1:;lOn cQn~.dcr~ tbc oornroen.ts to ~tln be: ~pphcabJe. lJJ)d wo do !lOt need 10 rev,ew the new locatIon

No cDmmcnt:;!objc;[ition~

Contal;( Person: MICJ..I.Qt-L MlvUJfltl'i;A

signed:· __ :?,-Ai:,..... ('-Jt~~/t.=""'~:...l.,·==-~_f ____ ~~ Phone: __________ _

r'lA'r' - 21 - 2008 03: 08Pf'1 FAX: 8085864351 ID: DL~~R CWRM PAGE: 007 R='34~:

~lA'{-21-2008 14:52 From:DOWSAFE wvr;R BRANH 8085854351 To:801? -·'7 0219

CWRM Application Source: pattycake 1 Well (Well No. 3688-24)

Safe Dr!nking Wgter S~angh (SRWB) - Engineering Section

See private water wells information sheet

SDWB Unde~g~ound Injection Control (UIC) Section

In general, a shallow well, or a well that recharges quickly from local rainfall, should not be used as a potable water source because such a well increases the risk of having unsatisfactory groundwater quality that when consumed may compromise health. Factors that directly influence a well's groundwater quality include wastewater disposal systems (cesspools, septic systems, drainage wells) I lawn/garden/cropg:r'owing activities, and even the proximity to the ocean where salt water intrusion may occur.

Well water quality should be initially and periodically tested for it's acceptable and intended use, especially if for human consumption. Water quality should not be presumed acceptable and unchanging. Land-based activities around the well and within the well's recharge area may, over time, have an unacceptable effect on the well's wateJ::' quality. Well construction materials and related equipment could also affect water quality.

CWFIM Well Application Standard Comments (SDWB)

Vers. 4/5/08

P.8 r 18

r1R'r'-21-2008 03: 09P~1 FRX: 8085864351 ID: DU1R CWRM PRGE:008 R=94%

t'lA'{-21-2008 14:52 From:DOWSAFE WQTI:;R BRANH 8085854351 To:80P -'"'!7 021'3 P.'3/18

" ....

WARN.ING! As the owner of a privately-owned well, you should NQI assume that

water from your well is safe for consumption. It is your responsibility to make sure that your well water is safe to drink. The only way to do this is to have your well regularly tested for bacteriological and chemical contaminants,

There are no regulations controlling water quality in private wells serving individual residences as there are for public water systems (public or privately owned utilities supplying water to 25 or more people or 15 service connections). In otl1er words, there are no enforceable limits for contaminants and no requirements for regular testing. Private wells are often found in rural areas, where many activities such as onsite wastewater disposal can contaminate the ground water,

U.S. ENVIRONMENTAL PROTECTION AGENCX(EPA) ReCOMMENOATIONS

The EPA recommends that private well owners test their well water each year for such contaminants as Total Coliform Bacteria, Nitrates, as well as any other contaminants that may be of concern in your area. More frequent testin9 may be appropriate if you suspect a problem, EPA also suggests that you consider testing for pesticides, organic chemicals, and heavy metals before using it for the first time, Please refer to the EPA website on Private Drinking Water Wells at http://www.epa.gqv/safewater/privatewells(fag.html

OTHER CO!':I,T AM I NAIIITS

Water testing can be very expensive. It is important that you spend time to identify what other potential contaminants may be of concern, Please refer to the EPA website on Private Drinking Water Wells at http://WINW.epa.gQVlSafewater/privatewells/whatyOYCando.html for more helpful information. Be aware of what and how you use and dispose of household and garden chemicals. Also determine the location of nearby septic tanks or cesspools, and agricultural or industrial activities in the area. General information on known chemical contamination of ground water in Hawaii can also be found at the DOH website www,hawaii,gov/health/eoyicoomental/water!sdwb/conmaps/pdf/conmapsOS,pdf

bAPQRAH®ES

Local commercial laboratories can be found in the yellow pages of the telephone book under "Laboratories, Analytical." Whenever possible, utilize a laboratory that is certified or approved for the specific drinking water tests and carefully follow their instructions for collecting, staring, and transporting the samples. Just be sure to ask the lab to use EPA approved methods for dnnking water analysis. A list of labs certified or approved by the Department of Health can be found at www.hawaii.QQv!IJealth/environmental/waterlsdwb/sdwblpdftIesting%20LabS.pdt.As lab certification status changes constantly, confirm their status when you contact the lab. Please note that the list is limited to currently regulated contaminants in public water systems,

RESULTS

Once the lab provides you with the test results, you will be in a better position to determine if your well water is safe to drink or what contaminant you need to treat for. Generally, you shOUld compare the results with Federal (WoNW,epa,qov/safewater/mcl.html) and State (www,hawaii,gov/heglth/environmentallwater/SQwbl§dwb/pdfJState%20MCL,Pdf) drinking water standards. Where your test results are greater than the State or Federal maximum contaminant levels, your well water should be considered as unsafe for consumption.

MA'(-21-2008 03:09PM FAX: 8085864351 ID: DUiR CWRM PAGE:009 R=94%

'.


o o

STATE OF HAWAII



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



DEPARTMENT OF LAND AND NATURAL RESOURCES

COMMISSION ON WAT~:: B~;~?URCE MANAGEM~ENT ',' c~\~ . .&; '~I, \ HONOLULU, HAWAII 96809 • ::> v- f

May 5,2008

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

.Jtomas See, Chief, Wastewater Branch Stuart Yamada, Chief, Safe Drinking Water Branch Alec Wong, Chief, Clean Water Br ch

FROM: ~Laura H. Thielen, Chairperson ~. f~ \' Commission on Water Resource Management

SUBJECT: Well ConstructionlPump Installation Permit App ication Pattycake 1 Well (Well No. 3688-24)

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

We would appreciate your comments on the captioned application for any conflicts or inconsistencies with the programs, plans, and objectives specific to your department. Please respond by returning this cover memo form by June 13,2008. If we do not receive comments or a requs for additional review time by this date, we will assume that you have no comments. ~ It':? CII7

(F-ld

Please find the attached maps to locate the proposed well. If you have any qUestrons atJDt this" permit application, ~equest additional information, or request additional review time,~~~e contflC:t Ryaii.I1 Imata of the CommISSIOn staffat 587-0255. t'':' ':;~ - (j

::: ~ (..0.) f11 RI:ss Attachment( s)

-< rr1

__ ,' .''3Iit''

RESPONSE: c:;;:;t c.al [ I

• - nI This well qualifies as a source which will serve as a source of potable water to a public water system (defined as serving mi' more peopl~ast 60 days per year or h"" IS or more service connections) and must receive Director of Health approval prior to its use to comply with Hawaii Administrative Rules (HAR). Title 11. Chapter 20. Rules Relating to Potable Water Systems. §11·20-29.

[ I 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.

[ I 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.

[ I 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 contaminatiowis [ I is not located near the proposed well site (information attached).

[ I

)( [ I

An NPDES permit is required. •

Other relevant DOH rules/regulations. information, or recommendations are attached. ~Js. a;rJL-- 1..{}J1Jn leJ a ~ In the event that the location of the well changes but is still within the parcel described on this aJplication. our lvision considers the comments to still be applicable. and we do not need to review the new location.

ttact~~~~a. ih f.}, '10 Phone: C; 33--0 i/o/ SIgne~ ~~'1-tA /h'tJibol{,£I"'--Date:_(J_~----,1_8_-o--=B_

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Application Information

Pennit 10, 37363 ~------J IWS Type, Cesspool-New v. ---------------------

File Number, 0 1.-------::1

Island, LHawaii ~

Application: 0 Status: ~. App~oved "(I

I Project Information I Engineer, l~~!'1.:.~~_!'~ ______________ ~J ~ TMK, 1315052076 •

IWS may be within 1,000 ft. ofa potable we

Street Address, 115- 151 0 7th Avenue

Street Address 2,

Suite I Apt.,

City, "-IH;,,;.p-'-p ______________ -'

State: Hawaii

Zip Code, r------,

I Payment Information I

Source, WWB

Description, I

I Review Information

Submit Date, 18/16/2007

Reviewed, 18/23/2007

Plan Approved, 18/23/2007

Inspection Date, 112/18/2007

Final Approval: 11/3/2008

Tennination Date,

Hlm"A Hu.!.!A H';HA

H+"A Hlm"A

Payment Type, [Check _ "".,1 Check Number, 1"'1...;.7..0.8.;.9.;.8 __________ --' Amount: 1"'1..0.0.;.0"'.0..0.0 ___ ---'

Check Date: 18/16/2007 I Payor' Ius Postal Service

-Added By, Ifukushima 8/16/2007 12,53 PM Last Modified, jnunogawa 1/3/2008 1,18 PM

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Site Information

I Prol!en:l Owner I

First Name: IRobert

Last Name: IAnderson

Street Address. 115-1510 7th Avenue

Street Address 2:

Suite/ Apt. Number:

City. IHPP

State: [Ha'waii ~ '--.J

Zip Code: I Use Project Address: [EJ

411 Reports fiL-~""'. Grants

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I Dwelling Information I Lot Size (sq ft.): 143560

CPR Lot.

Dwelling Type: [New Dwelling

Existing IWS.

# of Existing IWS:

other Wastewater Bldgs:

Total Bedrooms: ~~----jiJ Designed Flow Rate (gpd): 1800

Building Type: ~nti.I~1

LCC: [EJ Potable Well within i,OOOft? [EJ

§;. My Profile

Added By. Ifukushima 8/16/2007 12:53 PM Last Modified: jnunogawa 1/3/2008 1,18 PM -• Internet

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I Cesspool Information 1----------------------------------------------------------------------,

Cesspool Depth (feet): ~ll:3=====~ Cove .. Diameter (feet): "'Is'--__________ --'

Cesspool Diameter (feet): ~16======~ Size of access thn.! cover: .... 16 ____________ --'

Ii" Inspection Pol"tw/Cap to Grade: ~ Lining Type: ~ _____ -¥_'--'-'.I

RemarKs:

Added By: Ifukushima S/16/2007 12,53 PM Last Modified: jnunogawa 1/3/200S 1, lS PM Save

Il http://onestop ,eha.local/wwb/Permits/PermitSystemCP .aspx?permitID=eeed7677-fbf3-43e8-bf40-14971a9a284d&FReNumber=O&TB=tabIWSSy • Internet

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r"\ 0 "-Ii CESSPOOL INFORMATION CARD DEC .~ 7 lW7hk \

~K: (3)/ .. G"- 5i"Z: 76 Lot No. v

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Properly Own«: ~~; /h./iJi!(2,$t:1A/ /5"-/6"/0 7 iil1 AZJ!L

Project Addreu: «?i&d:V ' d?fI..u,IAt/ District: _-4-~"';;~:c.fU.=-~c... ____ _ PAJd/.V8If11L1JJ:? \J IP/1Jlt1 ~J7f~ "5~~

Engineer. ~!~ I/tf'IINf Contractor: ~&J77 JC==7 ~~~ Distalla: from Building: /" I Distance from Property Line:4G /

/' /~I Di ....... (Clear) F~: 0 Depth Fed: . ____ I.._....:.,~ ______ _

__ )_2_~_·_' ___ Ground Slope: __ -o~_-______ _ No. F~ to Water Table:

Type of Lininl: _---:IJ:...-a...;~_=------ Reinfora!d Concrete Cover. __ .s.~_~_~~ ___ _

/ ~ Distance from Finished Ground to Top of Cover (F~): ____ ... _~ __________ _

Date Inspec~ by Engineer: It. ·/~ .07 No. of bedrooms: _=3::.-__ .

Ali tM engi ..... petfonninl the final inspection, ( submit the above . . and the -As-built- u drawn OD the back of this .:ard. I also submit the (oUowin. statelMllt: ~ ~ MARK ~ -.-L The cesa .. pool has been i witfl submitted and approved by DOH.

--v- The noted changes to ~~=~I~~:t~=' installed is acceptable to me. The construction the , ved plans and I do not accept the changes made to the pi

C 2 6 2007 En!:ln~r'!I Signature and Dale: --L..-~~---~~~;::::;iOIIf'1~~--------

'~(l:1' ---- ..

May-12-2008 01 :22pm

LINDAUNGLE GOJEH~o.R:OFHAW"'"

From-DEPT OF HEALTI~,d"1 RONMENTAL MNGMT 8085864352 T-430 P,006/00T F-204

L.AVRA H. THIEL~N Ot-A_PJ;fI:!.O~

MEREDITH J. CHING JAlvES A. FRAZieR ~EAL s. FUJIWARA CAliI

CHIYOMe l. FuKINO. M.O, OOIllNA FAY K KIYOSAKI, P.E,

LAwRENCE Ii. MilKE, M,O,. J 0.

STATE OF HAWAII DEPAf(iMENT OF LAND AND NATURAl. RESOURces

COMMISSION ON WATER RESOURCE MANAGEMENT 1".0. eOJ(B11

HONOLULU, HAWAII e.ijQ$

May 5,2008

KEN C. Il'AWAHARA. P.E, !;IiPIITY ~1RGCTOfi

26B8 HAY 3 10:40M

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

Tomas See, Chief, Wastewater Branch $tuan Yamada, Chief, Safe Drinking Water Branch

JAlec Wong, Chief, Clean Water Bra ch

FROM: ~aura H. Thielen, Chairperson 't, raL---... \ Commission on Water Resource Management

SUBJECT: Well ConstnlctionJPump Installation Permit App 'cation Panycake I Well (Well No. 3688-24)

Transmitted for your review and comment is a copy of the captioned Well ConstructionfPump 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 reSj!ond by returniDI this c()ver memo form by J .... e 13, 200K If we do nOt rc:ceive comments or a request for addifional review time 6y this date, we will a!igunte that you have no comments,

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

Rl:ss Attachment(sl

RESPONSE:

( 1

I)

II

[ I

f I

( 1

c./ [ 1

( 1

Tllis w-II qUb.lif"lI!os as a sourw wblGh will ,.,,,.,, as a BOllrCC ofl'",.\:>I. w .. ..,.I<> 0 publiC wat •• 'Y"ttn:. (dcfiaed as s..-vinlJ Z~ or morcpcople 'U""$! eo d~ PO' YOM Of "'l" l! ot: mOT< sc:vi<IC "onnc"t;<:>no) ililiI'-USl rtceivc Dire",,,, ofH.~leh approv.1 ~ III ItQ Ill!: Ie CCtllllJlly with Hawni; Administrative R.les (HAR), Tltl- ll, Chaprcr 20, RlIlcsRolatma CO ?Il\llble Wattt Systems. ~11-lO·29

TIll. _II 010'" not'l"a1ify .s a 80urW •• rvins _ J'"blic wa"" system (s.rve, I ... th~n 25 pBopl~ "" m"'~ ~cple a, least 60 days per year or 15 sen'i..e ""Illl~t.ons) and ifn..: woll w~v.c is .. sed for drinking, the pnn\<> Dvn1I'l' .!aallid tcst for ba~tcrii)logiQ~1 aDd Qhemi~ p ..... ~ .. It~ hefot! initiatillSSlICh 1190 lUId rOllli",,)y .1I/tAilor the water q~IiIY Uu>r"aiter However, if fututo rl.no,,01 ••• from this so"",,, iner .... e. to m •• , tile p1>l>Iio "",t., ,y~!"m oId'QiliQll thell Ditc<Icr ofH.~IIL "Pptoval i. required ~ 10 imp\oml>"t.tiOIl

If th. woU i~ '1.,,41 ro supply both plYlabl. ~na:l nOn.putable pUIJlOK;~ In a aD!!I. zy,tcm, Ihe .. ~e.- Sholl cli.nillale croas-;oIlMQfiom; ;md \Iiocktlow eOWlections by pby~,c.lIy ~epal'atj,.g p<ltable ~nd non-pot"bl. S}I'It"M by all air liSP or .n i\PJlfCYVod b.ok!k>w ptt;wn[cr, and by (;lcllriy labelilli allllOnJKi!ihklspigoti willi Wl!%1\in~ "Ill\s [0 pttVCl1! .ina4v~mnl oO!l>UmptiDn of lion-potable wilier. Tlaoldlow PJevention devices should be coUIinr;l)I inslX'Qtcd lind t~Slod.

IttiOl!!8 nor appcilr thill lb •• WI>II will be uacd f<lf c;)ru;ympliv. purpo ••• and i6 uOt sub,lcct ro Safe Dnnl;ill8 W~t.r Rogul&tiollOl.

fonl\(; appliQallt'. illfor ... """ • 8()\.rct ofposaiblc w~~,=.ter oOllbmin&ticlll Ilia 11 ia!lot 1<>0 .. 11>4 lle;p- tbe propD •• d well ;it. (illfut.tlariou attaChed).

An !>WOES pennir is ~ui",d.

OIh", "'\.vi.t\t OCH rulealrc8\lhIlIQn" inlonnation, Oi recommcndation~ aJO ~~;och.d.

III tbe evenl,ht tb .. IO(;2[i()11 of me well phAn!!'l~ W .~ ,1,11 withi,\ tilt PlII'cc) described Oil ,1m .pplicstion, our Jivi!io.1 COllSider. the comments to still be "fFlc::tOID, lionel wI) dQ not nHc.i l('l ,...v1I1Ut t"", nc"", (Qt;:l.tiCtn.

1'10 ~tlm_lIls1otUcclion~

Contact 'Person: ~_.-..!.G~.I!!!~=~:-.-_L_ . ....;~~.!'--____ _ Phone: 5e~ ~'~jO~

Date: ? /z...- 06 Signed: __ ~(!r---J="::~==~O\~h1w'o,,-=-___ ~

tvlA\'-12-2008 01: 06PM FAX: 8085864352 ID:DLNR CWRM PAGE:006 R=96%

I

~ay-12-2008 01 :2lpm From-DEPT OF HEALT~IRONMENTAL ~G~T 8085864352 ~T-430 P.OOI/OOT F-204

Fax to: Company:

FAX TRANSMITTAL State of Hawaii Department of Health Environmental Management Division

Clean Water Branch· Engineering Section Phone No.: (808) 586-4309

Fax No.: (808) 586-4352

~r. Ryan Imata . . / Mr. Charley lee OmmlSSlOfl n Water Resource Managemel1t

Department of Land and NaTUral Resources

Date: 5.'Z,·oe Fax from: Joanna L. Seto ~

Fax No.: 587·0219 Total Pages, il1cl. cover: 1

Subject; Well Construction/Pump Installation Permit Application(s) \VeIlNo(s) • .j\pse-Z:3 ,56,-15 ~I.OBe-2-1 -;3",ee-~2- ,1<.066-2..1

I I I r J

The Department of Health~ Clean Water Branch (CWB) has the following comments: 5'40e.,-o 2-

(ruW<4 ~ ~~)

1. For Well-Drilling Activities

Any discharge to State waters of treated process wastewater effluent associated with well drilling activities is regulated by Hawaii Adminisrrative Rules, Title 11, Chapter 55, Appendix I, effective October 22, 2007. Treated process wastewater effluent covered by this general permit includes well drilling slurries, lUbricaring fluids wastewater, and well purge wastewater. This general permit does not cover well pump testing. The applicable Notice oflntent (NOI) Fonus and filing fee shall be submitted at least thirty (30) calendar days before the start of discharge to the:

Department of Health Clean Water Branch 919 Ala Moana Boulevard, Room 301 Honolulu, liawaii 96814-4920

The CWB-NOI Forms are available online at http://www,hawaii.g.ov/healthlenvrronmentalJwater/c)eanwater/forms/genl-index.html. Inquiries may be directed to the CWB at (808) 586-4309 Or by fax (808) 586-4352.

2. For Well Pump Testing

The discharger shall take all measures necessary to prevent the discharge of pollutants from enteling State waters. Such measures shall include, ifnecessary, containment of initial discharge until the discharge is essentially free of pollutants. If the discharge is entering a >

stream or rivt:!r bed, best management practices shall be implemented to prevent the discharge from disulTbing the clarity of the receiving water. lfthe discharge is entering a storm drain, the discharger must obtain written pennission from the owner of the stonn drain prior to discharge. Furthermore, best manageme1lt practices shall be implemented to prevent the discharge from collecting sediments and other pollutants prior to entering the storm drain.

MRY-12-2008 01:04PM FRX:8085864352 IO:OLNR CWRM PRGE:001 R=96%

CQISSION ON WATER RESOURCE MANAGEMENQ ROUTE SLIP FOR NEW APPLICATIONS

FROM: RYAN DATE: a-Apr-Oa -----------------

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

-1-HARDY, R. HIGA, D.

-2-HOAGBIN, S. ICE, C.

5 IMATA, R.

KUNIMURA, I.

4 ~~~~: L. \. ./

~--SAKODA' E. _' __ SWANSON, S.

UYENO, D. --YODA,K. --YOSHINAGA, M.-

-3-KAWAHARA,K.==

SUSPENSE DATE:

1 Approval -3-Signature -4-lnformation

WELL NUMBER S0B9-.1Lt

D WELL CONSTRUCTION

WELL NAME Pattycake 1

D PUMP INSTALLATION

ATTACHMENTS FOR APPLICATION PROCESSING - Both applicant & staff generated 1 TRANS. LETTER

2 PERMIT PROCESS TABLE

3 CWRMMAP

4 APPL. FORM (11 COPIES)

5 USGS MAPS (11 COPIES)

6 TAX MAPS (11 COPIES)

7 PARCEL OWNER VERIF.

8 CONTRACTOR VERIF.

9 ALL INFO FILLED IN

---;;r ----:;T, MLS PRINTOUT ---7- DCCA LICENSE SCREEN PRINTOUT -:7

15-Apr-08

PLEASE:

See Me -1-Review & Comment

Take Action Type Draft acknow letter

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

Xerox copies

e:(BOTH

10 BACKGROUND CHECK

11 $25 FEE DEPOSIT SLIP

12 DHP/CDUP/SMA pre-screen

~""'VVO~--<JpW~

'3'> (SMA m~J;in\iut ~p%is~~raI.COmlwebsite/Parcelzoninglviewer.htm.,or INGRID'S SMNCD MAP) --(LUC map printout http://luc.state.hLus/luc_maps.htm., or INGRID'S SMNCD MAP)

FOLDER:1Z1 D

MADE NEW FILE FOLDER, ATTACHED FILE FOLDER ALREADY MADE, IN FILE CABINET

INCOMPLETE ACTION DATES:

DATE ACTION

_...(,IlJ...u;M=.I"t...;...r---..:~!I<:..--_-':'·~_/.._\ -_?;_:}_--,,-,IM4~I€<c...>::.....-~~J{.;....t,._~ ~ ~ J+ o.prv'O?~~hl7

'------------------------... _ ..


Mr. Rod Diamond

o o




May 5,2008


Dear Mr. Diamond:



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 .

3688-24.ack

Well ConstructionlPump Installation Permit Application for Well No. 3688-24

We acknowledge receipt, on March 24,2008, of your completed Well ConstructionlPump Installation permit application and filing fee for the Pattycake 1 Well (Well No. 3688-24). 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: Robert Anderson

Sincerely,

~ AHARA, P.E. Deputy Director

LINDA LINGLE GOVERNOR OF HAWAJI

TO:

o o


COMMISSION ON WATER RESOURCE MANAGEMENT P.o. BOX 621


May 5, 2008

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

Tomas See, Chief, Wastewater Branch



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


Stuart Yamada, Chief, Safe Drinking Water Branch Alec Wong, Chief, Clean Water Bra ch

FROM: Q.v'Laura H. Thielen, Chairperson 1. rtiMJ~ \- Comrriission on Water Resource Management

SUBJECT: Well ConstructionlPump Installation Permit App ication Pattycake 1 Well (Well No. 3688-24)

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

We would appreciate your comments on the captioned application for any conflicts or inconsistencies with the programs, plans, and objectives specific to your department. Please respond by returning this cover memo form by June 13,2008. 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 staff at 587-0255.

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 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 IS service connections) and if the well water is used for drinking, the private owner should test for bacteriological and chemical presence before initiating such use and routinely monitor the water quality thereafter. However, if future planned use from this source increases to meet the public water system definition then Director of Health approval is required prior to implementation.

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

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

For the applicant's information, a source of possible wastewater contamination [ lis [ 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.

No comments/objections

Contact Person: _________________ _ Phone: ____________ _

Signed: ____________________________________ _ Date: --------

o o LINDA LINGLE

GOVERNOR OF HAWAII LAURA H. THIELEN

CHAIRPERSON

MEREDITH J. CHING JAMES A FRAZIER NEAL S. FUJIWARA



TO:

FROM:

SUBJECT:


COMMISSION ON WATER RESOURCE MANAGEMENT P.o. BOX 621


May 5, 2008

Morris Atta, Acting Administrator Land Division

Ken C. Kawahara, P.E., Deputy Director «~c, f~ Commission on Water Resource Management) _

Well ConstructionlPump Installation Permit Application Pattycake 1 Well (Well No. 3688-24) TMK 1-5-052:076


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 June 13,2008. If we do not receive comments or a request for additional review time by this date, we will assume you have no comments.

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

RI:ss Attachment( s)

RESPONSE:

[ ] 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




May 5, 2008

Nancy McMahon, Acting Archeology Branch Chief Historic Preservation

Morgan Davis, Assistant Archaeologist Historic Preservation

Ken C. Kawahara, P.E., Deputy Director tr!v Commission on Water Resource Management

Well ConstructionlPump Installation Permit Appl cation Pattycake 1 Well (Well No. 3688-24) TMK 1-5-052:076



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



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 June 13,2008. If we do not receive comments or a request for additional review time by this date, we will assume you have no comments.

Please find the attached maps to locate the proposed well. If you have any questions about this permit application or request additional review time, please contact Ryan Imata ofthe 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: ---------------

-------------_ .. " ....

Search Results o o Page 1 of 1

Assessed values for Oahu reflect tax year 2008. All others reflect 2007.

Search criteria: TMK Taxkey 3-1-5-52-76

• PUBLIC RECORD DATA Taxkey Subdiv ICondo Tnr Address Owner [Lessee IlfiIrn15. Land area Liv area Last SalE

ne3-1-5-52-76 Hawaiian F 7th Ave ANDERSON, DEBORAH J/ETALO 0 1.00 ac 07/20/200€ Paradise Park

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

Copyright ©4/18/2008 by Hawaii Information Service

http://webre2.hawaiiinformation.comlREsearchIHIS/Searchisearch _PUB.asp?NOCACHE... 4/18/2008

Professional and Vocational LiaSing (PVL) - powered by eHawaii.gov o Page 1 of 1

GENERAL LICENSEE

LIC 10: CT-23379 Active/lnactive: ACTIVE

NAME: RODNEY K DIAMOND

TRADE NAME:

STATUS: CURRENT, VALID & IN GOOD STANDING

ENTITY: INDIVIDUAL BUSINESS CODE: SOLE OWNER

ORIG LIC DATE: 10/12/2001 EXPIRE DATE: 09/30/2008

CLASS PREFIX: BC SPECIAL PRIVILEGE:

RESTRICTION: EDUCATION CODE:

BUSINESS ADDR: HCR #3 BOX 14073 KEAAU HI 96749

MAILING ADDR:

Click here to enter search criteria for prior complaints history -> For prior complaints and disciplinary history, contact licensing and business information center at (808)

587-3295.

http://pvl.ehawaii.gov/pvlsearch/app? _ a=d& _ f=n&lictp=CT &licno=23 3 79&off=&nm=RO ... 4/1812008

QARTMENT OF LAND AND NATURAL RESAES DOCUMENT NO . .. UAC OR ATTACHED WORKSHEET DATE· March 28 2008 ,

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

S 08 326 C 1026 0752 (1) $25.00 County of Maui

" " " " " " (2) $25.00 Mark F. Watters

" " " " " " (3) $25.00 Susan Hawks

" " " " " " (4) $25.00 Robert Anderson

" " " " " " (5) $25.00 Engineering Concepts

" " " " " " (6)

(7)

(8)

(9)

(10)

TOTAL $125.00

REMARKS: LINE (1) KeanaeWell2 LINE (2) BiskeylWatters Well LINE (3 Wai 0 Ola E Mana Well LINE (4) Pattycake #1 Well LINE (5) Anuhea Place Well LINE (6) LINE (7) LINE (8) LINE (9) LINE (10)

'STATEOFHAWi 0 DEPARTMENT OF LAND AND NATURAL RESOURCES COMMISSION ON WATER RESOURCE MANAGEMENT

APPLICATION FOR A WELL CONSTRUCTION I PUMP INSTALLATION PERMIT


RECEtVFO

DB MAR 24 A 8 : 2? Instructions: Please print in ink or type and send completed application with attachmenIs to !he Commission on Weier Resource Management, P.O. Box 621, Honolulu, Hawai 96809. AppIicaIion must be accompanied lIv10 copies and a n0nrefundable filing fee of $25.00 payable to !he Depl. or Land and Natural Resources. The Condl_sion may nul accepI incomplete applications. For assistance, caM !he Regulation Branch at 587~. For furthef infollnation and updates to this application form, visit hIIp:llwww.haoNaii.gov/cllnrlcwrm.

WELL LOCATION INFORMATION 1. STATE waL NO. (if aRady assipd)

same Well Operator's Mailing Address

same

15-1510 7'h Ave. HPP

2. WEl.J.IWE

Pattycake #1

same

3.1SlANO

Hawaii 4.TMK 1

ZONE

6. LANDOWNER'S NAME/COMPANY

Robert Anderson

L.andcJwmr's Mailing Address PO Box 665 Mt. View, HI 96771

5 052 SEC PLAT

Landovvner's Contact

same

076 PARC

Wei Operator's Phone Well Operator's Fax Well Operator's E-mail L.andcJwmr'sFax Landowner's E-mail

982-9162 PROPOSED WELL CONSTRUCTION PROPOSED PUMP INSTALLATION 7. Proposed Work. 8. Conslruclion Type 10. Prq:Josed Work. 11. Proposed Pumping Rate, !JlIII (gaIuns per minute) n Method of flow measurement

X Instal New Pwnp. 16 x Flow meter o Replace Pwnp \-:-;;:------....,.,.,---......,-:---.,..---1 0 Open Pipe X Construct New Well. X Drilled. o MoOty Existing Well. 0 Dug o Abandon/Seal Well. 0 Shaft. o Tunnel

12. Prqxmd Amcult of WiIKtaiIIaI. gpd (gallns per day) 0 Weir

Yes X No

250 0 Orifice o Other

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

X 16 Domestic Number of units to be served:

and no. of acres

21. Conservation District Use Permit (COUP) o Required, COUP # date approved X Well is not in Conservation District []..Not Required (attach documentation from OCCL)

Site Photo

~ I h8118 not checked ~ OCCL about whefher or not a COUP is required. , undetsIand that checIring willi !he County prior to mailing this application will expedite my review. , further understand that issues raised this or resuI in denial or !he . issuance, or nwocaIion or !he after iI is issued. 22. Special Management Area Permit (SMAP) o Required, SMA # date approved . o Not Required (attach documentation from applicable County agency) !i2t I have not checked ~ \he <XlUIlIy about whethef or nul an SMA is required. I undeIsIand that checking willi !he County prior to mailing this application will expedite my review. I further understand that issues raised this or resuI in denial of the . issuance, or rewx:ation of!he . after it is issued. 23. Historic Preservation Division (HPO) of !he DlNR 0..1 hllll8 consuled ~ \he HPD regarding poIenIiaIimpaclsof welconsIrucIion adMtieson hisDic silas. I hale aIIached appIcabIe 00camB1IaIi0n from lie HPD. ~ I have not consuled ~ \he HPD regarding paIenIiBIinlpa:tsofwelconsIrucIion a:tNiIieson hisDic siles.llRllrstInfllalc:hecblg will lie HPO pmr~ maki1g!lis ~ wilexpedite my review. I further undeffltlJ1d that issues nised !lis or red iI deriaI of lie . is$uIn:e or -.am of lie . after iI is issued. . \he' of lim use is att!l:hed.

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

NOTE: Signing below indicales thai !he signaIoIies ... !derslalld and swear thai !he inrormatiun pn:Nided is accurate and true to !he best or their knowledge. Further, the signatories understand that upon permit approval: 1) !he proposed work is to be completed within two (2) ,.ears or !he approval date; 2) !he contractor shall submit to the Commission a well completion/abandonment report within 60 days after" !he completion date or !he penniIted work; 3) in !he -.t thai !he application is nul completed correctly, any permit may be sus ndad until the item is in to . , and work done whie lie . is in . resuI in tines of to 24. WELL DRILLER (Must be filled out if application is for WeI Construction) 25. PUMP INSTALLER (Must be filed cd if app\icaIion is for Pump InstaIIation)

Rodney K Diamond BC23379 Rodney K Diamond BC23379 business name C-57/C-57aJA License No. Licens usiness name C-57fC.57aJA License No.

Rodney K Diamond t14-08 :Lrk£2-..fl Rodney K Diamond t~ 4-08 Print Print

HCR #3 Box 14073 Keaau HI 96749 HCR #3 Box 14073 Keaau HI 96749 Address Address

987-8100 966-4129 987-8100 966-4129 Phone Fax E-mail Phone Fax E-mail

l~~---- SiJilif.Oty----C.-.~oo~~--~-~-~.

Hli

\

0001 )IHdVH!)O~!)

lVNOIlVN

' ... o o .I PROPOSED WELL SECTION (please attach schematic if different from diagram provided below)

Grouting method: Positive

Displacement

x Other

Total Depth

-.1QLfeet.

Hole Diameter: 8 inches.

Minimum of Z Radius & 4W Thick Concrete Pad (to contain benchmark Elevation at top of casing 97.4 ft .. msl* ,- surveyed to nearest 0.01 ft.)

"', 11--4 ---.Lt_-+l~1 ~._ .-1...+ - .. -i .. .-I

: I Ground Elevation: 96.1t, msl*

~;r.' t.: ·t:,'.6,l.-.1 1_

~. .~---- - .... _- c"~1L·W.~; .::.~~:.rl-.---,~-- .. \,~ , I: . .fl"

Cement Grout:71 ft. It-:,, \7',

(min. 70% of distance from :: :: :: ::1

Please refer to the HAW AlI WELL CONSTRUCTION AND PUMP INSTALLATION STANDARDS

to ensure that your as-built is in compliance with applicable standards. ground elevation to top of ::: S ~~: :.', .;';.:. ,i.

II .... ·.:.3:.· water surface or 500 ft.. '_.' .4:1

whichever is less.) i ,:.~:: '~.:: ·-t k:; ;.::--

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

1.5 in. - ." ;'::;i

:\' ~:;J~ NI T .>~ :: ::,

'---------~ +-- t:~·;: .:~~: r-R-oc-k-o-r-G-ra-v-el-P-a-ck-in-g-: --', .Q~)

-2.!L ft. 1 ~ Material:

x Crushed Basalt :

~_O __ Ro_U_n_ded __ G_r_aV_e_1 _~.I ~~r-~~

t-.

Estimated Water Level Elevation:

Est. 2

L I o-t .. I I U

ft. msl*

.... 1

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

Total Length: 96 ft.

Nominal Diameter: 4.5. in.

Wall Thickness: 840 in.

Bottom Elevation: -0- ft., msl*

Open Casing: • Perforated 0 Screen

Total Length: 5 ft.

Nominal Diameter: ___ ~4~.5~ _____ in.

Wall Thickness: ____ S=-..l.4-""O __ ~in.

Bottom Elevation: __ ,.;;.-""S ____ ft .. msl*

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

Open Hole:

Length: __ ,!.-'N<L,A-'-______ ft.

Diameter: ____________ i,n.

Bottom Elevation: ft., msl'

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

For non-salt water Basal Wells - bottom elevation of well should not be deeper than 1/4 of aquifer thickness or, Bottom Elevation of Well Limit = CNateI' Elevation - ) Example: Estimated + 2 ft. Water Le\IeI EJev. Bottom Elevation of Well Limit = (2 -) = -18.5 ft.

Solid Casing Material: Carbon Steel: compliant with (check one or more): OANSIIAWWA C200 OAPI Spec. 5L o ASTM A53 o ASTM A139

And compliant with (check one or more): 0 ASTM A242 (or A606) 0 Type E 0 Type S 0 Grade B 0 Other Stainless Steel: (check one): o ASTM A409 (production wells) o ASTM A312 (monitor wells) ABS Plastic conforming to ASTM F480 and ASTM 01527: (check one) 0 Schedule 40 0 Schedule 80 PVC Plastic conforming to ASTM F480 and (ASTM 01785 or ASTM 02241): (check one): • Schedule 40 0 Schedule 80 0 Schedule 120 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 D3296

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

And compliant with (check one or more): 0 ASTM A242 (or A606) 0 Type E 0 Type S 0 Grade B 0 Other Stainless Steel: (check one): 0 ASTM A409 (production wells) 0 ASTM A312 (monitor wells) ABS Plastic conforming to ASTM F480 and ASTM 01527: (check one) 0 Schedule 40 0 Schedule 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 0329 o FEP Fluorocarbon Tubing conforming to ASTM 03296

WCPI App. Form 10105104

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