Roux - HIGP

'0 COMMISSION ON WATER RESOURCE MANAGEMEN~

ROUTE-SLIP FOR PERMIT ISSUANCE 6/25/08

FROM: RYAN DATE: 3/19/09 ....:::..:...:....::.;:...::...::'--_____ SUSPENSE DATE:

TO: INIT. TO:

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

KIMURA, J. KUNIMURA, I. LEROUX, E. MILLS, D. OHYE, L. OHYE, M.

INIT.

""---

Approval -3-Signature

4 Information

-1-HARDY,R. 16 SAKODA, E. til -2-HOAGBIN, S. SWANSON, S.

ICE, C. UYENO, D. IMATA, R. YODA, K. ---3-KAWAHARA, K. YOSHINAGA, M. --

WELL NUMBER 4959-25 WELL NAME

application type BOTH 1 WCP COVER LEITER • / 2 WCP ----v-3 WELL CHECK PRINTOUT -;;r-

proposed well section issu~ ,.,b/

4 PIP COVER LEITER 5 PIP

COMMENTS: date rec'd

Roux

issues? 6 SDWB J 7 WWB -=V~;--------------

8 CWB iZ 9 LD ~~~j _______________________ _

10 HP 1Z 11 LUC not in CD X 12 OCCL not in CD ~X;------------------

13 SMA not in SMA.;..X:.......,..--______________ __ 14 .aws ~ _\/-'--_____________ _

NOTES: DRILLER

TMK

phone fax cell

PUMP CAPACITY WELL OWNER LANDOWNER COMMENT DEADLINE

Beylik Beylik Drilling and Pump Service, Inc. 21896 91-259A Olai Street Kapolei 682-5554 682-5866 478-7112

7-2-017:006 55

David Roux David Roux

HI 96707

PLEASE:

See Me -1-Review & Comment

Take Aclion Type Draft

-2-Type Final File Xerox copies

if checked, send 10 applicant

LINDA LINGLE GOVERNOR OF HAWAII

Mr. Fred Camero

o o

STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES

COMMISSION ON WATER RESOURCE MANAGEMENT P.O. BOX 621

HONOLULU, HAWAII 96809

April 28, 2009

Beylik Drilling and Pump Service 91-259A Olai Street Kapolei, HI 96707

Dear Mr. Camero:

Pump Installation Permit Roux Well (Well No. 4959-25)

LAURA H. THIELEN CHAIRPERSON

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

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

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

KEN C. KAWAHARA, P.E. DEPUTY DIRECTOR

Ref: 4959-25.pip

Enclosed are two (2) originals of your approved Pump Installation Permit for the captioned well(s) that authorize permanent pump installation work for your well( s). As part of the Chairperson's approval, the following special conditions were added and are part of your permit under Permit Condition 14:

Special Conditions

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

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

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 copy to the Commission office 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 staff at 587-0255.

Sincerely,

, ~L 12. ___ L RA H. T~J~EN . l"'Y C airperson

Enclosure

c: David Roux (with applicable comments - DOH SDWB, WWB, CWB) USGS HawaiiDWS

o PUMP INSTALLATION PERMIQ Roux Well, Well No. 4959-25

Note: Tlris permit sir all be prominently displayed at tire site until tire 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 Roux Well (Well No. 4959-25) at TMK 7-2-017:006, 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 (HAR).

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 55 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 sixty (60) days after completion of work (please contact staff or visit www.hawaii.gov/dlnr/cwrm/resources -permits.htm for current form).

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, if relevant, any related staff submittal approved by the Commission are incorporated into this permit by reference.

10. If the HWCPIS are not followed and as a consequence water is wasted or contaminated, a lien on the property may result.

11. Any variances from the HWCPIS shall be approved by the Chairperson prior to invoking the variance.

12. 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.

13. 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.

14.

Date of Approval: Expiration Date:

April 8, 2009 April 8, 2011

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

Installer's Signature:

Printed Name: Fred Camero

C-57, C-57a, or A License #: AC-21896 Date:

Finn or Title:

-------Beylik Drilling and Pump Service

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

Attachments

/


Mr. Fred Camero

o o


COMMISSION ON WATER RESOURCE MANAGEMENT po. BOX 621


April 28, 2009

Beylik Drilling and Pump Service 91-259A Olai Street Kapolei, HI 96707

Dear Mr. Camero:

Well Construction Permit Roux Well <Well No. 4959-25)



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



Ref: 4959-25.wcp

Enclosed are two (2) copies of your approved Well Construction Permit for the captioned welles) that authorize well construction activities but excludes installation work for a permanent pump. As part of the Chairperson's approval, the following special conditions were added and are part of your permit under Permit Condition 17:

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 copy to the Commission office for our files. For copies of the aquifer pump test worksheet, please call staff or visit www.state.hi.us/dlnr/cwnnlforms.htm.

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

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

c.,LA RAH.~L "(. Ch irperson HfLEN

Enclosures

c: David Roux (with applicable comments - DOH SDWB, WWB, CWB) USGS HawaiiDWS

o o WELL CONSTRUCTION PERMIT

Roux Well, Well No. 4959-25 Note: This permit shall be prominently displayed at the construction site until the work is completed

In accordance with Department of Land and Natural Resources, Commission on Water Resource Management's Administrative Rules, Section 13-168, entitled "Water Use, Wells, and Stream Diversion Works", this document permits the construction and testing of Roux Well (Well No. 4959-25) at TMK 7-2-017:006, 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.

11.

12.

13.

14.

15.

16.

17.

The ChailJ!erson 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 (HAR).

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

The well construction permit shall be for construction and testing of the well only. The permittee shall coordinate with the Chairperson and conduct a pumping test in accordance with the HWCPIS (the latest pump test worksheet can be obtained by contacting Commission staff or at www.hawaii.gov/dlnr/cwrmlresourcesJlermits.htm). The permittee shall submit to the Chairperson the test results as a basis for supporting an application to install a permanent pump. No permanent pump may be installed until a pump installation permit is approved and issued by the Chairperson. No Withdrawal of water shall be made for purposes other 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. If it can be shown that the well does not tap basal ground water then this condition may be waived after consultation with and acceptance by Commission staff. However, in no instance can the well De drilled deeper than one-half (112) of the theoretical thickness without Commission approval.

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

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

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

The Well Completion Report Part I shall be submitted to the Chairperson within sixty (60) days after completion of work (please contact staff or visit www.hawaii.gov/dlnr/cwrm/resources_permits.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, if relevant, any related staff submittal approved by the Commission are incorporated into this permit by reference.

If the HWCPIS are not followed and as a consequence water is wasted or contaminated, a lien on the property may result.

Any variances from the HWCPIS shall be approved by the Chairperson prior to invoking the variance.

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

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

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

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

Special conditions in the attached cover transmitta1letter are incorporated herein by reference.

Date of Approval: April 8, 2009 Expiration Date: April 8, 2011

, 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 have signed, dated, and returned the permit to the Commission. I understand that this permit is not to be transferred to any other entity. I also understand that non-compliance with any permit condition may be grounds for revocation and fines of up to $5,000 per day starting from the permit date of approval.

Driller's Signature: C-57 License #:

Printed Name: Fred Camero

AC-21896

Firm or Title:

Date:

Beylik Drilling and Pump Service

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

Attachment

/

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

Well Number 4959-25 Well Name Roux Ground Elevation 10 Cement Grout 6 Grouting Method positive displacement Hole Diameter 15 Total Depth 20 Water Level 1 Depth to water 9 Public Water Supply Well? no Solid Casing Material pvc plastic plastic Solid Casing Specification Schedule 40 Solid Casing Length 8 Solid Casi~a Diameter 8 Solid Casing Wall Thickness 0.330 Open Casing Length 10

Results

Well Depth Theoretical Thickness of Aquifer 41 1/4 Aquifer Thickness 10.25 Depth of Wellbf:}1ow Sea Level· :.': " :. ('I,[O ol(# .... Section 2.2

Well Casina Minimum Wall Thickness

Material pvc plastic Minimum Thickness per standards no requirement Wall.Thickness Provided :\;:;.t· .,,';:::. : ;.0;33 no standard ~ Section 2.4(b)

Minimum Length of Solid Casing .,..-~ J .4.( g tV'v 90% of ground to top of aquifer /8':--1 \ l/"v/

J:.ength'ofso/i(lcasing Provided ·.'i.·;;,: ',: ..... ;.';./:.<:8 noyenQugh casing Section 2.4(c) CasiligMatedal : '.': :". Schedule.40 . . :.; :;:;;:;.~; . ~ . fWi' compliance Section 2.4(d) (for pvc only. check for 200'limit) •... , okay Section 2.4(d)

Annular Space Depth of Grouting /' . '""".. /'00

Calculated Depth of Grouting ~.3 \ J .JtVarV Depth ofGfouting pfovided .: '. i;:: .'\6 not en96gft/vu 7 Section 2.6(c)

Minimum Annular Space required 1.S --" Thickness Of Annular Space .,':' .. ' ...... ;':: ' '3;5 ok~y Section 2.6(d)

LINDA LINGLE GOVERNOR OF HAW All

March 23, 1009

o o


STATE HISTORIC PRESERVATION DIVISION 601 KAMOKILA BOULEVARD, ROOM 555

KAPOLEI, HAW All 96707


BOARD OF LAND AND NATURAL RESOURCES COMMISSION ON WATER RESOURCE MANAGEMENT

RUSSELL Y. TSUn FIRST DEPlITY

KEN C. KAWAHARA DEPUTY DIRECTOR· WATER

AQUA TIC RESOURCES BOATING AND OCEAN RECREA nON

BUREAU OF CONVEYANCES COMMISSION ON WATER RESOURCE MANAGEMENT

CONSERVATION AND COAST Ai LANDS CONSERVATION AND RESOURCES ENFORCEMENT

ENGINEERING FORESTRY AND WILDLIFE HISTORIC PRESERVATION

KAHOOLAWE ISLAND RESERVE COMMISSION LAND

STATE PARKS

Log No. 2009.0778 Doc No. 0903TD14

MEMORANDUM

TO: Ken C. Kawahara, P.E., Deputy Director State Commission on Water Resource Management ~

::;,~

FROM: ,;t :::::0

Nancy McMahon, Deputy SHPO/State Archaeologist and Historic Preser:vidon M~er

SUBJECT:

~a~~

Chapter 6E-42 Historic Preservation Review -Well ConstructionIPump Installation Permit Application, Roux Well (No. 4959-25) Kukio 1st Ahupua'a, North Kona District, Island of Hawafi TMK: (3) 7-2-17: 06

Thank you for the opportunity to comment on the subject permit application, which was received in our office on March 11,2009. The proposed well will be located within a 1.37-acre residential parcel that is part of the Kukio development area. This larger area has undergone historic preservation review, including an inventory survey (Pantleo et al. 1992), data recovery (Dye 2002), and preservation planning (Dye 2003).

We believe that no historic properties will be affected by this proposed activity because: D New construction or land alteration will not occur in connection with the permit [8J Residential development/urbanization has altered the land [8J Previous grubbing/grading has altered the land D An accepted archaeological inventory survey (AtS) found no historic properties within the parcel [8J SHPD previously reviewed this project and mitigation has been completed for the development D Other: There are no preservation sites within or near the proposed well location

In the event that historic resources, including human skeletal remains, lava tubes, and lava blisterslbubbles are identified during the construction activities, all work should cease in the immediate vicinity of the find, the find should be protected from additional disturbance, and the State Historic Preservation Division, Hawaii Island Section, should be contacted immediately at (808) 933-7653. Please contact Theresa K. Donham at (808) 933-7653 if you have any questions or concerns regarding this memo.

~ '" --t' .14ar-24-J009 11 :08am From-DEPT OF HEALTH ENVIRONMENTAL ~GMT 8085864352 T-672 P,014/021 F-616 r'

LINDA LINGLE "ov£icN:tfc OF H ... W .... II

I-AUAA 1'1, T~leLEN OlolA!RPr::;P:SO~

TO:

STATE OF HAWAII D'::PAR"rMeNf 0': LANO AND NAtURAL RESOURCES

COMMISSION ON WATER RESOURCE MANAGEMENT f' 0,80)(621

HONOlUW, HAWAII S6809

March 6, 2009

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

Tomas See, Chief, Wastewater Branch S,uart Yamada, Chief, Safe Drinking Water Branch

,...Alec: Wong, Chief. Clean Water Branch

IIIERI'OITH J. CHING JAMES A, I'AAzlER NEAL S, FUJIWAAA

CtilYOME L FuKINO. M 0 DONNA FAY K K1YOSAKl. P,E I,.AWRENCE H MIlKE. tv to .. J,C,

KENC, I'(AWAHAAA, P,[;, ce:MJTY OIUC.TOft

Dr. Keith Kawaoka. Office ofHaurd Evaluation and Emergency Response

FROM: W Laura H. Thielen, Chairperson ftt ~I! L-"\,- Commission on Water Resource Management I

SUBJECT: Wen Construction!Pump Installation Permit App iCiilion Roux. Well (Well No. 4959-25)

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

We would appreciate your comments on the captioned application for any conflicts or inconsistencies with the programs, plans, and objectives specific to your department. Please respond by returning this cover memo form by April 8. 2009. If we do not receive comments or a request for additional review time by thls date, we will assllme that you have no comments.

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

RI:ss Attachment(s )

RESPONSE: [ 1

r 1

[ I

r 1

r 1

r 1 [./ [ 1

[ I

Thi~ w~11 qll~litiOj; .~ ~ .eutce whillil will S.uve as a >0111'.0 of pOlabl. w"Ior ~ a p~bli< \V'll<>< 'Y"'~111 (<loIjjn~<I iii !~E ~~ or more people 8litaSI 60 doy. por)"Olll" or ..... 15 or mQr~ '<n'I"" ao .. n .... l.o ... ) "Ad m .... r_v. Dinoolor Qi H,,1II1b .ppr"v"l~ to iu U~ to comply with Hawa;; Adm;"; .... ,,,;,. Rule. (HAR). Title II. Chojller 20. Ru~ Relating to Pomble Wf1I.tr Sylltcma. §II·20-29,

This "",II ""0;; nQI q\l;O\.fy "":0 '0 .... 0<1 ''''''''"S' publ,c w.ld< ,y.'em (,",""".I.~, Ib"" 2S people <>r more p~opl~ alio:an 60 days pCf )I~ar or 15 SCIV;c.: oOllJloorion,) 1100 Iftbe w~1I wntc:r i. "sod f", dnnlo:ing> the: priv.l. owner .ho"ld t<o.t for baoton<:>logloal and c:hcmic:al prcaCDCC befort itli'iMiil& .""h u'" and routill~ly moailof me water 'luality lhereafter However. it future planned us, from this sc..rcc inC(caa~s to .nelll th~ pubhe w~l.t .y~"'m ~~finitio~ lIlom DlroclCr or ttoouth approv.1i IS Isquited ~ lCl ;mpiemtiltaticn.

Iflhc well i~ UliI:IQ III ,,,pply b~h pOIabl<> ~n<l '''JlI"'JIolabl. p~.n" ,iogh, ~Y'Ionl, Ih.> 11_ .h~lI.iimil\Atc QfOlS:KI()~lions and ba~kllow connection. byphY9lcall)' separatln, potab!.: and 1I01I-potable S)'oStcms by an air sap or !Ill appr.:lvcd bKldlow preVCIITet, and by cl.atly labeling ~II non' pc,abl~ >pi~o,s w;fh w8I'1Iillg aijp\ll ro prevelll in8dve~eI\l cc>nsumpl;OI'l DfilC>tI-pOlkble I:.ikf!f, ~>lcl:f1ow PfOV'"lielll /!$vi_ ~hould b. roubn.ly m.1"fI"l"d :end ItBled.

for \h. flpph.~fit·, .delrlna-lion. a SDll!C" ofpos9ible Wastewalcr COIl18lll1M1tion lli.. I J I~ not lllGated ntat tbl> propo!.tld well .ite (illformJlior. ilfl:aohcd).

An NPDE!.S p"1mit is r"'luired,

Other relevant DOH ruic&trcguiations. informillion. or recommendations are &ruIch~d

tn ~ht: evern d'un the loc.illicS\ of t~ wdl chJlJlges but 15 still with •• t.he ~ de:icnbed on thu, apphoou.icll~ our divlIiiiao IJQnI.i.denz lhe c:o&nmet'ltl I"" Qlil, hI,; ii1ppliC2Lblcs. i31Dd We:! do nDt need lo revi'l5w th.~ new location.

Contact Person: do~ L::.~ Phone: 26<O-.,~~

;3·U.oe Signed: ~~ ~~

Dare:

MAR-24-2009 10:51AM FAX: 8085864352 ID:OLNR CWRM PAGE: 023 R=96%

Mar-24-~09 11 :02am , '"

From-DEPT OF HEA~ENVIRONMENTAL MNGUT 8085864352 o T-672 P.001/021 F-616

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

Fax to: ~ R~ ~J.9' Mr. Charley Ice I Ms. Denise Mills Company: Commission on Water Resource Management

Department of Land and Natural Resources

Date: ~""""~ ut- WOe> " . Fax from: Joanna L. Seto (f

Fax No.: 587-0219 Total Pages, incl. cover: 2+ W

Subject: Well Construction/Pump Installation Permit Application(s) Well No(s). 465j-01} ,((Ii34h !JQ 5(p\O~O;z', '5~e{p-3i11f66 -0I,'6D%. ... 09,

~eoz-,o)

The Department of Health, Clean Water Branch (eWB) has the following comments: 4000 - 0 1,

1. t.~e""~03

For Well-Drilling Activities ~ (06'1-""'1\

Any discharge to State w~rs of treated process wastewater effluent associated with well 1"4~ ~ drilling activities is regulated by Hawaii Administrative Rules (HAR}t Title 11, Chapter 55,":; 5 ~(P J~ Appendix I, ef'fetttive October 22.2007. Treated process wastewatereftluent covered by 4~5~&z. this general permit includes wen drilling slurries~ lubricating fluids wastewater, and well :3~g~ .. 0: purge wastewater. Tbis.general pennit does not cover well pump testing. The applicable S 'Z..o<et-O Notice of Intent (NOI) Forms and filing fee shall be submitted at least 30 calendar days before the start of discharge to the: ~co61-'t

Department of Health Clean Water Branch 919 Ala MoanaBoulevard, Room 301 Honolulu, Hawaii 96814-4920

The CWB-NOI Forms are available online at http://www.hawaii.govlhealthlenvironm,,ental!water/cleanwater/formslgenl-index.hnn1. Inquiries may be directed to the CWB at (808) 58643Q9 or by fax (808) 586-4352.

~48~ ... oe 1~44-ot

5"3.tt3-o\.ft ().f

2. For Well Pump Testing

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

t1AR-24-2009 10: 46AM FAX: 8085864352 IO:OLNR CWRM PAGE:010 R=100%

J ,

o

Mr. Ryan !mata / Mr. Charley Ice / Ms. Denise Mills Commission On Water Resource Management

o

FAX TRANSMITTAL Page 2

3. For Construction Activities Disturbing One (1) or More Acres of Total Land Area

By lIAR. Title 11, Chapter 55, Appendix C, effective October 22,2007, an NPDES permit or Notice of General Permit Coverage is required before the start of the construction activities that result in the disturbance of one (1) or more acres of total land area, including clearing, grading, and excavation. The total land area includes a contiguous area where multiple separate and distinct construction activities may be taking place at different times on different schedules under a larger common plan of development or sale. An NOI (see Comment No.1, above) shall be submitted 30 calendar days before the start of construction activities.

MAR-24-2009 10:46AM FAX: 8085864352 ID:DLNR CWRM PAGE:010 R=100%

~1i. t, 17, 2009 8: 58AM DOH-HEER O~~ICE 808-536-7537 •• 0

~o, 1871 p, L/6

LINDA UNGlE Q"'Y61R:~OR Qf Hf.WAjI

HEC£IVED LAU~~,!~;L(;:N PEPAR1MENT OF HEALTH MEREDllHHfilNO

TO:

JAMES A. FRAZIER NEAL S. FUJIWARA ton HAR 12 P l?o 2 O~HIYOM'I-. FUKINO, M.O.

. ". . lflNIoIA FAYK IOYOSAKI, P.E.

8T ATE OF HAWAII. HE£R OFFICE

DEPARTMENT OF LAFolD AND NATURAL RESOURCES COMMISSION ON WATER RESQURC):'-MANAGI:MENT

P.O. BOl{ 521 k'

HONOLULU, HAWAII ~6609

March 6, 2009

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

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

LAWRENCE H. MilKE, MD .• J.[).

KEN C. KAWAHARA. P.E. OE.I"ufYOHl:I!c;lo",

\Ilr. Keith Kawaoka, Office of Hazard Evaluation and Emergency Response

FROM: Car Laura H. Thielen, Chairperson 1f~ 1aw~ L-. \: Commission on Water Resource Management

SUBJECT: Well ConstructionJPurup Installatlon Permit App ication Rom, Well (Well No. 4959-25)

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

We would appreciate your comments on the captioned application for any conflicts or inconsistencies with the programs, plans, and objectives specific to your department. Please res ond b returning this cover memo form by April 8, 2009. Ifwe do not receive comments or it request 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 questjons about this permit application, request additional infonnation, Or request additional review time, please contact Ryan Imata of the CommiSSion staffat 587-0255.

RI:ss Attachment(sJ

RESPONSE: [ J

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This well quoliJres a. 'oourtc which ,v'II~ ••• ~..,urce of Jlolabh wat.ilo 0 publio ",.ter 'yalem (defined •• • ...,..e;lS Qr morc propl. at I .... 60 days por year or has 13 or IlJOJI!> s~rvi~e conn~tliQn~) and mud reotive tlireotor ofHe1ltL :lPI7>Il>\I~1 ~ 00 its use 10 ~omply with Hawai' AdDlinisliAlivc A~I •• (a:Al<), Tide II. Chapter 20, Rule. R.Eo!a,lnBIO Potable Water Systew, §11.2().l9,

Th;~ w~lJ does nol qualify aa a sOllrce serving. pubticwate< .~I&m (."", •• j.ss I~.n 25 people or more people at le •• 1 60 doy. per ybat o~ IS ..... ioe> .o"r, •• ti~n.) am:! ifl~" , •• 1\ IValer i, )lied fO(dliilkilll!, the pri~lle Qwnl)l sbould leat f(j( bac\.riologiolllllld chemical pre_c. b~fol'l! inililting sue.h. lISa ... d loullnely monllor Ih. W ..... quahl)ll~ .. r •• i!.r. Howevtf, If ti,tu,. pl'Qn~ •. ",. from ibIS soure. JnC(~'.' to mUI Ibe publiC water sy;taat dofinilion thell Dir •• 14lI of H •• 11~ ~pprovil is required I!l:i!l!: to impJ .. ment~tion.

Il,a. ",.11 i. used 10 supply both ~Qtabl. a.\d nan-poloble plllpooe! illl si"gle iyll"m, Ihe us~r shall elimlnale t<os,.ton~.'uons and blCknol" oolUle~tion3 by physically $ep~IJIlni! potable and nOh-piltoDle $jlllcms by an air gop or aJ\ .pp,o".d b.~~flo\V prcvenler, aDd by clearly l~b.ling: all nonpMahI •• .,o801S with wlIIlIing sigm let prev""l in.dveI1ent oonlYmptiol'lCi IlOIl-polabl. WHIM'. Backllow prev.nlion (lr,Vl~CS .hould be roulin.ly itlSp;c\.d sndte.led.

Ii does not &ppeaf Ihallhi1 >1/,,11 will be lIied for con'lll'l/Ilive p~"'OSCi ADd ia not aubjttt to Safe l)r,,*iB! Wiler RegulaljoM.

For Ihe appticant'~ jnfOfflliltion, •• OV,Qe <,fpossible wast .... al.' tOnla1llinlllion Illg I ) I. ROt localed neu till: ploposed well ,ilo (illfclrIu(i". ~It.ohed).

All NPDES pennil i. ",q~irotl.

O(},/!f rel.vaol DOH rlJle>iro~IRtions, informalioll, orr.~omI!\end.tionB arc atlached.

In th~ ~veDt Ihallh.lotal'o;. ofth. w~1I chong .. bul is sliD wilhi. Ih. plITc;1 d~icribed on Ihis applicaliQn, QUI diviiion ooDsiden rhe COInm ... ts 10 slill be applitabl., :and we do not need 10 review the ~e" l~cilliGn.

J<l No COsltnontsiobieolioDs n Contact PersOll: {2i Gha..rot r o..l wt R...,y-' Phone: jJ6 .... 09 :F7

Signed: ifhJ(JPA'( Bf~ Date: .1./.Lb!t?,Od? MRR-17-2009 10:00RM FRX:808 586 7537 ID:DLNR CWRM PRGE:004 R=95%

t1AR-17-2009 07:57 From:DOWSAFE,yqTER BRANH 8085854351

'""J To:808 587 0219

, "''!o_

"U"" RECEIVED .... '" .• '--SAFE DRINKlNG WATER BRANCH

liNDA LINGLE OOVEANJ:l1I t'P' ~.

WAR 1 2 lAURA H. THIELEN

C~"'IIt"~F!:!t&H

STATE OF HAWAII DEPARTMENT OF LAND ANO NATURAL RESOURCES

COMMISSION ON WATER RESOURCE MANAGEMENT PO. 60X 621

HONOlULU HAINAII 96809

March 6, 2009

MeREDITH J. C~I~G JAMES A FR"l.IEI:! NEAL S f:IJJIW~

GHI,(OMr: L. F\.JKINO, 1\4 D DONNA FAY K. KJYOSAI(I, P E. lAWIIEt-ICr: II MilKE M.O, J 0

J<EN G KAINAHAAA, PE e.~I'v"y".I::'::T6~

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

omas See, Chief, Wastewater Branch _ Stuart Yamada, Chie:f, Safe Drinking Water Branch

Alec Wong, Chief, Clean Water Branch Dr, Keith Kawaoka, Office of Hazard Evaluation and Emergency Response

FROM: C-v{" Laura H. Thielen, Chairperson 1f~ ~t\ L-. '\ Commission on Water Resource Management {

SUBJECT Well Constructlon/PUmp Installation Permit App ication Raux Well (Well No. 4959·25)

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

We would appreciate your commen.ts on the r::aptioned application for any conflicts or inconsistencies with the programs, plans, and objectives specific to yom: department. Please respond by returning this cover memo form by AprilS. 2009. 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 att&ched 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 oftbe Commission staff at 587~0255_

RI:ss A ttachrnent(s)

RESPONSE: ( 1

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Tllis well qU.a.liflc~ ,U ~ to\l,l'\)C wh:loc:h wdJ ;\;crvc:,s,;J. ~QIUC::C ofpQl~b~e Water to a pubbc 'Nili:l!:r sysl'tem (~efihl!!d a~ iCf'VUlg 25 DJ" :m(J~ p!'Q~J~ at leas160 d.l" per y...,. or ~~. 15 ~r m()fe s ...... ce "t>nnoct,,;ms) md IIIlHtreGel~e DI"",IQI' ~f B.~I(\, oppro",11!!1J!l: 10 Ito .... Ie .. ,mply wilh 11 .... 3" Adrn •• "trilbvo R.b (UAR~. Till. 1 L o..pl.r 20, Rule, Rol'I'"1l: 10 Pmable WOter Sy.:cms,.? 11-20-Z'

This w.,11 d(1l!~ JI(II qu.lIfv a! 3 source servins a ~ubh, water system (."",., I ... th~ ~5 p~pl. '>Y "''''r. pt,oplo all ••• 1 00 dol" po' Y""" or IS ,."'.,"" oonn •• "oo,) .. 0<1 If Ih. '';011 w~tor IS ,",.<1 fQT "'inkln~. !he priv.te own., ,bo"ld ,e~t for baclWoloII<;:al and chen"..,' Pf_llIJe before tnlt"b~/it slI¢h u;o, and routInely mOnllor t~. waI., Quality ltu.roafl.". Row.v"" ,f1\.l\l>Xo .,1'"011,,<1 " •• /rom Ih .. ~~\1r.~ in.re ••• , 10 "'''''. Iho publiC wolcr 'yslom ddinrllon th ... O .... loT of H.~lt~ ""P'Clvol i. req\lll"ed ~ 10 unpl~m~ntatll:m

If\~. wd: 13 used to 1upply both potabl~ and non-potable purpose, "'. SUls!O 'y",em, Ih" ~a ... Iih.1I el'm'()~t. "'OSS-C(llUIe~I!OIU and ba~kflcw <"",,«Iton, by pi,)",c,liy "'P"""inf )7<'labl • ..,d """·pot."I. ~yrt~m$lly .u. 311 ~~p or 'OIIaPPlo.".d b ... kfl~w proventer, and by ,1 ..... ly labch"g i)Jloon. pot.b'~ 'PI~OU WIth Wo>m>ng .i~ 10 p,~v."t i .. ,aven"", oon~urT)p[jOn of llUn-P0I.\>lo WI\I~f. 8~dd'o"" prcvatlQlI devlCt;$ !h~~hl b. ,0uMoly tn!PCOI<'<i ~!Id IUled

AJJ NJ'OES pmlIlI t. ,~qlli.od

Olhe. r.levml DOH rul.!ilr~gulattOI'll:, mf.;>rmQtlon. u. re~l!\m.nd~l\Q1IS are attached

In .h~ event [hat Ik. !"cotll)/) oftllC ",.11 <1."'£1" 1M" .",1 w,thln tile "or",,1 dC>crlbed 0<11~" ,pph"""on. OIlT dIVISIO~ .nn,;dc~ the commen .. to ',111 be ~p~licablc, ... d we do nol nt~d 10 r"vlew (l,. uew location

t ) )J" CO/IIlntr.I,/ob)oc,u,n,

Contact Person: lt1/GUtjZ.,t ...

Sjgn~d: --...,.r----"~ 7 -...A.~ MAR-17-2009 08:27AM FAX: 8085864351

Phone:

Date:

ID:DLNR CWRM

:5~~i1J8

3j) 7 In PAGE:007 R=94%

DEPARTMENT ~HEAlTH o W A co ... "': \'} to, T r: '0 :l P ~\ u r.l ... !

;.... • -_ ........ I _.. _~',,,. f ~ J




March 6, 2009


MEREDITH J. CHING JAMES A FRAZIER NEAL S. FUJIWARA

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

LAWRENCE H. MilKE, MD., J.D.

KEN C. KAWAHARA, PE OEPUTY DIRECTOR

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

$'omas See, Chief, Wastewater Branch Stuart Yamada, Chief, Safe Drinking Water Branch Alec Wong, Chief, Clean Water Branch Dr. Keith Kawaoka, Office of Hazard Evaluation and Emergency Response

FROM: C"" Laura H. Thielen, Chairperson f~ 1{4.vtt L \,' Commission on Water Resource Management

SUBJECT: Well Construction/Pump Installation Permit App ication Roux Well (Well No. 4959-25)


We would appreciate your comments on the captioned application for any conflicts or inconsistencies with the programs, plans, and objectives specific to your department. Please respond by returning this cover memo form by AprilS, 2009. Ifwe do not receive comments or a request for additional review time by this date, we will assume that you have no comments.

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

RI:ss Attachment(s)

RESPONSE: ;-;, .''0 il

[ 1

[ 1

[ 1

[ 1

[ 1

[ 1

[ 1 [ 1

This well qualifies as a source which will selVe as a source of potable water to a public water system (defined as Serving'2's or:.~ore peopl,,,lJeast 60 .""") days per year or has 15 or more selVice connections) and must receive Director of Health approval prior to its use to comply.with Hawail7!:i!ministrativel 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 (selVes less than 25 people or more people at least 60 daY'l;per year oEI3:service , connections) and if the well water is used for drinking, the private owner should test for bacteriological and chemical presence.;t>efore initiating such. us~ J and routmely momtor the water quahty there~er. However, If future plarmed use from thIS source mcreases to meet the:ptJ.bh~;water sys(em defimtlon .. -then DIrector of Health approval IS reqUIred pnor to ImplementatIOn. ., --

If the well is used to supply both potable and non-potable purposes in a single system, the user shall eliminate cross-conn;;iions and back~ 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 [ 1 is Dot 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 /110 p.e wYllis Dane Hiromasa in Kona

Contact pe~so . " ~-

Signed: ___ -=-U~ J ~ ____ (}n __ (jrJ-IuG 322-1963

Date: I

o o

COQSION ON WATER RESOURCE MANAGEMENT 0 ROUTE SLIP FOR NEW APPLICATIONS

FROM: RYAN DATE: 22.Sep·08 SUSPENSE DATE: 29-Sep-08 -----------------

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

-1-HARDY,R. k' HIGA, D.

-2-HOAGBIN, S. ICE,C.

-S-IMATA, R. -3-KAWAHARA,K.==

WELL NUMBER Lf t7) S-0- "2. <;"'

rilf WELL CONSTRUCTION

4

KUNIMURA, I.

NAKAMA, L. ~. OHYE, M. SAKODA, E. SWANSON, S. UYENO, D. YODA, K. YOSHINAGA, M.-

1 Approval -3-Signature -4-lnformation

PLEASE:


Take Action Type Draft acknow letter

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

Xerox copies

WELL NAME Roux ~7'P-U-M-P-I-N-S-TA-L-LA--T-IO-N-----

WUP Number

D WUPA

ATIACHMENTS FOR APPLICATION PROCESSING - Both applicant & staff generated 1 TRANS. LEITER ~ 2 PERMIT PROCESS TABLE ~ 3 CWRM MAP ---L 4 APPL. FORM (11 COPIES)

5 USGS MAPS (11 COPIES) 6 TAX MAPS (11 COPIES) 7 PARCEL OWNER VERIF.

8 CONTRACTOR VERIF.

~

---t7----A.L. MLS PRINTOUT \/ . DCCA LICENSE SCREEN PRINTOUT

9 ALL INFO FILLED IN

10 BACKGROUND CHECK

11 $25 FEE DEPOSIT SLIP 12 DHP/CDUP/SMA pre-screen

# VLv I- .:-, 00 6V ~ =z (SMA map printout httP:/~is.hicentral.comlwebsite/parcelzoning/viewer.htm.,or INGRID'S SMA/CD MAP) (LUC map printout http://luc.state.hLus/luc_maps.htm., or INGRID'S SMA/CD MAP)

FOLDER: o D

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

INCOMPLETE ACTION DATES:

ACTION

~ ew4: -11Rd p cI~ 0/ ¥- ~,?,. r UIA' vvorv-c5 frv- U (r; £"7 -() 3- i-~ S -0 J

OV\ 3'S-IO.,= A~t ~

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

COQSSION ON WATER RESOURCE MANAGEMENT 0 ROUTE SLIP FOR NEW APPLICATIONS

FROM: RYAN

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

-1-HARDY, R.

HIGA,D. -2-HOAGBIN, S.

ICE,C. 5 IMATA, R.

-3-KAWAHARA,K.==

DATE: 5-Mar-09

KUNIMURA, I. NAKAMA,L.

-4-0HYE,M.

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

SUSPENSE DATE:

1 Approval -3-Signature -4-lnformation

WELL NUMBER 4959-25 WELL NAME Roux

D WELL CONSTRUCTION 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

10 BACKGROUND CHECK

MLS PRINTOUT DCCA LICENSE SCREEN PRINTOUT

12-Mar-09

PLEASE:


Take Action Type Draft acknow letter

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

Xerox copies

WUP Number NA

D WUPA

11 $25 FEE DEPOSIT SLIP

12 DHP/CDUP/SMA pre-screen (SMA map printout http://gis.hicentral.com/website/parcelzoning/viewer.htm.,or INGRID'S SMNCD MAP) (LUC map printout http://luc.state.hLus/luc_maps.htm., or INGRID'S SMNCD MAP)

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

INCOMPLETE ACTION DATES:

DATE ACTION

o o LINDA LINGLE

GOVERNOR OF HAWAII


COMMISSION ON WATER RESOURCE MANAGEMENT

Mr. Bill Godwin Beylik Drilling and Pump Service 91-259A Olai Street Kapolei, HI 96707

Dear Mr. Godwin:

P.O. BOX 621 HONOLULU, HAWAII 96809

March 6, 2009



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



Well Construction/Pump Installation Permit Application for Well No. 4959-25

We acknowledge receipt, on March 5, 2009, of your completed Well Construction/Pump Installation permit application and filing fee for the Roux Well (Well No. 4959-25). 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: David Roux

Sincerely,

~~,~rJ--N c. KA HARA, P .E.

eputy Direc or

--------_. __ .. -----_._ ... --


o o




March 6, 2009



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


KEN C. KAWAHARA, P.E. OEPUTY DIRECTOR

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

Tomas See, Chief, Wastewater Branch Stuart Yamada, Chief, Safe Drinking Water Branch Alec Wong, Chief, Clean Water Branch Dr. Keith Kawaoka, Office of Hazard Evaluation and Emergency Response

FROM: C~ Laura H. Thielen, Chairperson frt v(OWIA L-~ Commission on Water Resource Management f.

SUBJECT: Well ConstructionlPump Installation Permit App ication Roux Well (Well No, 4959-25)


We would appreciate your comments on the captioned application for any conflicts or inconsistencies with the programs, plans, and objectives specific to your department. Please respond by returning this cover memo form by AprilS, 2009. If we do not receive comments or a request for additional review time by this date, we will assume that you have no comments.


RI:ss Attachment( s)

RESPONSE:

[ I

[ I

[ 1

[ I

[ 1

[ I

[ 1 [ 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 15 service connections) and ifthe 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 afpossible wastewater contamination I Jis I J is not located near the proposed well site (information attached).

An NPDES permit is required.

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

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:

AU


TO:

FROM:

SUBJECT:

o o




March 6, 2009

r~~ib~~~~dministrator f f Ken C. Kawahara, P.E., Deputy Director 4 (!, '(). L-Commission on Water Resource Management

Well Construction/Pump Installation Permit Ap ication Roux Well (Well No. 4959-25) TMK 7-2-017:006



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

KEN C. KAWAHARA, PE. DEPUTY DIRECTOR

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 with regard to the programs, plans, and objectives specific to your division. Please respond by returning this cover memo form by April 8, 2009. If we do not receive comments or a request for additional review time by this date, we will assume you have no comments.



RESPONSE:

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

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

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

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

[ ] No objections

[ ] Other comments:

Contact Person: _________________ _ Phone: -------

Signed: __________________ _ Date: --------


TO:

FROM:

SUBJECT:

o o




March 6, 2009

Dr. Puaalaokalani Aiu, Administrator Historic Preservation

Morgan Davis Historic Preservation

Ken C. Kawahara, P.E., Deputy Director 1~ lC t~ LCommission on Water Resource Management' r· V'

Well Construction/Pump Installation Permit Application Raux Well (Well No. 4959-25) TMK: 7-2-017:006



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




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 April 8, 2009. 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 of the Commission staff at 587-0255. If you require additional information regarding specific information that can be provided by the applicant, please contact the applicant directly at the contact information provided on the application form.


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: ----------------

Wen Background Check

Approved Well No. Well Name

2/3/1992

6/8/1994

12/16/1994

5nt1997

04/1997

Roux

4960-05 SPI

5024-01 Blue Earth 1

5846-01 Waikoloa MLR 1

3554-06 Kaluanui 3

3155-02 Halekii-DWS

4110-01 Saddle Road A

2001-12 Keaunui Area 30

Applicant

David Roux

SPI Holdings

Blue Earth Maui Biodiesel

Mauna Lani Resort, Inc. [01]

Honolulu BWS

HawaiiDWS

Hawaii DWS

Gentry Investment Prop.

7/12/1997 3957-09 Malaekahana 2 Honolulu BWS

7/21/1997 0023-02 Pukaki

7/21/1997 0124-02 Hanamaulu 3

8/21/1997 5824-09 Puhi 5B

Kauai DWS [01]

Kauai DWS [01]

Kauai DWS [01]

11/19/1997 1848-01 Waahila Monitor Honolulu BWS

1213/1997 5846-02 Waikoloa MLR 2 Mauna Lani Resort, Inc. [02]

7/27/1998 5634-02 Hanapepe 4 Kauai DWS [01]

10/6/1998 1325-03 Earhart Anne Earhart

10/14/1998 1127-02 Princeville 4 Princeville Util. Co., Inc

10/26/1998

Q9/1998

2/8/1999

4/26/1999

5nt1999

5/7/1999

7/6/1999

1901-05 Gentry Area 13 Gentry Homes, Ltd.

1019-08 Papaa Bay Ranc Mandalay Properties LLC

2449-02

1747-05

3858-01

2500-03

6752-01

Windward Oahu State DLNR-Land Division

Waialae West Ex Honolulu BWS

Kalaoa Keopu De State of Hawaii CWRM

Waiola Deep Mon Honolulu BWS

Heffner 1 Chandi Heffner

Well Construction Driller Pump Inst. Type Issued Signed WCR1 Accept

Pump Installation Issued Signed WCR2 Accept

AC-21896 AC-21896

AC-21896 AC-21896

AC-21896 AC-21896

AC-21896

C-16437 AC-21896

AC-21896

AC-05058 AC-21896

AC-21896 C-22214

AC-21896

C-19137 AC-21896

C-19137 AC-21896

AC-16437 AC-21896

AC-21896

AC-21896

AC-21896

AC-16437 AC-21896

AC-21896

AC-21896 C-21457

C-21457-5 AC-21896

AC-21896

AC-21896

AC-21896

AC-21896

AC-21896

BOTH

BOTH

BOTH

WELL

BOTH

PUMP

BOTH

BOTH

213/1992

6/8/1994

5/9/1997

6/411997

213/1992 5113/1993 9/811999

7/20/1994 6/26/1996 612611996

4/23/2001 6/25/1999 6/25/1999

9/23/1999 6/411999 9/8/1999

WELL 7/15/1997 7/2211997 3114/2000 7/18/2000

BOTH 7/23/1997 4/611998 31811999 3115/1999

BOTH 7/23/1997 4/611998 3/15/1999 3/21/2003

BOTH 8/26/1997 10/20/1997 7117/1997 1/27/1998

WELL 11/20/1997 711411998 5/25/1999 5/25/1999

PUMP

PUMP

8/19/2002 9/312002

12130/1994 11/20/2001

915/2001 9/13/2001

9/24/1999 7/10/2000

,~\ \ '7

~~ 6/6/2001 ( \{ ~ CI

3/21/1997 (3~21/1997

1017/20020

4/10/2001 4/10/2001

4/611999 4/8/2002 3/18/2004 3/25/2004

3/27/2003 8/27/2003 3/24/2006 4/14/2006

21211998 2113/2002 3/212004 3125/2004

12116/1997 12124/1997 211811999 2118/1999

7/30/1998 3/2212000 3/29/2000

BOTH 10/8/1998 10/29/1998 11/911998 11/9/1998 11/23/1998 5/17/2000 5/18/2000

PUMP 10/20/1998 1 01712002 101712002

BOTH 11/211998 1125/2000 11712000 1/25/2000 213/2000 4110/2001 5/312001

BOTH 11123/1998 412311999 9/27/1999 101711999 10/15/1999 1/15/2002 111512002

WELL 2119/1999 3/9/1999 10/19/2000 10/19/2000

WELL 4/30/1999 5/20/1999 8/29/2001 9/412001

WELL 5/13/1999 10/30/2000 10/10/2002

WELL 5/13/1999 7/21/1999 5/812000 5/8/2000

WELL 7/13/1999 7/20/1999 10/11/2000 10/11/2000

7/13/1999 5849-03 Mauna Lani 9 Mauna Lani Resort Operation, AC-21896 WELL 7/15/1999 7/20/1999 3/16/2000 212612001

7/13/1999 5849-02 Mauna Lani 8 Mauna Lani Resort Operation, AC-21896 WELL 711511999 7/20/1999 3/16/2000 212612001

7/26/1999 5739-03 Lahaina Deep Mo State of Hawaii CWRM AC-21896 WELL 8/1211999 8/25/2001 8/29/2001 9/19/2001

Monday, September 22, 10/5

Approved Well No. Well Name Applicant Well Construction

Driller Pump Inst. Type Issued Signed WCR1 Accept Pump Installation

Issued Signed WCR2 Accept

8/26/1999 5220-01 Haliimaile Maui Pineapple Co., Ltd.

10/29/1999 5320-01 Hamakuapoko 2 Maui DWS

10/29/1999 5420-02 Hamakuapoko I Maui DWS

11/16/1999 0739-03 Kokee-Noe Land Division [06]

12127/1999 2153-05 Moanalua Monitor Honolulu BWS

12/27/1999 2458-06 Manana Deep Honolulu BWS

12/28/1999 2301-48 Waiawa Explorat Land Division [05]

11712000 5824-08 Puhi 5A Kauai DWS [01]

AC-21896 AC-21896

AC-21896

AC-21896

AC-21896

AC-21896

AC-21896

AC-21896

AC-21896

#i3/2000

'15/2000

5313-02 Ohanui-Kailua

1751-08 Kewalo Basin

East Maui Irrigation Co., Ltd. [ AC-21896 AC-21896

Kewalo Basin Marine Mammal AC-21896 AC-21896

6/21/2000 2602-02 Poliwai Gulch De Honolulu BWS AC-21896

9/14/2000 0124-03 Hanamaulu 4 Kauai DWS [01] C-21358 AC-21896

10/18/2000 5731-04 Kanoa 2 Maui DWS AC-21896

10/20/2000 2557-04 Waimano Gulch Honolulu BWS AC-21896

10/25/2000 5129-02 Waikapu Baseyar Consolidated Baseyards, LLC AC-21896 AC-21896

1/23/2001 1850-30 Punchbowl Deep Honolulu BWS

2/1212001 4657-02 Kaupulehu Potabl Kaupulehu Makai Venture

2/26/2001 5849-02 Mauna Lani 8

2126/2001 5849-03 Mauna Lani 9

A5/2001

~8/2001 7/20/2001

2301-44

5548-01

2703-01

Waipahu IV-2

Parker 1

Kunia Camp 1

Mauna Lani Resort Operation,

Mauna Lani Resort Operation,

Honolulu BWS

West Hawaii Water Co.

Del Monte Fresh Produce

10/8/2001 6428-02 Honokaa Explorat State DLNR-Land Division

10/17/2001 3405-05 Helemano Deep Honolulu BWS

10/31/2001 4708-03 Kaieie Mauka HawaiiDWS

11/1/2001 0622-02 Kapaa Homestea Kauai DWS [01]

12/12/2001 7449-02 Hawi 1 HawaiiDWS

9/27/2002 3554-05 Kaluanui 2 Monit Honolulu BWS

Monday, September 22, 2008

AC-21896

AC-05058 AC-21896

AC-21896

AC-21896

AC-21896

AC-21896

AC-21896

AC-21896

AC-21896

BOTH 9/2/1999 9/9/1999 6/6/2000 6/6/2000 7/14/2000 7/20/2000 7/21/2000 7/21/2000

PUMP 11126/1999 12129/1999 8/2211997 8/2211997

PUMP 11126/1999 1212911999 8/2211997 8/2211997

PUMP 11119/1999 11/29/1999 612112000 6/21/2000

WELL 1/5/2000 1/24/2000 1/212002 113/2002

WELL 1/5/2000 1/24/2000 711212000 7/1212000

WELL 1/5/2000 6/23/2000 8/112001 1018/2001

PUMP 1/1212000 21212000 31212004 3125/2004

BOTH 212312000 3/11/2000 1/10/2001 3/19/2001 5/11/2001 6/13/2001 12/18/200112118/2001

BOTH 41712000 6127/2001 8/31/2001 8/31/2001 911712001 9/24/2001 9/25/2001 9/25/2001

WELL 6/26/2000 7/28/2000 512512001 6/4/2001

BOTH 9/21/2000 5/2212001 8/5/2002 8/5/2002 8/28/2002 8/30/2006 7/16/2007 7/16/2007

PUMP 11/8/2000 1211212000 1/29/2002 112912002

WELL 11/20/2000 1211112000 11/27/2001 415/2002

BOTH 1118/2000 1119/2001 7/21/2001 7/21/2001 1011/2002 10/2212002 1 0/6/2003 1 0/6/2003

WELL 1/29/2001 211512001 11126/2001 11/26/2001

BOTH 2120/2001 8/30/2001 10/3/2002 10/3/2002 111712002 11/15/2002 1215/2002 1215/2002

PUMP 3/6/2001 6/13/2001 7/17/2002 7/17/2002

PUMP 3/612001 6/13/2001 7/17/2002 7/17/2002

PUMP 4/24/2001 5/11/2001 111712005 111712005

WELL 4/2212004 ~ A 1 1131/2003 4/2212004

C4 UAl :7' ~05 "'MOOS PUMP

WELL 7/23/2004 6. \ J \ ~\- 0 & 121412002 1214/2002 \}I ~ ,...",\'8 WELL 1012212001 10/26/2001

BOTH 11/23/2001 1215/2001 11121/2002 10/112004 6/23/2005 12127/2007

PUMP

PUMP

WELL 11/20/2002 111412003 3/19/2004 4/812004

11/16/2001 11/12/2003

113112002 211812002


Driller Pump Inst. Type Issued Signed WCR1 Accept

10/22/2002 5629-01 Piwai 2 Kukuiula Development Co., LL AC-21896 AC-21896 BOTH 10/25/2002 112812003 7/17/2003 7/17/2003

5/21/2003 4854-02 Lanai 14

9/2/2003 1901-06 EP 27

9/2/2003 1902-11 EP 27

9/2/2003 1902-10 EP 27

9/2/2003 1902-09 EP 27

Lanai Holdings, Inc.

Haseko Hawaii, Inc. [02]




AC-21896

AC-21896 AC-21896

AC-21896 AC-21896

AC-21896

AC-21896 AC-21896

9/5/2003 5629-02 Piwai 3 Kukuiula Development Co., LL AC-21896 AC-21896

11/21/2003 2458-05 Manana 1 Honolulu BWS

"",,3/2003

VO/2003 8 Kaupulehu Potabl Kaupulehu Makai Venture

5118-02 Pookela MauiDWS

1/6/2004 2703-03 BMW 2 Del Monte Fresh Produce



1/13/2004 3309-02 Mokuleia State DOWALD [05]

2126/2004 3857-04 Waiaha-DWS Hawaii DWS

4/22/2004 e Waikoloa DW-6 West Hawaii Water Co.

6/23/2004 -03 Ewa-Kunia Mauk State of Hawaii DLNR

AC-21896

AC-05058 AC-21896

AC-21896

AC-21896 AC-21896

AC-21896

AC-21896

AC-21896

AC-21896

C-16543 AC-21896

AC-21896

PUMP

BOTH 9/412003 9/9/2003 412212005 5120/2005

BOTH 9/412003 9/9/2003 4/2212005 5/16/2005

BOTH 9/412003 9/9/2003 4/2212005 5/16/2005

BOTH 9/412003 9/9/2003 4/2212005 5/16/2005

BOTH 9/912003 101712003 9/9/2004 9114/2004

PUMP

BOTH 12111/2003 215/2004 8116/2004 8/25/2004

PUMP

WELL 1/612004 1/8/2004 61212005 61212005

WELL 11612004 1/8/2004 61212005 61212005

WELL 116/2004 11812004 61212005 61212005

PUMP

PUMP

BOTH 412212004 4/2912004 1/13/2005 1/13/2005

WELL 6/2312004 8/16/2004 8/1212005 8/2212005


8/14/2003 121712005 3112/2008 3/24/2008

5/27/2003 5/21/2003 5/1212004 5/13/2004

5/25/2005 6/812007 3/6/2008

5/25/2005 6/812007 3/6/2008

5/25/2005 6/812007 3/6/2008

5/25/2005 6/812007 3/6/2008

9/17/2004 121712005 3/1212008 3/24/2008

12129/2003 213/2004 111712007

8/25/2004 4/20/2005

1/30/2004 6/25/2006

1/20/2004

3/312004

1/19/2005

11/221200/1/,

3/51200(/

1/3/2005 4656-01 Kaupulehu Pot 6 WBKD Acquisitions, LLC C-17737 AC-21896 BOTH 1/612005 5/18/2005 4/10/2006 10/20/2006 11/14/2006 11/17/2

2/21/2005 1750-15 HHV 1

ji1/2005

~1/2005 2/21/2005

2/21/2005

1750-16 HHV 2

1750-17 HHV 3

1750-18 HHV 4

1750-19 HHV 5

2/21/2005 1750-20 HHV6

2/21/2005 1750-21 HHV 7

Hilton Hotels Corp.

Hilton Hotels Corp.

Hilton Hotels Corp.

Hilton Hotels Corp.

Hilton Hotels Corp.

Hilton Hotels Corp.

Hilton Hotels Corp.

3/1/2005 4225-03 Kamaole Wailea Wailea 670 Associates

3/1/2005 4225-02 Kamaole Wailea Wailea 670 Associates

31712005 6853-03 Pohaku North Pohaku Kea, LLC

AC-21896

AC-21896

AC-21896

AC-21896

AC-21896

AC-21896

AC-21896

AC-21896 AC-21896

AC-21896 AC-21896

AC-21896 AC-21896

WELL 2123/2005 2124/2005 6/3/2005 6/16/2005

WELL 212312005 2/24/2005 6/312005 6/16/2005

WELL 212312005 2124/2005 6/3/2005 6116/2005

WELL 2123/2005 2124/2005 6/3/2005 6/16/2005

WELL 212312005 2124/2005 6/3/2005 6/16/2005

WELL 212312005 2124/2005 6/3/2005 6/16/2005

WELL 212312005 2124/2005 6/3/2005 6/16/2005

BOTH 3/15/2005 3/23/2007 7/15/2008 10/3/2007 1 0/22/2007

BOTH 3/15/2005 10/17/2007 7115/2008 10/3/2007 10/22/2007

BOTH 3/30/2005 3/27/2006 121612006 6/4/2007 7/312007

0/5


Driller Pump Inst. Type Issued Signed WCR1 Accept

31712005 6853-04 Pohaku South

5/15/2005 2503-04 BMW 5

Pohaku Kea, LLC

Del Monte Fresh Produce

AC-21896 AC-21896

AC-21896

5/17/2005 5129-03 CB No.2 Consolidated Baseyards, LLC AC-21896 C-18254

7/18/2005 2255-40 Halawa Deep Mo Honolulu BWS

7/26/2005 5425-15 Koloa F Kauai DWS

8/31/2005 2157-05 Navy Salt NAVFAC Pacific

11/15/2005 1705-01 Cates Exploratory Cates International Inc.

AC-21896

AC-21896

AC-21896

1/20/2006

~1/2006

~3/2006

4300-03 Exploratory Hamo Maui DWS AC-21896

1907-03 Ko Olina Explorat Honolulu BWS AC-21896

1906-12 Ko Olina Explorat West Honolulu Attractions, LL AC-21896

4/11/2006 0519-04 Kapaa Homestea Kauai DWS

6/5/2006 1805-17 TS006FW-2 Tesoro Hawaii Corp.

6/5/2006 1805-18 TS006FW-3 Tesoro Hawaii Corp.

7/31/2006 5228-22 Maui Lani 3 Maui Lani Partners

AC-21896

AC-21896

AC-21896

AC-21896

BOTH 3/30/2005 3/27/2006 1214/2006 6/4/2007

WELL 5/19/2005 5/24/2005 61212005 61212005

BOTH 613/2005 6/3/2005 10114/2005 10/14/2005

WELL 712912005 9/20/2005 212812006 4/5/2006

PUMP

WELL 9/1/2005 9/8/2005

WELL 1111212005 211612006 1/2212007 2127/2007

WELL 1/25/2006 1/20/2006 10/24/2006 10/3112006

WELL 21212006 216/2006

WELL 312212006 3/28/2006 6/2212007 6/2212007

PUMP

BOTH 6/19/2006 6/21/2006 1/2212007 5/24/2007

BOTH 6/19/2006 6/21/2006 1/2212007 5/24/2007

BOTH 8/2212006 8/23/2006 7/25/2007 7/25/2007


7/3/2007

3/2212006 3/24/2006 5/15/2006 6/812006

8/11/2005 8/1212005 4/9/2007 4/9/2007

4/18/2006 4/21/2006 8/28/2007 12113/2007

8/2212006 8/23/2006

12/8/2006 5129-04 Waiale 1 A&B Properties, Inc.

AC-21896 AC-21896

AC-21896 AC-21896

AC-21896 AC-21896

AC-21896 AC-21896

AC-21896 AC-21896

AC-21896 AC-21896

BOTH 12114/2006 12121/2006 111212007 11/5/2007 12114/2006 12121/2006

21712007 5547-01 WVA 1 Waikoloa Village Assoc.

2/10/2007 3311-01 Mokuleia Ekahi Dillingham Ranch Aina, LLC

2/10/2007 3311-02 Mokuleia Elua Dillingham Ranch Aina, LLC

7/20/2007 1126-03 Princeville 5

AOl2007

'-19/2007

6240-02 Waimea

3153-02 Hokukano 2

Princeville Utility Co., Inc.

Hawaii DWS

Hokukano Ranch, Inc.

12/27/2007 4958-01 Kaupulehu Lot 4A WBKD Acquisitions, LLC

2/1412008 3957-01 Keopu-Puuhonua Hawaii DWS

2/21/2008 6734-03 Kukuihaele Explo Hawaii DWS

2/22/2008 6428-02 Honokaa Explorat Hawaii DWS

2/25/2008 6734-03 Kukuihaele Explo Hawaii DWS

3115/2008 4954-03 New Lanai Well 3 Lanai Holding, Inc.

3/15/2008 4753-01 Well 15 Lanai Holding, Inc.


AC-21896

AC-21896

AC-21896 AC-21896

AC-21896

AC-21896

AC-21896

AC-21896

AC-21896 AC-21896

AC-21896 AC-21896

BOTH 8/21/2007 8/24/2007 6/15/2007 8/14/2007

BOTH 212612007 3/1/2007

BOTH 2126/2007 3/1/2007

BOTH 8/212007 8130/2007 8/29/2008

PUMP

PUMP

BOTH 12127/2007 12/28/2007 711112008

PUMP

PUMP

PUMP

WELL 3/19/2008

BOTH 7/10/2008 7/15/2008

BOTH 4/812008 4/14/2008

8/21/2007 8/24/2007 8/16/2007

8/212007 8130/2007

7/25/2007 7/27/2007 7/1212007 7/20/2007

91712007 9/17/2007

12127/2007 12128/2007

3/412008 3/6/2008

3/19/2008 312712008 1/25/2007 212512008

4/4/2008 4/8/2008

7/10/2008 7/15/2008

4/812008 4/14/2008

Page 4 0/5

Approved Well No. Well Name Applicant

4112/2008 4860-04 Hoffee Cooling John Hoffee

6/4/2008 4859-04 Hartman Onaway Investments, LP

o

o


\

Well Construction Driller Pump Inst. Type Issued Signed WCR1 Accept

AC-21896 AC-21896

AC-21896 AC-21896

BOTH 51712008 5f712008

BOTH 6/16/2008 6/25/2008


51712008 5f712008

6/16/2008 6/25/2008

Page 5 0/5

Professional and Vocational LiCeing (PVL) - powered by eHawaii.gov . 0 Page 1 of 1

Professional and Vocational Licensing (PVL) Search - General Licensee

GENERAL LICENSEE

L1C ID: CT-21896 Active/Inactive: ACTIVE

NAME: BEYLIK DRILLING & PUMP SERVICE INC

TRADE NAME:

STATUS: CURRENT, VALID & IN GOOD STANDING

ENTITY: CORPORATION BUSINESS CODE:

ORIG L1C DATE: 03/24/1999 EXPIRE DATE: 09/30/2010

CLASS PREFIX: AC SPECIAL PRIVILEGE:

RESTRICTION: EDUCATION CODE:

CONDITIONS AND LIMITATIONS:

BUSINESS ADDR: 91-259 OLAI ST #A KAPOLEI HI 96707

MAILING ADDR: 3000 WEST MACARTHUR BLVD #660 SANTA ANA CA 92704

OTHER BUSINESS/PERSON NAMES NAME EFFECTIVE

NAME END DATE DATE

BEYLIK DRILLING INC 03/24/1999 07/08/2004

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=21896&off=&nm=BE... 3/5/2009

1\e, i

)T 5 RESIDENCE)

~WATERIWIHOLE SEWER IWIHOLE

~WATERIWIHOLE NCE

;RAPHIC SURVEY

)WING EXISTING CONDITIONS UPON LOT 6 (FILE PlAN 2285)

TMK: (3) 7-2-17-6 :> PHASE 1-A, NORTH KONA, HAWAII

LEGEND: MI .wATER METER

TeOeWe -TOP Of' WAll

BeDeW. oBOlTOM Of' WAll

T.O.C. -TQPOFCURB

E.O.P. -EDGE OF PAVEMENT

TBM. s=TEMf'ORARY BENCH MARK

U.N.O. UNLESS NOTEl OTHERWISE

N.T.S -NOT TO SCALE

F.S. of'lNISH SURFACE

C.O. =ClEAN OUT

1/2" PIPE II'" 3 n. HlIRRIGAT10N CONTRa. BOX

~8EWER MANHOlE

NORTH

SCAlE: 1" = 20'

PROJECT LOCATION

VICINITY MAP SCAlE:NTS

Roger Dean Fleenor Registrotion No. LS 7276 Hawaii

.... T(, 5-13-08 o,.o..i"9' 72017006

PARCEL TIl/(: (:1) 7-2-17:2!1

flOOD A-E ZONE

'"////'

rNATUfW. LAVA ~

-

N01E8' L SCALE' 1'=211'. 2. ~ FJEl.IN\B ~ ~ 5-1 __

1 VERTICAL DAM MEAN SEA LEVEL. t ~ P!IR~ IT TI£ LAVA ROCK VALL CROSSES TI£

JIlJfllMY LlIE AND IS I/IDIIN lIIJlII LOTS 5 , ~

Tope

MAP

ATKI

Search Results c o Page 1 of 1

Assessed values reflect tax year 2008.

Search criteria: TMK Taxkey 3-7-2-17-6

PUBLIC RECORD DATA Taxkey Subdiv ICondo Tnr Address Owner ILessee Bds Bths Land area Liv area Last Sale Instr

re3-7-2-17-6KukiO F 72-2747 ROUX, DAVID & 0 0 1.37 ac 06/12/2007DEED$20 ULUWEUWEU BARBARA TR AKAU PL

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

Copyright ©3/5/2009 by Hawaii Information Service

http://webrel.hawaiiinformation.comlREsearchIHIS/Searchisearch _PUB .asp?NOCACHE=... 3/5/2009

c

DQRTMENT OF LAND AND NATURAL RESOUQS DOC UMENTNO.: UA CO R ATTACHED WORKSHEET DATE: September 18,2008

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

S 09 326 C 1026 0752 (1 ) $25.00 Beylik Drilling, Inc.

(2)

(3)

(4)

(5)

(6)

(7)

(8)

(9)

(10)

TOTAL $ 25.00

REMARKS: LINE (1) Roux Well No.1 LINE (2) LINE (3 LINE (4) LINE (5) LINE (6) LINE (7) LINE (8) LINE (9) LINE (10)

STATE OF HAW~ DEPARTMENT OF LAllI> AND NATURAL RESOURCES COMMISSION ON WATER RESOURCE MANAGEMENT

o APPLICATION FOR A WELL CONSTRUCTION I PUMP INSTALLATION PERMIT 9-2-08

08-57

For Official Use Only: /

Instructions: Please print in ink or type and send completed application with attachments to the Commission on Water Resource Management, P.O. Box 621, Honolulu, Hawaii 96809. Application must be accompanied by 10 copies and a non-refundable filing fee of $25.00 payable to the Dept. of Land and Natural Resources. The Commission may not accept incomplete applications. For assistance, call the Regulation Branch at 587"()225. For further information and updates to this application form, visit http://www.hawaiLgov/dlnr/cwrm.

aD S£p 18 A 9 :

WELL LOCATION INFORMATION 1. STATE WELL NO. (if already assigned) 12. WELL NAME

Roux Well No. 1

The following must be attached before this application is accepted as complete:

3. ISLAND Hawaii

14. TMK 7 zone

• Portion of 7.5-Minute Series USGS topographic map (scale 1 :24,000) with well location labeled and include the name of the quad map • Property tax map, showing well location referenced to established property boundaries • Photograph of the proposed well site .A schematic diagram showing the well site, access road and proposed well infrastructure • For dug, wells, attach a grading plan with cross section profiles showing existing and finish grades

5. ~LL OPERATOR'S NAME/COMPANY T Well Operator's Contact 6. LANDOWNER'S NAME/COMPANY DaVid Roux I David Roux David Roux

Well Operator's Mailing Address Landowner's Mailing Address

2 sec

:~Ull~.r'ilI'tt.V-.1jJ; '''WI! ". 1'[ f\[~\i" IU:!,",!,,':{ .lE

17

T Landowner's Contact I David Roux

2775 Sand Hill Road - Suite 150

Menlo Park, California 94025-7019 2775 Sand Hill Road - Suite 150 Menlo Park, California 94025-7019

Well Operator's Phone 650-233-8122 I

Well Operator's Fax 650-234-2501

I Well Operator's E-mail Landowner's Phone

I Landowner's Fax 650-234-2501 [email protected] 650-233-8122

PROPOSED WELL CONSTRUCTION 7. Proposed Work

• Construct New Well o Modify Existing Well o Abandon/Seal Well

8. Construction Type • Drilled o Dug o Shaft o Tunnel

9. Is this well part of a battery of wells? 0 Yes • No

PROPOSED PUMP INSTALLATION 10. Proposed Work • Install New Pump o Replace Pump

11. Proposed Pumping Rate, gpm (gallons per minute)

55

12. Proposed Amount of Withdrawal, gpd (gallons per day)

15,000

I Landowner's E-mail [email protected]

13. Method of flow measurement • Flowmeter o Other (explain)

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

Roger D. Fleenor - License No. 7676

PROPOSED USE

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

o 16. Domestic Number of units to be served:

o 17. Industrial (describe)

• 18. Irrigation (describe crop and no. of acres) Landscape irrigation on 1.3-acre lot.

o 19. Military (describe)

o 20. Other (describe)

OTHER LEGAL REQUIREMENTS /frequired, items 21. and 22. must be obtained before the Commission can legal/yissue 8 permit:

21. Conservation District Use Permit (CDUP) o Well is in Conservation District

o Required, CDUP # date approved o Not Required (attach documentation from OCCL) ----o I have not checked with OCCL about whether or not a CDUP is required. I understand that checking with OCCL prior to making this

application will expedite my review. I further understand that issues raised by this agency may delay or result in denial of the permit issuance, or revocation of the permit after it is issued.

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

review. I further understand that issues raised mav delav or result in denial of the permit issuance, or revocation of the oermit after it is issued. 22. Special Management Area Permit (SMAP) o Required, SMA # date approved o Not Required (attach documentation from applicable Coun-:-ty-a-g-en-cy-)~ • I have not checked with the county about whether or not an SMA Permit is required. I understand that checking with the County prior to making this

application may expedite my review. I further understand that issues raised by this agency may delay or result in denial of the permit issuance, or revocation of the permit after it is issued.

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

from the HPD. ' • I have not consulted with the HPD regarding potential impacts of well construction activities on historic sites. I understand that checking with the HPD

prior to making this application may expedite my review. I further understand that issues raised by this agency may delay or result in denial of the permit issuance, or revocation of the permit after it is issued. Additionally, the history of past land use is attached.

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

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

Beylik Drilling & Pump Service, Inc. AC-21896 Lic::nsee bU.Z.2e. C-57 License No.

~~I( h'/(?u;M~6pO~A/ 9-/oS'-o! Signature Print ~ Date

Beylik Drilling & Pump Service, Inc. AC-21896 Licensee b~S ~y§ii / C-57/C-57a/A License No.

~.M': $~ 4J@J6ze1<l;./. 9-/~-tJB 6(gnature Print Date

WCPI Application Form 02/26/2007

r

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

Hole Diameter: __ 1_5 __ ,in.

Elevation at top of casing ~ ft., msl* Minimum of 2' Radius & 4" Thick Concrete Pad (to contain benchmark surveyed to nearest 0.01 ft.)

Ground Elevation' 10ft msl* {

., , IIM'~

Please refer to the Cement Grout: 6 ft. (min. 70% of distance from ground elevation to top of water surface or 500 ft., whichever is less.)

:. ~. .~. ',: .::' ;. ';.:'

:.1" HAWAII WELL CONSTRUCTION AND .. ' ?'.': PI.!Mf IN~TALLA TION STANDARD~ .:t>' ~ :;.: to ensure that your as-built is in compliance with .....

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appl icable standards.

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

:. t-.. ' :~'.':

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

• Positive displacement

o Other 3 in.

Rock or Gravel Packing:

.. :p' . ;,.:. ',':',

I

Total Length: a ft .

Nominal Diameter: 8 in.

Wall Thickness: 0.33 in.

Bottom Elevation: 2

ft., msl*

Total Depth

20 ft.

None ft. Open Casing: • Perforated o Screen Material:

o Crushed Basalt Total Length: lQ ft.

I ! I

o Rounded Gravel

Estimated Water Level

// Nominal Diameter: 8 in.

" Wall Thickness: 0.32 in.

Bottom Elevation: -8

ft., msl*

I

Elevation: 1 note: Neither bentonite nor mud should be used in __ 1._0_ft. msl*

-

i saturated zone during drilling

I Open Hole: i I Length: 2 ft.

Diameter: 15 in. J_ .. ________ ~ - Bottom Elevation: -10 ft., msl*

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

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

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

Example: Estimated + 2 ft. Water Level Elev. -- Bottom Elevation of Well Limit = (2 _ 41 ~ (2») = -18.5 ft.

Solid Casing Material:

Roux Well No. 1

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

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

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

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

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

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

o Centrifugally Cast Resin Pipe conforming to ASTM 02997

o Reinforced Plastic Mortar Pressure Pipe conforming to ASTM 03517

o Glass Fiber Reinforced ReSin Pressure Pipe conforming to AWNA 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 ANSIIAWNA C200 0 API Spec. 5L 0 ASTM A53 0 ASTM A 139

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

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

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

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

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

o Centrifugally Cast 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

.g WCPI Application Form 02/26/2007

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Roux - HIGP