c~ssion me -1-review & comment take action type draft acknow letter -2-type final, label file...

$: C~SSION Me -1-Review & Comment Take Action Type Draft acknow letter -2-Type Final, label file folder, update People.db 4 File & Input Issue Date Xerox copies WELL NUMBER S &; \ D -$
FROM: RYAN

FUJII, N.

-1-HARDY,R.

~ -2-HOAGBIN, S. ICE, C.

-4- IMATA, R.

C~SSION ON WATER RESOURCE MANAGEMENT 0 ROUTE SLIP FOR NEW APPLICATIONS

DATE: 14~un-11

KUNIMURA, I. -3-TAM,W.

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

SUSPENSE DATE:

Approval -3-Signature

Information

21-Jun-11

PLEASE:

See Me -1-Review & Comment

Take Action Type Draft acknow letter

-2-Type Final, label file folder, update People.db 4 File & Input Issue Date

Xerox copies

WELL NUMBER S &; \ D - 04 ~ WELL CONSTRUCTION

WELL NAME Kahinano

yrPUMP INSTALLATION DWUPA

WUP Number na

Dwup Transfer DDEC-ADM97-A1 Modification

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

2 PERMIT PROCESS TABLE

3 CWRMMAPS

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

11 $25 FEE DEPOSIT SLIP

12 DHP/CDUP/SMA pre·screen

13 EA 343 5(a) triggers?

~ making 1-mile radius and penciling in on hanging maps /'

~ ,,~~ ~ MLS PRINTOUT ~ ~ ~ DCCA LICENSE SCREEN PRINTOUT ~,

~ ,P". ---v- \ I' SM~ I t-v+ t I"l C (/ --7-"(SMA map printout http://gis.hicentral.com/website/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)

..I NO YES - trigger identified is: (if triggered, exemption analysis memo must be attached before accepting)

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

INCOMPLETE ACTION DATES:

DATE ACTION

NEIL ABERCROMBIE GOVERNOR OF HAWAII

Mr. Rod Diamond

o o

STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES

COMMISSION ON WATER RESOURCE MANAGEMENT P.O. BOX 621

HONOLULU, HAWAII 96809

August 22,2011

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

Dear Mr. Diamond:

WILLIAM J. AILA, JR. CHAIRPERSON

WILLIAM D. BALFOUR, JR. SUMNER ERDMAN

LORETTA J. FUDDY, A.C.SW., M.P.H. NEAL S. FUJIWARA

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

WILLIAM M. TAM DEPUTY DIRECTOR

561O-04 .. ack

Well Construction/Pump Installation Permit Application for Well No. 5610-04

We have received your Well Construction/Pump Installation permit application and filing fee for the Kahinano Well (Well No. 56lO-04). We are processing your past well completion reports, and there are some discrepancies that need to be resolved by you (specifically a pump test for well no. 3558-02). However, we can still process this application for review. If the review warrants the issuance of a permit, we will either send you: 1) the approved permits, or 2) a letter of assurance that the permit will be issued to you once your outstanding completion report issues are resolved to our satisfaction.

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 no water may be pumped other than for testing until a certificate of well construction/pump installation completion letter is issued to the well operator and landowner.

The permitted pump capacity described on the pump installation permit may be reduced if the pump test does not support the capacity. No certificate of pump installation will be issued until the Commission determines that the pump capacity will not have adverse effects on the aquifer, other nearby wells, or streams. Thus, you may need to remove the pump and install a smaller pump if the Commission decides a smaller pump is required to protect water resources 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 or toll-free at 974-4000 (Hawaii), 274-3141 (Kauai), 984-2400 (Maui), or 1-800-468-4644 (Lanai & Mo10kai) extension 70255.

RI:ss Attachment

c: Geoffrey Molfino

;;;~d-WILLIAMM. TAM Deputy Director

o o NEIL ABERCROMBIE

GOVERNOR OF HAWAII


TO:


COMMISSION ON WATER RESOURCE MANAGEMENT P.O. BOX 621


August 22, 2011

Honorable Loretta J, Fuddy, A.C.S.W., M.P.H., Director Department of Health Attention: Acting Chief, Wastewater Branch

Joanna L. Seto, Chief, Safe Drinking Water Branch Alec Wong, Chief, Clean Water Bra


LOREnA J. FUDDY, A.C.S.w., M.P.H. NEAL S. FUJIWARA


WILLIAM M. TAM OEPUTY DIRECTOR

Dr. Keith Kawaoka, Office of Haz a valuation and Emergency Response

FROM: () William J. Aila, Jr., Chairperson rei\.. Commission on Water Resource Manageme

SUBJECT: Well Construction/Pump Installation Permit Application Kahinano Well (Well No. 5610-04) TMK 3-4-003:001 Well address: 34-1106 Hawaii Belt Road

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 September 6, 2011. If we do not receive comments or a request for additional review time by this date, we will assume that you have no comments.

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

RI:ss Attachment( s)

RESPONSE:

[ I

[ 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 IS or more service connections) and must receive Director of Health approval prior to its use to comply with Hawaii Administrative Rules (HAR), Title II, Chapter 20, Rules Relating to Potable Water Systems, § 11-20-29.

This well does not qualif'y 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 Regnlations.

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.

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

[ I In the event that the location ofthe well cl,anges but is still within the parcel described on this application, our division considers the comments to still be applicable, and we do not need 10 review 1be new location.

I [ I No comments/objections I I I

Contact Person: i Phone: -----------------Signed: _________ -+-________ _ Date: --------------------


TO:

FROM:

SUBJECT:

o o


COMMISSION ON WATER RESOURCE MANAGEMENT po. BOX 621


August 22, 2011

Russell Tsuji, Administrator ~ Land Division

William M. Tam, Deputy Director ~. . Commission on Water Resource Managemen

Well ConstructionlPump Installation Permit Application Kahinano Well (Well No. 5610-04) TMK 3-4-003:001

WILLIAM J. AI LA, JR. CHAIRPERSON


LORETTA J. FUDDY, AC.SW., M.P.H. NEAL S. FUJIWARA



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 September 6, 2011. Ifwe do not receive comments or a request for additional review time by this date, we will assume you have no comments.

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

RI:ss Attachment( s)

RESPONSE:

[ ] A water lease/permit is required ofthis 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: _________ -c-. ________ ___ Date: --------------

''''".'''_,..-~------., .... o.\>' ... '.~~''.'


TO:

FROM:

SUBJECT:

c o


COMMISSION ON WATER RESOURCE MANAGEMENT po. BOX 621


August 22, 2011

Dr. Puaalaokalani Aiu, Administrator Historic Preservation ~ Attn: Theresa Donham

William M. Tam, Deputy Director~ Commission on Water Resource Management

Well Construction/Pump Installation Permit Application Kahinano Well (Well No. 5610-04) TMK: 3-4-003:001



LORETTA J. FUDDY, A.C.S.W, M.P.H. NEAL S. FUJIWARA



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 September 6, 2011. Ifwe do not receive comments or a request for additional review time by this date, we will assume you have no comments.

Please find the attached maps to locate the proposed well. If you have any questions about this permit application or request additional review time, please contact Ryan Imata of the Commission staff at 587-0255. If you require additional information regarding specific information that can be provided by the applicant, please contact the applicant directly at the contact information provided on the application form.

RI:ss Attachment(s)

RESPONSE:

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

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

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

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

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

Search Results o o Page 1 of 1

Search criteria: TMK Taxkey 3-3-4-3-1

PUBLIC RECORD DATA Taxkey Subdiv/CondoTnrAddress Owner/Lessee Bds Bths Land areaLiv area Last Salelnstr Price

r .3-3-4-3-1 Waikaumalo- F 34-1106 MOLFINO, 1 1 2.45 ac 2,852 6/6/1997 DEED $175,000 Maulua HAWAII GEOFFREY M & Homesteads BELT RD BEVERLY

http://webl0.hawaiiinformation.comlREsearchiHIS/Searchisearch_PUB.asp?NOCACHE=... 811012011

Professional and Vocational Li~nsing (PVL) - powered by eHawaii.gov

'-' 0 Page 1 of 1

GENERAL LICENSEE

L1C ID: CT-23379 Active/Inactive: ACTIVE

NAME: RODNEY K DIAMOND

TRADE NAME:

STATUS: CURRENT, VALID & IN GOOD STANDING

ENTITY: INDIVIDUAL BUSINESS CODE: SOLE OWNER

ORIG L1C DATE: 10/12/2001 EXPIRE DATE: 09/30/2012

CLASS PREFIX: BC SPECIAL PRIVILEGE:

RESTRICTION: EDUCATION CODE:

CONDITIONS AND LIMITATIONS:

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/pvlsearchlapp? _ a=d& _f=n&lictp=CT &licno=233 79&off=&run=RO... 8/12/2011

DEQTMENT OF LAND AND NATURAL RESOURQ DOCUMENT NO . .. UAC OR ATTACHED WORKSHEET DATE· June 8 2011 ,

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

S 11 326 C 1026 0752 (1 ) $25.00 Rod Diamond

" " " " " " (2) $25.00 Rod Diamond

" " " " " " (3) $25.00 Rod Diamond

" " " " " " (4) $25.00 Rod Diamond

" " " " " " (5) $25.00 Rod Diamond

" " " " " " (6) $25.00 Rod Diamond

" " " " " " (7) $25.00 Rod Diamond

(8)

(9)

(10)

TOTAL $ 175.00

REMARKS: LINE (1) Paul's Well LINE (2) NahlaWeli LINE (3 Powers Farm Well LINE (4) Kahinano Well LINE (5) LuaWaiWeli LINE (6) Well #3 and Well #4 LINE (7) Well #1 and Well #2 LINE (8) LINE (9) LINE (10)

o o

Lorrie, For the Water Commission, I was signing their form and emailing it back· now since this is going to you instead, I will need to make a new form • 1m not going to write individual letters for each well. Please be patient, there are choke people waiting for my reply on everything under the sun.

Rod Diamond <[email protected]> OS/27/2011 12:49 PM To [email protected] cc Subject Re: Conservation Clearance on following Properties

Ryan,

[email protected] cc

SubjectRe: Conservation Clearance on following Properties

The Hilo office is closed until June 15th• Therefore Theresa is out. I have showing above what she sent me regarding all of these applications.

o o

o Q Rod Diamond <[email protected]>

State of Hawaii Land Use Commission Verbal Interpretation per Various Tax Map Keys at Hamakua, Kapehu, Keaau, Waikaumalo, & Opihikao, Hawai'i 1 message

Fred Talon <[email protected]> Wed, May 18, 2011 at 2:38 PM To: Rod Diamond <[email protected]> Cc: Bethany Morrison <[email protected]>, [email protected], Dan Davidson <[email protected]>

Dear Mr. Diamond,

Please except our apologies for late response.

Tax Map Keys:

1-3-003: 022 SLU Agricultural

1-5-031: 069 SLU Agricultural District

2-8-008: 003 SLU Agricultural I Conservation District

3-4-003: 001 SLU Agricultural I Conservation District



If you require clarification or further assistance please feel free to contact our office at 8085873822.

Mahalo, Fred Talon State Land Use Commission Phone: (808) 587 -382? Fax: (808) 587-3827 E-Mail: [email protected] or luc@dbedt hawaii.gov Website: http://Iucstatehius c"'!:~r'~i!l~

, \

William P. Kenai Mayor

May 11, 2011

Mrs. Lorrie Diamond

o

County of Hawai'i PLANNING DEPARTMENT

Aupuni Center. 101 Pauabi Street, Suite 3 • Hilo, Hawai'i 96720 Phone(808)961-8288 • Fax(808)961-8742

Diamond Drilling & Pump, LLC HC 3 Box 14073 Kea'au, ill 96749-9229

Dear Mrs. Diamond:

BJ Leithead Todd Director

Margaret K. Masunaga Deputy

'.

SUBJECT: Special Management Area (SMA) Permitting Requirements Various Parcels; Hawai'i

Thank you for your recent email correspondence dated May 4. 2011 requesting Special Management Area (SMA) permitting requirements for the following proposed water well projects.

It is our understanding that your company will be submitting applications for well construction! pump installation pennits with the Department of Land and Natural Resources Commission on Water Resource Management. As part of the application. you are requested to obtain the SMA pennitting requirements from our office.

For your use and convenience, we have provided the following table. It includes the County Zoning designation, State Land Use designation, and General Plan LUP AG designation. It also indicates whether or not the property is located within the SMA and if any SMA pennit is required from the Planning Department for well construction! pump installation.

Hawa; 'j County is an Equal Opportunity Provider and Employer

... ' o

Q

Mrs. Lorrie Diamond Diamond Drilling & Pump. LLC May 11,2011 Page 2

Well TMK County Zoning Name

Well #1 (3)4-8-003:010 Agricultural-40a

Well#2 (3)4-8-003:010 Agricultural-40a



Nahla (3)2-8-008:030 Agricultural-40a Well .. ~

Lua Wai (3)1-5-031 :069 Agricultural-l a Well

Kahionano (3)3-4-003:001 Agricultural-20a Well

Powers (3) 1-3-003 :022 Agricultural-lOa Fann Well

State Land Use

Agricultural

Agricultural

Agricultural

Agricultural

Agricultural

Agricultural

AgriculturaV Conservation

Agricultural

We have no further comments to offer. at this time.

o

LUPAG SMA SMA Permits

Required Important Not in None Agricultural SMA" Required Lands Important Not in None Agricultural SMA Required Lands/ Expansion Important Not in None Agricultural SMA required Lands Important Not in None Agricultural SMA Required Lands

Important Not in None Agricultural SMA Required Lands Open Within SAA-ll-

SMA 000655 exempted well from pennitting requirements

Important Within Exempt per Agricultural SMA Planning Lands/Open Department

letter dated August 9, 2000

Important Not in None Agricultural SMA Required Lands n

o Mrs. Lorrie Diamond Diamond Drilling & Pump, LLC May 11,2011 Page 3

If you have any questions or if you need further assistance, please feel free to contact Bethany Morrison of this office at 961-8138 .

. ~ BJ LE EAD TODD \J Planning Director

BJM:cs P:\wpwin60\CZM\l..etters\20 II \ Well Permit Inquiry- Diamond 504II.doc

cc: Mr. Ryan Imata State ofHawai'i Department of Land and Natural Resources Commission on Water Resource Management P.O. Box 621 Honolulu, ill 96809 '.or

'. \.

STATE OF HAWAP DEPARTMENT OF LAND AND NATURAL RESOURCES COMMISSION ON WATER RESOURCE MANAGEMENT

o APPLICATION FOR A WELL CONSTRUCTION I PUMP INSTALLATION PERMIT

ORIGINAL MAII,ED on JUN -8 AM 8: i+' 7JunlJ II

Instructions; Please print in ink or type and send completed application wit! attachmenlS to the CommIssIon on water Resource Management, P.O. Box 621, Honolulu, Hawaii 96809. AppicaIion must be accompanied by10 copies and a,.. refundable filing fee of $25.00 payable to the Dept. of Land and Natural Resoun:es. The Commission may not accepI incomplete applications. For assistance, call the Regulation Branch at 587..Q22S. For (Urth« inlOnnafion and upda(es fo this application form, visit htIp:llYNNi.hawai.gov/dlnr/cwrm.

same

than 25 individuals or 15 service

Geofl"ery M. & Beverly Und Molfino

POBox 190 Papa'aloa, HI 96780

same

U. Spedal Ma....-.t Area Permit (SMAP) Required. SMA # Datc: approved:

X Not Required <attach docummlation fium applicable County Agency) I have not checked with the county about wbether or not an SMA Permit is required.

Hist<lIic:.:iIe!t I haote aItIIlhed appicabIe dlcumentaIioo from HPO.

3.Q 0. An Environmental Assessment was completed, md o An Environmentall~act Stalementwasrequinldand has been aooepI9d (8lB:ll1allarol ~). PubicaIioo dale 011 The &MronmanIaI NoIio&:

A findng of No Si!J1iica1t Impact has been deBnined (Mta:h letter). PubIicafion dale on The EnWonmentai Noioe: This project proposes:

Use of sIaIe or county lands, or use of stale or 0WIIy tmds Use v.ilhin 9 National or Hawaii regstered histlric site A wastewater treatment unit

Use wit1in a stale <Xln99MlIIion dskicI Use within !he Waikiki Special District WIJSte..Io.energ faciily

needed)

Use wihn 8 shon!ine selleck area The consm:tcn. exp6Ilsion or mocHcaIion 01 heicopter facility larKIiI

Rodney K Diamond BC23379 C-571C-57t1111 l.lcenM No. ~~~ I

C-57fC..57t1111 license No.

Rodnev K Diamond . nature Print

10 May 2011 Dale

//Jw k/~ Rodney K Diamond 4inature Print

10 May 2011

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

987-8100 966-4129 987-8100 ~129 Phone Fax

diamond.driing.pumpOgmaiI.com

E-mail Phone Fax

WCPI Af!P. Form 813112010

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

Hole Diameter: 8.S inches. Elevation at top of casing ~ ft., msl*

Grouting method: DPosiIive

Displacement

x Other

Total Depth

..2®...feet.

Cement Grout: 182 ft. (min. 70% d distance from ground elevation to lop of water surface or 500 ft., whichever is less.)

Annular space bel-. hole and casing (1.5" for posIive displacement, 3" for other methods):

~in.

Rock or Gravel Packing:

78 fl.

Material:

x Crushed Basalt o Rounded Gravel

Estimated water Level Elevation:

_S_ft.msl*

- , , : .... l

:

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I

" '

-. '.

:

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Minimum d 2' Radius & ... Thick Concrete Pad (to contain benchmark surveyed to nearest 0.01 ft.)

1

Ground Elevation: 245Jt, msI*

··t~ 'v;-

Please refer to the HAW All WElL CONSTRUCTION AND PUMP INSTAlLATION STANDARDS

to ensure that your as-buih is in compliance with applicable SIalldards.

Solid casing: (= 90% x (Ground Elev.-water Level Elev»

Total Length: 245 ft.

Nominal Diameter: ___ .... 4...,.S _______ ,in.

wag Thickness: ___ .... S40~ ___ __...iin-

Bottom Elevation:. ___ .....;-O-~ ____ ft-. msI*

Open Casing: • Perforated 0 Screen

Total Length: 15 ft.

Nominal Diameter: ___ 4 ..... "'S'--_____ in.

Vllall Thickness: S40 in_

Bottom Elevation:, ___ .-:;;.J-l .... 5~ ____ ft., msl*

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

Open Hole:

Length: __ ... N'-<..A>-______ ft,. Diameter: ______________ in.

Bottom Elevation: ft., msI*

* The approximate elevation must be referenced to mean sea level (msl) at the time of application filing. Final elevations ofweH components shall be submitted in the Well CompletionlVVell 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 otwell should not be deeper than 114 of aquifer thickness or, Bottom Elevation ot Well Umit = (Water Elevation - 41 x water Level Elevation 1 4) Example: Estimated + 2 ft. Water Level Elev.>>> Bottom Elevation otWell Umit = (2 - 41 x (2) 14) = -18.5 ft.

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

And compliant with (check one or more): DASTM A242 (or A6OO) 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 AWvVA 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 ANSI/AWvVA C200 0 API Spec. 5L 0 ASTM A53 0 ASTM A 139

And compliant with (check one or more): 0 ASTM A242 (or A6OO) 0 Type E 0 Type S 0 Grade B 0 Other Stainless Steel: (check one): 0 ASTM A400 (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 AWvVA C950 o PTFE Fluorocarbon Tubing conforming to ASTM 03296 o FEP Fluorocarbon Tubing conforming to ASTM 03296

WCPI App. Form 8131110

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NEW HESIDf:NCE t·O!.

GEOFFREY &: BEVERLY MOLFINO

20 MM, tlAWAII BELT r,OAD IIIOl1WAY 19 NINOLE, N. HILa 'r.l\lJ\, (3) 3-L~-()03: OOl Lol A

I (i1 f.:>li~f.: , .14B/o:,

ZONIN(;: ",\ .... 20/CONf,1: ~;VA llml IIVINCj ARE/,: NON LlVINi':; AREA

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• STATE OF HAWAP 0 DEPARTMENT OF LAND AND NATURAL RESOURCES COMMISSION ON WATER RESOURCE MANAGEMENT

APPLICATION FOR A WELL CONSTRUCTION I PUMP INSTALLATION PERMIT 2011 JUN -8 AM 8: 50

InstructionS: Please print In Ink or type and send completed appIcatIon wit! attachmenlS to the ComrniI;$ion on water Resource Management, P.O. Box 621, Honolulu, Hawaii 96809. AppIcation must be acctlIlipallied by10 copies and a n0n

refundable filing fee of $25.00 payable to the Dept. of Land and Natural Resouroes. The Commis6ion may not accept incomplete applications. For~, can the Regulation Branch at 587~. For futther information and updales to this application form, visit http://wv.w.hawai.gov/dlnr/cwrm.

0. An Assessment was completed, SId

Geoffery M. & Beverly Und Molfino

Mailing Address

POBox 190 Papa'aloa, HI 96780

Landowner's

same

13. )(flowmeter o.Open~

\T2~;;;;;tA;;;;ni;Hiiii;;jg;;~gpd~(~gabb;IS~~ 0. Weir

n. Sped" Maugemeot Area Permit (SMAP) Required, SMA II Date approved:

0. Orifice 0. Other

X Not Required (attadt documaJtatiOll from applicable County Agency) I have not checked with the county about whether or not an SMA Permit is required.

I have atta:hed awic8b/e cb:umentation from HPO.

0. All Environlll8fllall~ Stalement was raquinId and has been accapIBd (altach IeItsr of aocepI!n:e}. Pubic&Iion daIrJ on The fIMmIrmenIaI Notice: A findng of No Si!Jiicsrt 101J8d has been delemined (1iIs:h BIter). Pubic&Iion dale on The ErNionmentaI Nob:

This project proposes: Use of stale or county lands, or use of stale or county .,ods Use within a National or HIIWlii Illjjstered hisklric site A wastewater treatment unit

Rodney K Diamond LioellS\l8,business name

I/~J/ <7 /l .~ IL~ RodneY K piamond ~nalure Print

HCR #3 Box 14073 Keaau HI 96749 Address

987-8100 96Et4129 Phone Fax

Use witlin a stale conservaIion ci>*ic:t Use wiIIin the Waikiki Special 0isIricI WastHHInergy fa:iity

Use witRn a shaIeIina seiback area

BC23379 c.511C-57e1A license No.

10 May 2011 Dale

The consIrucion, expansion or IIIOIHcaIion of heIioopler fa:iity landIiI

Rodney K Diamond u-.~~~ /1

,- /,JIwkU;-:! RodneY K pjamond Qre Print

HCR #3 Box 14073 Keaau HI 96749 Address

987-81OQ 966;4129 Phone Fax

BC23379 c.51/C.57e1A License No.

10 May 2011

WCPI App. Fonn 813112010

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

Hole Diameter: 8.5 inches. Elevation at top of casing ~ ft., msr

Grouting method: o Posilive

OispIacemant

xOlher

Total Depth

.2§jLfeet.

" . :-":': ',: .. .'

Cement Grout: 182 It. (min. 70% d distance from ground elevation to lop of water surface or 500 ft., whichever is less.)

Annular space 00.- hole and casing (1.5" for posiive ...... displacement, 3" for other methods):

_2_ in. ': '~" ..

:,'.'

Rock or Gravel Packing: I ..

78 ft.

Material: x Crushed Basalt

, . " . o Rounded Gravel

r-E-st-im-at-ed-wa-te-r-Le-v-e-I -...., - . ~r-; ... ' .•..... 1.1

Elevation:

, t~Il _5_ft.msr

~ Minimum d 2' Radius & 4" Thick Concrete Pad (10 contain benchmark surveyed

.' . . '.

..... to nearest 0.01 ft.)

I

Ground Elevation: 245-'t, msI*

.. ~,. '-.,,~ .-----------. Please ref« to the

HAW All WEll. CONSTRUCTION AND PUMP INSTAlLATION STANDARDS

to msure that your .... built is in compliance with applicable standards.

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

Total Length: 245 It.

Nominal Diameter: 4.5 in.

wan Thickness: ___ ... S40"""" ___ -.Jin.

Bottom Elevation:~ __ --,,:-O-::loC.. ____ ft., msI*

Open Casing: • Perforated 0 Screen

Total Length: 15 It.

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

wan Thickness: S40 in.

Bottom Elevation: -15 ft., msl*

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

Open Hole:

Length: _ ........ N.L%L..tll..-______ ft. Diarneter: __________________ ,m.

Bottom Elevation: ft, msI*

• The approximate elevation must be referenced to mean sea level (mst) at the time of application filing. Final elevations of weH components shaH 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 WeH Umit = (water Elevation - 41 x water Level Elevation 1 4) Example: Estimated + 2 ft. water Level Elev.>>> Bottom Elevation of Well Umit = (2-41 x (2) 14) = -18.5 ft.

Solid Casing Material: Carbon Steel: compliant with (check one or more): 0 ANSIIA'lflNA C200 DAPI Spec. 5L 0 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) 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 A'lflNA 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): DANSIIA'lflNA C200 DAPI 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 A400 (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 A'lflNA C950 o PTFE Fluorocarbon Tubing conforming to ASTM 03296 o FEP Fluorocarbon Tubing conforming to ASTM 03296

WCPI App. Form 8131110

II

155'13'00' W

NATIONAL GEOGRAPHIC

TOPO! map printed on 06101111 from "Untitled.tpo" 155'12'00' W

0.0 0.1 0.2 0.3 0.4 0.5 o.e 0.7 0.8 mile,

I" \' I II ' " I " II I " ' Ir II I I, I I ! I. " ' I II' II , i I I i ( ( I 0.0 0.5 1.0 km

WGS84 155'10'00" W

TNlM'l 10'

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NEW HESIDENCE t·O!.

GEOFFREY & iBEVERLY MOLFINO

20 MI"l tlAWAJI BELT r~OAD IIIOl1WA Y 19 NINOLE, N. HILO T,~1J\, (3) 3-L~-()03: 001 tot A

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c~ssion me -1-review & comment take action type draft acknow letter -2-type final, label file...

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