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NEIL ABERCROMBIE GOVERNOR OF HAWAII

Mr. Tom Ramey 1370 Front Street Lahaina, HI 96761

Dear Mr. Ramey:

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, 2011

WILLIAM J. AI LA, JR. CHAIRPERSON

WILLIAM O. BALFOUR, JR. SUMNER ERDMAN

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

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

WILLIAM M. TAM DEPUTY DIRECTOR

3807-02,ccpi

Certificate of Pump Installation Completion for Kaupo-Ramey Well Well No. 3807-02 (TMK (2) 1-7-002:026)

We are pleased to inform you that the Pump Installation work permitted for the KaupoRamey Well (Well No. 3807-02) is complete and acceptable and welcome you as a new member to the community of well owners and ground water users in Hawaii. This certificate of pump installation completion allows you to commence pumping your well for reasonable & beneficial water use.

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

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

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

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

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

o o Mr. Tom Ramey Page 2 April 28, 2011

5. Your approved pump has a capacity of 25 gpm at a head of 750 ft. In the future, pump replacements of equal or lesser capacity will not require an additional permit from the Commission, but will require the submission of a Well Completion Report Part II by the licensed pump installer. If the pump replacement is greater than the existing pump, you will need to apply for a new pump installation permit.

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

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

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

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

If you have any questions, please contact Charley Ice of the Commission staff at 587-0218 or toll-free at 984-2400 (Maui), extension 70218.

CI:ss Encl: Water Use Report Forms

c: Wailani Drilling, Inc.

Sincerely,

WILLIAM M. TAM Deputy Director

c o NEIL ABERCROMBIE

GOVERNOR OF HAWAII WILLIAM J. AILA, JR.

CHAIRPERSON




April 28, 2011

WILLIAM D. BALFOUR, JR. SUMNER ERDMAN

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

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

WILLIAM M. TAM OEPUTY DIRECTOR

3807-02.ccwc

Mr. Tom Ramey 1370 Front Street Lahaina, HI 96761

Dear Mr. Ramey:

Certificate of Well Construction Completion for Well No. 3807-02 (TMK (2) 1-7-002:026)

We are pleased to inform you that the Well Construction work permitted for the Kaupo-Ramey Well (Well No. 3807-02) is complete and acceptable and welcome you as a new member to the community of well owners and ground water users in HawaiI.

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

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

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

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

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

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

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

If you have any questions, please contact Charley Ice of the Commission staff at 587-0218 or toll-free at 984-2400 (Maui), extensIOn 70218. .

Sincerely,

~

Deputy Director

CI:ss

c: Wailani Drilling, Inc.


Mr. Michael Robertson Wail ani Drilling, Inc. 110 West Uahi Way Wailuku, HI 96793

Dear Mr. Robertson:

o o


COMMISSION ON WATER RESOURCE MANAGEMENT po. BOX 621


April 28, 2011

WILLIAM J. AILA, JR. CHAIRPERSON


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

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


3807-02.wcrl &2.acc

Well Completion Report Parts I & II for Well No. 3807-02

We received the final requirement for the Ramey Well (Well No. 3807-02) permitting process on April 21, 2011 and acknowledge that Well Completion Report Parts I & II are complete.

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

If you have any questions, please contact Charley Ice of the Commission staff at 587-0218 or toll-free at 984-2400 (Maui), extension 70218.

CI:ss

c: TomRamey

Sincerely,

WILLIAMM. TAM Deputy Director

FROM: Charley TO: _'MATA,R.

_ UYENO, D. _ CHONG, R.

_ FUJII, N. _ KIMURA,J. _ YOSHINAGA, M.

_ KUNIMURA, I.

() (1 COMMISSION ON WATER RESOURCE MANAGEMENT

DATE: {Co Ape i( INIT. TO:

_ TAM,W. ~ HARDY, R. _ OHYE, L.N.

_ HOAGBIN, S _ DAN BARRA, S. _ YODA, K ..

INIT. FOR: _ Approval _ Signature

Information

PLEASE: Review & Comment

_ Type Draft _ Type Final

File _ Copies: __

Take Action:

24Nov10

c

MEMO and ROUTE> SLIP (ver. 5/11/10) o

04/18/11

WCR 1 Check for Well No. 3807-02 (GW regulation route)

1. From Roy __ ~~+-__ (initial)

Initial entry in to well index Ingrid's spreadsheet updated needed/done

Pump Tests Check

Step-Drawdown Test: followed WCPI Stds analysis attached

Constant Rate Test: followed WCPI Stds analysis attached

Potential Well Interference:

Potential Stream Impacts:

Additional Testing or Data Required:

Pump Test Comments Attached:

Proposed Pump Capacity is OK.:

B" o do gpm no test required

~ o

~/ I LY ~50 gpm no test required

o r/ o 17" If yes, stream name(s):

o ri o , o

2. Well Log Check Geology Code for Well Index: ~y\ Fm Name~",i~Jeremy 0Jl: (initial)

3. , ~ (initial)

""

data complete 1ii 0 followed Special Cond & elevations 0 0 location unchanged from WCPIPA? 0 M

If yes, is SMA, CD, TMK changed? 0 J!l

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

2 COUNTY COMMENTS (DWS/SMA)

3 DOH COMMENTS

4 DLNR COMMENTS (LD/OCCUDHP)

5 WCR 1 Accept .{ z. 6 WELL CON ST. COMPLETIQN CERTIFICATE 7 ·~i}~· < :""........~.,...,.. .a nc.

9 Jta~Q~:~.::k~;;,g~~~

NA

o ;( o o

If no, describe deficiency

red penciled completed location too . .,/

/' not necessary - only WCP or BOTH.

} To be sent to driller/pump installer

<------ To Landowner

} Staff internal checks

4. Roy ~ 5. SusanH~

(initial) check (Entered WCR 1IWCCC accept date into database) (initial) -finalize

6~1 7: jlarl~yan

(initial) signature File & Enter PIP issue date if attached/required

Results

Well Depth Theoretical Thickness of Aquifer 1/4 Aquifer Thickness DfI>th··f')fwtBf;JeIow Sea Level

Well Casing Minimum Wall Thickness

Material Minimum Thickness per standards ~M;rm,*n~8S Provided

Minimum Length of Solid Casing 90% of ground to top of aquifer LetdfI'f')f solldcaslngP~· .

• CssllJlillmeff81 ' . .'.': :: :.

(for IIYtfDhly • cl'/eck for 200' limltJ Annular Space

Depth of Grouting Calculated Depth of Grouting ~tft'f')fGmUting 1I~'

Minimum Annular Space required Th/~ orAimular Snace .

yes no

steel stainless steel

steel

ASTMA53

o

533 133.25

-49 okay Sec;tion 2.2

#N/A 0.28 nostandarel settion 2.4(b)

486.9 583 okay SeQtion.'2.4(c)

Incompliance SeQtion 2.4(d) .' okay Section 2.4(d)

378.7 .

400 okay. '.

Sec;tior-.2.6(c) 2

. 3;25 okaY . SeCtIon 2.6Cd)

pvc plastic abs plastic thermoset plastic other

steel ANSI/AWVVA C200 API Spec. 5L ASTM A53 ASTM A139 ASTM A606 other

positive displacement other

steel public steel non public

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

steel ANSI/AWVVA C200 API Spec. 5L ASTM A53 ASTM A139 ASTM A606 other

#N/A

0.28

stainless steel ASTMA409 other

pvc plastic Schedule 40 Schedule 80 other

Wailani Drilling Services <wailanidrilling @gmail.com>

04/15/2011 02:00 PM

.. To [email protected]

cc

bcc

Subject Kaupo Ramey Well 3807-02

As per our conversation, Thanks, Michael

Wailani Drilling Services Inc. 808.249.0149 wk 808.244.4791 fx

Water- The Drop of Life ~. ~

WCP.pdf Notice to start work. doc WCR1.pdf WCR2.pdf Pump curve. pdf Well Head Picture. doc

o 0 Wailani Drilling Services, Inc. License #C57-20115 110 West Uahi Way, Wailuku, HI 96793 Phone: 808-249-0149 • Fax: 808-244-4791 E-mail: [email protected]

Dear Mr. Charley Ice, July 28, 2008

This letter is to notify you that we will be mobilizing and starting work at the well site for Mr. Tom Ramey with the state issued well named "Kaupo-Ramey Well #3807-02" within the next two weeks. Please let me know that you received this notice.

Thank you, Leah Robertson Assistant Project Coordinator

o o WELL CONSTRUCTION PERMIT

Kaupo-Ramey Well. Well No. 3807-02 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 Kaupo-Ramey Well (Well No. 3807-02) at TMK 1-7-002:026, Maui, subject to the Hawaii Well Construction & Pump Installation Standards (HWCPIS - February 2004) which include but are not limited to the following conditions:

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

II.

12.

13.

14.

15.

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

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

The well construction permit shall be for construction and testing of the well only. The permittee shall coordinate with the Chairperson and conduct apumping test In accordance WIth the HWCPIS (the latest rump test worksheet can be obtained by contacting Commission staff or at www.bawaii.gov/dlnr/cwrmlfonns.htm). The permittee shal submit to the Chairperson the test results as a basis for supporting an application to install a permanent pump. No permanent pump may be installed until a pump installation permit is approved and issued by the Chalfperson. No withdrawal of water shall be made for purposes other than testing without a Certificate of Pump Installation Completion. The pennitted 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 (1/4) of the theoretical thickness (41 times initial head) of the basal ground water unless otherwise authorized by the Chairperson.

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

In the event that historically significant remains such as artifacts, burials or concentrations of shells or charcoal are encountered during construction, the permittee shall stOll 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 pennit 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 aIIer completion of work (please contact staff or visit www.hawaii.gov/dlnr/cwrmlforms.btm for current form).

The permittee shall comply with all applicable laws, rules, and ordinances; non~mpliance may be grounds for revocation of this pennit.

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

The work proposed in the well construction permit application shall be completed within two (2) years from the date of permit approval, unless otherwise specified. The pennit 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 pennit 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) 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 ofthe 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 instanation pennit In accordance with Hawaii Administrative Rules § 13-168-12(t).

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

Date of Approval: April 30, 2008 Expiration Date: April 30, 2010

, Chairperson Resource Management

I have read the conditions and terms of this permit and understand them. I accept and agree to meet these conditions as a prerequisite and underlying condition of my ability to proceed and understand that I shall not commence work until I 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 ~ounds for revocation and fines of up to $5,000 per day starting from the permit date of approval.

~ ~~: 20115 Date: \Q.t2.~ Driller's Signature:

Printed Name: Michael Robertson Finn or Title: Wailani Drilling, Inc.

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

Attachment

c (f~i;l~)

State of Hawaii For Official Use Only:

COMMISSIO~I ON WATER RESOURCE MANAGEMENT

~ ,j: t~,·,·~,~ti::, Department of Land and Natural Resources

I \~:;!:~~fl~~ii:? WELL COMPLETION REPORT - PART I Well Construction

Instructions: Please print in ink or type and send completed report (with attachments, if applicable) 10 the Commission on Water Resource Management, P.O. Box 621, Honolulu, Hawaii 96809. The Commission may not accept incomplete reports. This form shall be submitted within 60 days of the completion of work. For assistance, please consult the Hawaii We" Construction and Pump Insta"ation Standards or call the Regulation Branch al 587-0225, For updates to this form or additional information, please visit our website at http://www,state.hi.usldlnr/cwrm/

1. State Well No.: 12~01" 02- Well Name: ~~--~~ Island: H2i1A 2. Address: l ::;1"-0 fl--tht qr. ~h~iha Hi q LP=T~/ Tax Map Key: /.~. 1J(J2" ()z&;

3. Drilling Company: W ~', bvt I l)ri II i t¥:1 I hv ' 4. Drilling method used during construction: '1 Rotary ~percussion 0 Other (describe)

5. Date Well Construction (drilled,cased,grouted) completed: bf' 4 ,of!, Attach Completed Driller's Log month/day/year-

6. Was the subject well cored? 0 Yes ~ No

7. Step-Drawdown Test completed? '¢ No DYes Attach Step-Drawdown Test form (12117197 SePTD Form)

8. Constant Rate Aquifer Test completed?'ri-No DYes Attach Constant Rate A~ uifer Test form (12117197 CRPTD FormJ Water Level

Depth to = ft. above mean Reference point - water sea level (see Date/time of

Water Level Data: elevation (feet) note below) measurement 9. Initial encountered during drilling Grou~? 'fft. msl ~Jf/ )3 0-25 ,DB jlhis should also be filled in on the driller's log)

1 O. Just~ior to casing installation Gro~~ 'T ft. msl 64-{ 13 ~ ,~fj-08 If th is reference

11. After casing installation point is not the (this information should be before any pump tests are benchmark, the {,0 tl·4- 010 performed with casing installed) difference between 5/.·fI,7 Chloride: ~ ppm, Temperature: :::ro.DoF

the benchmark and Ihi~oint is: • S I

$' ,7ft. note: for all elevations referenced to mean sea level, take the ground elevation (surveyed or estimated if survey not required at this time) and subtract the depth to the water level.

12. As-built section filled in completely )t 13. Photograph of well and concrete pad showing benchmark on concrete pad attached '5i 14. GPS coordinates provided in degrees, minutes, seconds i--15. If a pump is not planned to be installed, please describe (below in the remarks section) how well is secured to prevent unauthorized access (example: lockable cover, threaded coupling, etc.)

16. Remarks:

Licensed Driller (pr~ W~ . C·57 Lie. No '1-011'5

/0, f -06 Signature -~ Date

weR1 Form 6112107 Page 1 of 5

o o 12. AS-BUILT WELL SECTION (Please attach as-built if different from diagram provided below)

" Hole Diameter: /2·:5 in. Elevation at top of casing ~ft., msl' _, ~j" . . ,. ". (to nearest 0.01 ft.) ~.: _, ~41'-- MInimum of 2 Radius & 4 Thick Concrete Pad

r:::==-==----l-------------,"",:.:f';-;· r~~t:.; (_. Ground Elevation: ?'QJf, ft., msl 0 Surveyed VEstimated Bench mark ... : ,d. . ..•.. 1 , l" -

~;;;n~., mSI" Cement Grout~-lf-O-Q ft~~ I [\, i:; II - ',=,

o (Surveyed to (min. 70% of ~istance from ::::.; :::.:. ~ I nearest 0.01 ft.) ground elevation to top of 't:;}' ;.[-'.3' .-i(Estimated) water su~ace or 500 ft., .:./: ::,:.:':[ 1i I )'" whlcheverls less.) '.', . .'. " '"

;.::. ;::;'[ ~ ~

Grouting method: ;,~i~~~~'d~;.;sir;g~(1:5~fur I I}:i r~lf ~; o P~sitive. positive displacement, 3" I ~~:. >. -g I

displacement (~f for other methods): I /t~:~ :,:;.::\1 ~ annular space IS a, './ ~ -:. ; . :. (!)

less than two ---:.L- in.---1 ::,'. .::,.-; inches. attach , ::.:.: '~.:.:. '#-

,. '--;:::::===========~ I A~~ .. I~r ~n~~ "~"un~n I

"('Other Rock or Gravel Packing:" 0]8' ~

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

with applicable standards.

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

Length: Cj0~ ft.

Nominal Diameter: UJ in.

Wall Thickness: . '2. fJ() in.

Bottom Elevation: - 210 . 'S ft., msl

I photo oftremie) . +', .;;; 0

T' 1\ I I ~ I (1JI I

~;;-c :Cc! Open Casing: X Perforated 0 Screen

8 (;C,~II j: -"1 r-.. ~o- ';6 Length: L:1) ft . . ' ~1~1 ~" -/// Nomina~ Diameter: (£) in.

RC~ fuA" Wall Thickness: 2? In.

~~ ~:~" I Bottom Elevation: tf0 ·0 ~ ~-r I! '

I ,j, I; I

: I __ .~_ LJ __ , L

Total Depth

LPO~ ft.

fl .. msl

Open Hole:

Length: N / It fl.

Diameter: in.

Bottom Elevation: fl., msl 'msl = mean sea level

Solid Casing Material: Carbon Steel: compliant with (cI7eckone or more): 0 ANSIIAVVWA C200 0 API Spec. 5L 'f ASTM A53 0 ASTM A139

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

Stainless Steel: (check one): 0 ASTM M09 (production wellS) 0 ASTM A312 (monitor wells) ABS Plastic conforming to ASTM F480 and ASTM 01527: (check one) 0 Schedule 40 0 Schedule 80

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

Thennoset 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 AVVWA 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 ANSIIAVVWA C200 0 API Spec. 5L ~STM,Ar3 0 ASTM A139

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

Slain less 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): o Schedule 40 0 Schedule 80 0 Schedule 120

Thennoset 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

[J Glass Fiber Reinforced Resin Pressure Pipe conforming to AVVWA C950


o FEP Fluorocarbon Tubing conforming to ASTM 03296

WCR1 Form 6112107 Page 2 of 5

o o 2c:c6

DRILLER'S LOG

WELL NUMBER: a ~ 0 q- - 0 2. In addition to the driller's log, if a geologic log was prepared, please submit with this form

Depths (fl.) Rock Description Water Level CI- Dates

T@p'soiJ / _'_toL w I t(D?{LS _____ 0 I 'b

~to 2"2 t.?n YVCK _____ _

1.:2 to 'I? b)J,U,rvtK _____ _

4s toUO tim rvCK _____ _

~ to e/6 ti IAL- YV6k. __

6£) to'1'2 1-® Vl)(,\<. __

q'2- to l&. bku. YVt¥. ___ _ blVLt votK...

~tol2fJ bOMdUo __ ___ _

/1'8 to /$ +m H){J<

/$ to l~ bl-tu YO U<

1% to 155 +)n He:/,:; __

105 to 116 bk VV~ __

~/11 ----

2iA2..to~03 fm H?t:-- __ ___ _

~o? to?J~ 0 bku yv ?J<. __ _ __ _

'310 to??lR fP11 H(}::. __ __ 10/:2..0

,??lPto ?~B blM£, voCk__ _ __ _

'2?~ to '?JIRfo 1011 rvvK __

~(p to 38q b ktu- vvu<_· __ _ _

Remarks:

Depths (fl.) Rock Description W<l.er Level CI- Dates

~1 to~ f?11 t7J()< ___ _

L/ 0f3 to J-./--;.o bUu.~ypvK-;--_ -rPY2 VV *- hJ /

420 to iva red vi etJ-- ___ _ L{-:J.~ to i.J-35 1m nt/J< _____ _

L/?J5 to 455 bku-VP t1<__ _ __ _

455 to Lf91> -r.m OrA< ____ r8/'22.

4-:Wto'508 b~ntl< __ ___ _

~o3 to5'/~ fen f7lt¥- ------~to?,~f3 6~vtJa< ___ _ '536 to'65"1) -j ~ YVU< __

550 to f){g3 b ~ ypc.K-'------_

69£$10 itJQ3 aiVieM __ _to _______ _

_to _______ _

_10 ___________ _

_to ___________ _

_to ___________ _

_to ___________ _

weR1 Form 6112107 Page 3 of 5

o Wailani Drilling Services <wailanidrilling @gmail.com>

04/21/2011 05:51 PM

o

To [email protected]

cc

bcc

Subject Re: Ramey PIP signature

Thought I had sent it, sorry but here it is. Thanks, Michael

On Thu, Apr 21,2011 at 5:20 PM, <[email protected]> wrote:

You sent the signed WCP -- you must have the signed PIP, too?

Wailani Drilling Services Inc. 808.249.0149 wk 808.244.4791 fx

Water- The Drop of Life

~ PIP.pdf

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

o 0 PUMP INSTALLATION PERMIT

Kaupo-Ramey Well, Well No. 3807-02 Note: This permit shall be prominently d;.~plaved at the site until the work is completed

In accordance with Department of Land and Natural Resources, Commission on Water Resource Management's Administrative Rules, Section 13-168, entitled "Water Use, Wells, and Stream Diversion Works", this document permits the pump instaIlation for Kaupo-Ramey Well (Well No. 3807-02) at TMK 1-7-002:026, Maui, subject to the' Hawaii Well Construction & Pump InstaIlation 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 §J3-168-15, Hawaii Administrative Rules.

2. No withdrawal of water shall be made other than for testing until a Certificate of Pump Installation Completion has been issued by the Commission.

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

4. The pump installation permit shall be for installation of a 25 gpm rated capacity, or less, pump in the well. This permanent capacity may be reduced in the event that the pump test data does not support the capacity.

5. A water-level measurement access shall be permanently installed, in a manner acceptable to the Chairperson, to accurately record water levels.

6. The permittee shall install an approved meter or other appropriate means for measuring and reporting withdrawals and appropriate devices or means for measuring chlorides and temperature at the well head.

7. Well Completion Report Part II shall be submitted to the Chairperson within 60 days after completion of work. This form can be obtained by contacting staff or on the internet at www.hawaii.gov/dlnr/cwrm.

8. The permittee, well operator, and/or well owner shall comply with all applicable laws, rules, and ordinances, and non-compliance may be grounds for revocation of this permit.

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

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

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

12.

Date of Approval: Expiration Date:

April 30, 2008 April 30, 2010 esource Management

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

and fines of up to $5,000 per day sta'l<tin from t per~ dat~ ~.

Installer's Signature: \,(~nse #: 20115 Date: lP' 1?1· wB Printed Name: Michael Robertson Firm or Title: Wailani Drilling, Inc.


Attachments

c o "'" "" k-·. State of Hawaii

/.,~~~·.i:·?·;<'~~\ COMMISSION ON WATER RESOURCE MANAGEMENT For Official Use Only:

{,,',\;,1~i~-n)J Department of Land and Natural Resources

">";;~~~r#,:~./'· WELL COMPLETION REPORT· PART II '''':~~::,;:.;,;;/;>' Pump Installation

Instructions: Please print in ink or type and send completed report (with attachments, if applicable) to the Commission on Water Resource Management, P.O. Box 621, Honolulu, Hawaii 96809. The Commission may not accept incomplete reports. This fonn shall be submitted within 60 days of the completion of work. For aSSistance, please consult the Hawaii Well Construction and Pump Installation Standards or call the Regulation Branch at 587-0225, For updates to this form or additional infonnation, please visit our website at http://www.hawaii.gov/dlnr/cwnn/

Island: /-1Pu i 1. State Well No.: 2'001-02. Well Name: f<arvpo - ~t!1j 2. Address: J 3::tO fvm-t Sf. leho i /Y;il- .Jtt g u::fW I Tax Map Key: I . -::J ' 002..: 02 [p

3. Pump Installation Company: VV p i I 'MIl Wi IIi rg / h {/ ,

4. Date Pump Installed: g , B' () S monthlday!year

5. PERMANENT PUMP INFORIVIATION

Pump Type, Make, Serial No.: FE;:fr5 - 3q DS. (?v'itndbs ('80511 DO :3tl/ r I Dq2 q 303 r >

Rated Capacity: 2? gpm at head of: qcsO Motor Type, H.P., Voltage, rpm: (pdri (2n» 9.5 HPJ '2-30 Y) 945 () vpm ... Pump type (check one):

o Deep Well Turbine

~ Submersible

o Centrifugal

6. Method of flow measurement:

o Rotary

o Rotary-Displacement

o Rotary-Gear

¥ Flowmeter wI totalizer Manufacturer 1:1ad fJ-eV-o Other, explain and attach schematic

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

8. Attach the rating curve for the installed pump.

o Propeller

o Reciprocating

o Impulse

Model no.3404126JB Size /.5 11

ft.

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

10. Well Owner

11. Land Owner

Company (.J.~ '!!!j / FrY If} / fh:JA ~ Address 1:3'1t> 'frmf sf· L-eha/t@

Phone ('/;O e,.) 1-022 . /.tJq21-Company 6~

Contact Ian rz Prnof:-!1 1ft q{j~1

Fax (~O~ lJJ(P1-'0/~O Contact _ .... ,5'-~-L.L-==-_____ _

Address _________________________ _

Phone Fax __________ _

12. Remarks ~1~ WtU W7Y;'. £:trilled at ttPPn>i-. Gt?I.-\-' ~'fh-e VVIA.+cV will 'ae ~ped 1V :3 to.li\tt: of AJPpm· q-~o ( 4lkvtt-6tt-v,

Pump Installation l;1J~~~;:;:::!~~~f=::::!.'-57/C-57a/A Lic. No. _c:::::..::.~:...;.!...:..:'/ 8==--____ --11

Signature Date \0·


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

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

.~ 11/1 ;;; till ;;; 1111 = 1111 ,~_-.. -··-·HI.",,_-··-·

Elevation of top of chase tube 555 ft. mean sea level

; ";'

,

.1.

Pump intake depth = r? J../. B ft. (referenced to bench mark)

Chase tube depth = "6Jf1- ft. (referenced to bench mark)

If airline installed, bottom of airline elevation = N / A ft. mean sea level


c H I 25S75-39

Product name: 25S75-39 (tt) Product No: 05110039 EAN number: 5700390233358

Technical: 1000 Speed for pump data: 3450 rpm Rated flow: 26.42 US GPM Flowrange: 3.43 .. 34 US GPM Rated head: 774 tt 800

Curve tolerance: ISO 9906 Annex A --Stages: 39 Model: B 600 Valve: pump with built-in non-retum valve

Materials: Pump: Stainless steel 400

1.4301 DIN W.-Nr. 304AISI

Impeller: Stainless steel 1.4301 DIN W.-Nr. 200

304AISI

Installation: 00 Pump outlet: 1 1/2" NPT 5 10 15 20 25 Q(USGPM)

Motor diameter: 6 inch P2 (HP)

Liquid: Maximum liquid temperature: 104 OF

:~ -Electrical data:

Applic. motor: GRUNDFOS Power (P2) required by pump: 8.234 HP Start. method: direct-on-line

Others: Sales region: Namreg

0

Printed from Grundfos CAPS 1/2

05110039 25575-39

H (ft)

1200

1000

800

600

400

200

25S75-39

%L--------5--------~10--------~15~------2~0--------2~5~------3~0~-Q~(U~S~G~P=M~)

P2 (HP)

10

8

6

4

2

o Printed from Grundfos CAPS 2/2

o " Wailani Drilling Services, Inc. License #C57-20115 110 West Uahi Way, Wailuku, HI 96793 Phone: 808-249-0149. Fax: 808-244-4791 E-mail: [email protected]

Kaupo-Ramey Well #3807-02 GPS: N 20° 38.513' 30.:fZ"

W 156° 07.809' 45 . .9t"

--

FROM: Charley TO: _IMATA,R.

_ UYENO, D. _ CHONG, R.

_ FUJII, N. _ KIMURA, J. _ YOSHINAGA, M.

_ KUNIMURA, I.

() () COMMISSION ON WATER RESOURCE MANAGEMENT

DATE:G8"Atrn'( 11 INIT. TO:

_ TAM,W. _ HARDY, R. _ OHYE, L.N.

INIT.

_ HOAGBIN, S tMM _ DAN BAR RA, S. C _ YODA, K ..

FOR: _ Approval _ Signature

Information

PLEASE: Review & Comment

_ Type Draft _ Type Final

File _ Copies: __

Take Action:

Please See Me

24Nov10


Mr. Michael Robertson Wailani Drilling, Inc. 110 West Uahi Way Wailuku, HI 96793

Dear Mr. Robertson:

o o


COMMISSION ON WATER RESOURCE MANAGEMENT po. BOX 621


April 14, 2011

WILLIAM J. AILA, JR. CHAIRPERSON


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

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


3807-02.exp

Expiration of Well Construction/Pump Installation Permit for Well No. 3807-02

This is notice that your Well Construction/Pump Installation Permit for the KaupoRamey Well (Well No. 3807-02) expired on April 30, 2010.

Based on your conversation with staff, we understand no work was done and there are no current construction plans for the well. Therefore, the permit expiration date will not be extended. You can reapply for a new permit at any time in the future should you decide to recommence this activity.

Please be aware that no further work should be done on this well without a valid signed permit nor can it be pumped without valid well and pump completion certificates. Work without a valid and active permit or failure to adhere to conditions of the permit is a violation of the state water code and may be subject to fines of up to $5,000 per day.

If you have any questions, please contact Charley Ice of the Commission staff at 587-0218 or toll-free at 984-2400 (Maui), extension 70218. 7

s~ncere~y, ~ U/~~~

WILLIAM M. TAM / Deputy Director

CI:ss

c: TomRamey

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

o Q Wailani Drilling Services, Inc. License #C57-20115 110 West Uahi Way, Wailuku, HI 96793 Phone: 808-249-0149 • Fax: 808-244-4791 E-mail: [email protected]

Dear Mr. Charley Ice, July 28, 2008

This letter is to notify you that we will be mobilizing and starting work at the well site for Mr. Tom Ramey with the state issued well named "Kaupo-Ramey Well #3807-02" within the next two weeks. Please let me know that you received this notice.

Thank you, Leah Robertson Assistant Project Coordinator

cOJ .. \SION ON WATER RESOURCE MANAI1ENT . (03/08)

FROM: ROY DATE: --~------------

JUN 1 2 2008 SUSPENSE DATE: ----~~~--~~- ---------------------

TO:

CHENG, C. CHING, F. CHONG, R. DANBARA, S. ENGLAND, D. FUJII, N. HARDY, R. HOAGBIN, S. ICE,C. IMATA, R. KAWAHARA, K. KIMURA, J.

INIT. TO:

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

INIT: FOR:

__ Approval Signature Information

PLEASE:

See Me Review & Comment Take Action Type Draft

__ Type Final File

__ Xerox _ copies

LINbA LINGLE GOVERNOR OF IIA WAIl

o o LAURA H. THIELEN

CHAlRPERSON BOARD OF LAND AND NATIJRAL RESOURCES

COMMlSSJON ON WATER RESOURCE MANAGEMENT

RUSSELL Y. TSUJI FffiSr DEPlTIY

12 AS' 15 KEN C. KAWAHARA

DEPUlY DIRECTOR - WATER

AQUATIC RESOURCES

DEPARTMENT OF LAND AND NATURAL RESOURCES

STATE HISTORIC PRESERV ATIm{QIVlSIDN 601 KAMOKILA BOULEVARD, ~~M 555;

( .... t.: 'lot. li c,,_,

BOATING AND OCEAN RECREATION BUREAU OF CONVEYANCES

COMMlSSION ON WATER RESOURCE MANAGEMENT CONSERVATION AND COASTAL LANDS

CONSERVATION AND RESOURCES ENFORCEMENT ENGnffiERING

KAPOLEI, HAWAII 967tiT"·" "

June 2, 2008

Mr. Ken Kawahara Commission on Water Resource Management Department of Land and Natural Resources P.O. Box 621 Honolulu, Hawai'i 96809

Dear Mr. Kawahara:

SUBJECT: Chapter 6E-8 Historic Preservation Review -Well Construction/Pump Installation Permit Application

FORESlRY AND Wll.DLIFE ImiTORlC PRESERVATION

KAHOOLA WE ISLAND RESERVE COMMISSION LAND

STAlE PARKS

LOG NO: 2008.1283 DOC NO: 0805JP43 Archaeology

(Well Number 3807-02) for the Proposed Installation of the Kaupo-Ramey Well Kaupo Ahupua'a, Hana District, Island of Maui TMK: (2) 1-7-002:026 (Portion)

Thank you for the opportunity to comment on the well and pump installation pennit application, which was received by our staff on April 11, 2008. Our review is based on reports, maps, and aerial photographs maintained at the State Historic Preservation Division (SHPD). There has been archaeological mitigation for the subject area. An archaeological monitoring program is currently in place.

Based on the submitted documents, the subject action for the proposed project consists of the construction of one domestic well and the installation of an associated pump. The subject parcel is located within a very culturally and archaeologically sensitive region.

We accepted an Archaeological Inventory Survey report for the subject parcel entitled An Archaeological Inventory Survey of 23.492 Acres in Kaupo, Kepio Ahupuaa, Hana District, Maui Island, Hawaii, TMK (2) 1-7-002:026 ... Scientific Consultant Services, Inc., ms (LOG NO: 2007.03711 DOC NO: 0702MK02). Four historic properties were listed on the Statewide Inventory of Historic Places (SlliP) including SlliP 50-50-16-6085: a large rectangular enclosure, SlliP 50-50-16-6086: one enclosure and two rock walls, SlliP 50-50-16-6087: a permanent pre-Contact habitation complex consisting of eight enclosures, two platforms, one modified cave, one terrace, and one mound (Features 7 and 12 consisting of a C-shape with makai platform and a rock wall, both extend onto adjacent parcel 004), and SlliP 50-50-16-6088: Lshape remains from an enclosure. We continue to encourage the property owner to preserve all of the recorded features on the parcel, if at all possible.

SlliP 50-50-16-6087 was slated for permanent preservation and a preservation plan has been accepted by our office (LOG NO: 2006.38081 DOC NO: 0705MK04 and DOC NO: 0804PC04). We wish to reiterate that this site extends onto the adjacent parcel [TMK (2) 1-7-004:004]. Preservation measures have not been addressed for portions of the significant site that are located on the adjacent lot.

An archaeological monitoring plan was accepted by our office (DOC NO: 0804PC05). We continue to recommend full time archaeological monitoring for all ground altering activities on the subject parcel; including all ground alterations associated with the current well and pump application.

Mr. Ken Kawahara Page 2

o o

Based on the recommendations in the accepted Archaeological Inventory Survey, and with the implementation of the accepted Preservation and Archaeological Monitoring plans; it is unlikely that any historic properties will be adversely affected by the proposed project. If there are any archaeological discoveries inadvertently uncovered by construction work, then the appropriate proceedings specified in the accepted archaeological monitoring program will be fully executed. If there are any concerns or questions, please feel free to contact the Maui SHPD office at (808) 243-4641, (808) 243-4640, or (808) 243-1285.

Aloha,

Nancy McMahon, Deputy SHPO/State Archaeologist Historic Preservation Manager State Historic Preservation Division

JP:

c: Maui Cultural Resources Commission, Dept. of Planning, 250 S. High Street, Wailuku, HI 96793 SCS Archaeology FAX: (808) 597-1193

LINDA LINGLE GOVERNOR OF HAWAII

Ref: 3807-02.wcp

Mr. Michael Robertson Wailani Drilling, Inc. P.O. Box 790299 Paia, HI 96779

Dear Mr. Robertson:

o




Well Construction Permit Kaupo-Ramey Well (Well No. 3807-02)

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

May 16,2008

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

Special Conditions

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

2. Attached for your information is a copy of the State Department of Land and Natural Resources Land Division's comments related to water lease requirements.

Please refer to the Permit Processes Worksheet (transmitted with your acknowledgement letter) for further information regarding the process of drilling a well and installing a pump.

No withdrawal of water shall be made other than for testing purposes until a certificate of pump installation completion has been issued by the Commission.

Please sign both permit originals and return one for our files. For copies of the aquifer pump test worksheet, please call staff or visit www.state.hi.us/dlnr/cwrmlforms.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 Charley Ice of the Commission staff at 587-0251.

Sincerel ,

.H~~~ lrperson

Enclosures

c: Tom Ramey (with applicable comments - DOH SDWB, WWB, CWB, Land Division) USGS MauiDWS

- o o WELL CONSTRUCTION PERMIT

Kaupo-Ramey Well. Well No. 3807-02 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 Kaupo-Ramey Well (Well No. 3807-02) at TMK 1-7-002:026, Maui, 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.

IS.

The Chai'1!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.

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 rump test worksheet can be obtained by contacting Commission staff or at www.hawaii.gov/dlnr/cwrmlCorms.htm). The permittee shal submit to the Chairperson the test results as a basis for supporting an application to install a permanent pump. No permanent pump may be Installed until a pump installation permit is approved and issued by the Chatrperson. No withdrawal of water shall be made for purposes other than testing without a Certificate of Pump Installation Completion. The permitted pump capacity described on the pump installation permit may be reduced in the event that the pump test does not support the capacity.

In basal ground water, the depth of the well may not exceed one-fourth (114) of the theoretical thickness (41 times initial head) of the basal ground water unless otherwise authorized by the Chairperson. .

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

In the event that historically significant remains such as artifacts, burials or concentrations of shells or charcoal are encountered during construction, the permittee shall 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/cwrmlCorms.htm for current form).

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

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

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

If the well is not to be used it must be 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) prior to any well sealing or plugging work.

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

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

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

Date of Approval: April 30, 2008 Expiration Date: April 30, 2010

, Chairperson Resource Management

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

Driller's Signature: C-S7 License #: 20115 -=~~----------

Date:

Printed Name: Michael Robertson Firm or Title: Wailani Drilling, Inc.


Attachment

~ ...•. ------------

/


Ref: 3807-02.pip

Mr. Michael Robertson Wailani Drilling, Inc. P.O. Box 790299 Paia, ill 96779

Dear Mr. Robertson:

o o




Pump Installation Permit Kaupo-Ramey Well <Well No. 3807-02)


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.


May 16,2008

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

Special Conditions

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

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

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

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

If you have any questions, please call Charley Ice of the Commission staff at 587-0251 or toll-free at 984-2400 (Maui), extension 70251.

Enclosure

c: Tom Ramey (with applicable comments - DOH SDWB, WWB, CWB, Land Division) USGS MauiDWS

C pUMP INSTALLATION PERMITO Kaopo-Ramey Well. Well No. 3807-02

Note: This permit shall be prominentlv displaved at the site until the work is completed

In accordance with Department of Land and Natural Resources, Commission on Water Resource Management's Administrative Rules, Section 13-168, entitled "Water Use, Wells, and Stream Diversion Works", this document permits the pump installation for Kaupo-Ramey Well (Well No. 3807-02) at TMK 1-7-002:026, Maui, subject to the Hawaii Well Construction & Pump Installation Standards (HWCPIS - February 2004) which include but are not limited to the following conditions:

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

2. No withdrawal of water shall be made other than for testing until a Certificate of Pump Installation Completion has been issued by the Commission.

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

4. The pump installation permit shall be for installation of a 25 gpm rated capacity, or less, pump in the well. This permanent capacity may be reduced in the event that the pump test data does not support the capacity.

5. A water-level measurement access shall be permanently installed, in a manner acceptable to the Chairperson, to accurately record water levels.

6. The permittee shall install an approved meter or other appropriate means for measuring and reporting withdrawals and appropriate devices or means for measuring chlorides and temperature at the well head.

7. Well Completion Report Part II shall be submitted to the Chairperson within 60 days after completion of work. This form can be obtained by contacting staff or on the internet at www.hawaii.gov/dlnr/cwrm.

8. The permittee, well operator, and/or well owner shall comply with all applicable laws, rules, and ordinances, and non-compliance may be grounds for revocation of this permit.

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

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

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

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

Date of Approval: Expiration Date:

April 30, 2008 April 30, 2010

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

Installer's Signature: C-57, C-57a, or A License #: 20115 Date:

Printed Name: Michael Robertson Firm or Title: Wailani Drilling, Inc.


Attachments

/

CQISSION ON WATER RESOURCE MANAGEMENQ ROUTE SLIP FOR PERMIT ISSUANCE 5/19/05

FROM: CHARLEY e$~ 08 ". '/1" DATE: It). i;1I SUSPENSE DATE:

ANAKALEA, P. --BAUER,G.

CHING, F. DANBARA, S. FUJII, N.

--GOODING, K. -1-HARDY, R.

HIGA,D. ICE,C. IMATA, R.

WELL NUMBER 3807-02

~ WELL CONSTRUCTION

KUNIMURA, I. NAKAMA, L. NAKANO, D.

-3-0HYE,M. SAKODA, E.

-2-SUBIA, S. SWANSON, S. UYENO, D. YODA,K.

__ YOSHINAGA, M.

ATIACHMENTS FOR WELL CONSTRU.eTION PERMIT: 1 COVER LETIER ~ 2 PERMIT (2x)_ "'_

COMMENTS: 3 SDWB 4 WWB

Approval -- --Signature

~ 3 ','onnatlo'

Kaupo-Ramey

5 CWB TO BE SENT TO APPLICANT

6 HEER 7 LD 8 HP 9 OCCL

10 SMA FOR OFFICE USE ONLY

't)(f PUMP INSTALLATION

ATIACHMENTS FOR PUMP I NSTALLA}'fON PERMIT: 1 COVER LETIER ./ 2 PERMIT (2x) ·7'

COMMENTS: 3 SDWB 4 WWB 5 CWB TO BE SENT TO APPLICANT

6 HEER 7 LD 8 HP 9 OCCL

10 SMA FOR OFFICE USE ONLY

PLEASE:

See Me -1-Review & Comment --Take Action

Type Draft _2_TyPe Final -4-File

Xerox __ copies

Results

yes no

steel stainless steel

o Q

pvc plastic abs plastic thermoset plastic other

steel ANSI/AWWA C200 API Spec. 5L ASTMA53 ASTM A139 ASTMA606 other

positive displacement other

steel public steel non public

e

steel ANSI/AWWA C200 API Spec. 5L ASTMA53 ASTMA139 ASTMA606 other

#N/A 0.28

o

stainless steel ASTMA409 other

pvc plastic Schedule 40 Schedule 80 other


TO:

FROM:

SUBJECT:

c o CEIVE.O n DIVISION

APR -8 A It): 32 STATE OF HAWAII

DEPARTMENT OF LAND AND N~TUBAL RESQUijG~ ~

COMMISSION ON WAT;~ B~r~~V~qENl1~~~~~~T HONOLULU, HAWfl~~ao9 -j '. " ,iI, II

April 4, 2008

Morris Atta, Acting Administrator Land Division t Ken C. Kawahara, P.E., Deputy Director t ~. Commission on Water Resource Management

Well ConstructionlPump Installation Permit Appli ation Kaupo-Ramey Well (Well No. 3807-02) TMK 1-7-002:026


.' MERE~H J, CHING JAME' FRAZIER NEAL t ' . "'AlARA

CHIYOME , __ , ,i"INO, M.D. DONNA FAY K. KIYOSAKI, P.E. LAWRENCE H. MilKE, M.D., J,D,

KEN C, KAWAHARA, P.E. DEPUTY DIRECTOR

:::'~T "':"';~

("', .::,,. ~- . --~ ....

,"7':/! i~~:" :.,;;.; i; r • "':?I

, ~~

'- ,.::' )/

'-'-',;~

-il , 'r

... , ;;;'.J'

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 30, 2008. If we do not receive comments or a request for additional review time by this date, we will assume you have no comments.

Please find the attached maps to locate the proposed well. If you have any questions about this permit application, request additional information, or request additional review time, please contact Charley Ice of the Commission staff at 587-0251.

CI:ss Attachment(s)

RESPONSE:

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

k~ A water lease/pennit is not required of this applicant.

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

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

[ ] No objections

~~ Other comments: Original source of private title is Grant 2826:2 issued prior to statehood.

Contact Person: ____ G_a_r"'-y_M_ar_t_I-'· n-'--______ _ Phone: 587-0421 --=-::"':--=--=-=-'---

-~..,~ ~. signed: __ "'7_'£~_.3L-__ I-_' __ ' ~ ________ _ Date:_"",tl-,-,-'; k-,-,-' 1'_-....::2-'-' _2_00_8_

...

(

ct

o

To:808 587 0219 P.4/7

" 'APR~30-2008 06:11 From:DOH/SAFE WATER BRANH 8085864351

TO:

~HfCEllIED SAFE DRINKING WATER BRANCH

ArH

STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOU~CE8

COMMISSION ON WATER RESOURCE MANAGEMENT ~.o. BOXB~1

HONOLULU HAWAII 1;1;809

April 4, 2008

U'<URA H THIELEN

"'~~Dlnl J CHINe. JAMeS A. FRAZIER NEAL 5 FUJIW.I\I'll'l

OHIYOME L. FUKINO. M.D. DONNA FAY Il KIYOSAKI, P.E lAWRENCE H. MilKE. M.O .• J.D

!<EN C, IQ.,WAfoIAAA, PE. :>a'\ITV I>IIItcTO~

In General: :tf,?€J0l - 02-

Q ?;I(',OOD

use = dome~flc.~ atNu-. 0 -t.~~) ff.'r-e;.)

locatIOn :;. t<avpt> M~l/I Honorable Cbiyome L. Fukino, M.D., Director (above). J lUIC line Department of Health Attention: Director's Office grd. elev. = C7 L-O

Tomas See, Chief, Wastewater Branch well dia. = (.,,,. Jstuan Yamada, Chief, Safe Drinking Water Branel 11 d th 070' Alec Wong, Chief, Clean wa1ter;aJTO\t we ep

FROM: ~Laura H. Thielen, Chairperson W t!-f d (;llef. We:< i 16\111 i Drllli~ ~ \ Commission on Water Resource Management

SUBJECT: Well Construction!PUID,I! Jnstallation Pennit Appl cation Kaupo-Ramey Well ("'ell No. 3807-02) IVl1K: ~ !·1·z..: Z(p

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

We would appreciate your comments on the captioned application for any conflicts or inconsistencies with tbe programs. plans, and objectives specific to your department. Please respond by returning this cover memo form by ARril30. 2008. If we do not receive comments or a request for additIOnal review time by this date, we will assume that you have no comments.

Ple:ase find the attached maps to locate the proposed well. If you have any questions about this permit application, reque:;t additional information, or request additional r~iew time, please contact Charley Ice of the Commission staffat 587-0251.

Cl:ss Attachment( s}

RESPONSE: ~ UIG: UYk::1i+i1lYl ~ 4-. -+/zPI/06 CH ...,..,.,. Th~ W1!111\l"'li~S ,~ 3 ZOIPCO wbic~ wiD IerYf ~ a ~o~. or polable w.I~' to a pl1\>h< w~te1 ry3Iem (ddined M Kft'int ~5 tM" mQroI Pt9,,1<: .11 .... 1 60 ~ ch)'5 ~ ~ or has 1:5 elf more !:~ee e~t~I)A!i) and lIl",t r~"c;~e DI!'~c.tQr QfIieaUb vpprova) I!!!!: to 1H II$CtQ comply with Ifav."oUl Mmj1J.;strativo£,

RuJ~s (HAA), TiTle II, OIajItcr 20. R,ul'lli ~i1111l8 10 Potabl, Wale, 3yslo",s. ~11-20-Z9.

[ I

[ )

'If)W ( )

( )

( )

[ I

I)

Th,~ _II 010'" not .... IiCy a, 3 .o~ •• ''''''',., • public W3to, ,y.t"" ( •• """, 10 .. !h.n 15 p..,,,le or IDO'" po<>plo al._ ~o days pet y~ar or IS """"~. cO!lIIeClJOns) and Iflbe wdl w.nu IS _d fQr dnnkiDg, tbe J)tlval. awoer ~bo\1ld "'~I for bacterlologlc!l Mel cheo,,",' pres • ...., )'of"", 11III1.line Noll.at and rOUline(y mOlli!M 'he II¥;ItOf quality Incrooil ... However, if fl,lu", plaMotI US~ Irom thi' ,ouret: jntt~C$ to meet !he pIlbhc w~t.,. sy~tem defmiliOll 111m DlrfetOl' of He~th ilpplOVlII is required J!.!:!&: to IrtJpl.m.n~"oo

If tht well IS usee! to .upply boIh potable and non-potable porpo.". 10 •• inglo .ySlcm, thc user mall .Ii",jn;ale "=S-~Oml~~IKlIII ilia lIiXl:flow "MI\~clion$ by phY~I<:aIly separating potablo and IIQ"1'otobl. s~m~ by !Ill air pp or lift ltpptOllcd b""kllow pr.""",\e.-, .nd by oI.orIy r.b.IaIlS"j1 nonpot;abk! sp~OIS wilh worlling sign! (Q p""".t inadvertent oonsumpbon ofnollll0Ul.bll: ,.·:.ter. e.okflow prc .... ~tIW .;l."",.s sJoould be routinely i"",,o<led and tCS1Cd,

It d"", noup_ that 1his well will be us.d fC" .,,~u'l'~.,., "wpQ~CS 3IId is not subj."t 10 Si\f. PrjW~6 Wat""l!.e~l.ti"ru;.

A1i NPDI<S Permit is rcqllind

Olho ..... I.v;ml DOH naJe"re~o.3, Infonnatioll. or rccomlllondalions '1':< .ttMh<:d.

illlhc cveOl that the localloll of t"" -II 01\'0))8"$ but is .\ill wiihin the Pl!I'cel dt~i~6 OIl1his appliOlaliotl, "ur djvi,iOIl cOll3iders tht eornl\lCilI> to still b. appllcalllt,lII1d W~ do not n •• d to review lb. new l"".tion

No <Dmmc:nt&'obj""tions

Phone: __________ __

Date:

RPP-30-2008 06:27RM FRX:8085864351 ID:DLHP CWPM PRGE:004 R=94%

• APR~0-2008 05:12 From:DOH/SAFE ~8JER BRANH 8085854351

".,""

CWRM Application Source: Kaupo-Ramey well (Well No. 3807-02)

To:80~587 0219

.. "

Safe Drinking Water Branch (SDWB) - Engineering Section

This well may qualify as a source that serves a regulated public water system. Federal and state regulations define a public water system as a system that serves 25 or more individuals at least 60 days per year or has at least 15 service connections. All public water system owners and operators are required to comply with Hawaii Administrative Rules, Title 11, Chapter 20, Rules Relating to Potable Water Systems.

All new public water systems are required to demonstrate and meet minimum capacity requirements prior to their establishment. This requirement involves demonstration that the system will have satisfactory technical, managerial and financial capacity to enable the system to comply with safe drinking water standards and requirements.

Projects that propose development of new sources of potable water serving or proposed to serve a public water system must comply with the terms of HAR 11-20-29. Thi~

section requires that all new public water system sources be approved by the Director of Health prior to its use. Such approval is based primarily upon the submission of a satisfactory engineering report which addresses the requirements set in section ll~20-23.

The engineering report must identify all potential sources of contamination and evaluate alternative control measures which could be implemented to reduce or eliminate the potential for contamination, including treatment of the water source. In addition, water quality analyses for all regulated contaminants, performed by a laboratory ~ertified by the State Laboratories Division of the state of Hawaii, must be submitted as part of the report to demonstrate compliance with all drinking water standards. Additional parameters may be required by the Director for this submittal or additional tests required upon his or her review of the information submitted_

CWRM Well Application Standard Comments ($DWB) 1/eJ:!3. 4/8/08

f=1F'R-30-2008 06:28f=1M Ff=1X:8085864351 IO:DLNR CWRM F'AGE:005 R=94%

, ~

'APR-30-2008 05:12 From:DOH/SAFE w,AJER BRANH 8085854351 To:8ptR,587 0219 " , "

All public water system sources must undergo a source water assessment which will delineate a source water p~otection area. This p~ocess is p~eliminary to the creation of a source water protection plan for that source and activities which will t~ke place to protect the drinking water source.

projects proposing to develop new public water systems or proposing substantial modifications to existing public water systems must receive approval by the Director of Health prior to construction of the proposed system Or

modification. These projects include treatment, storage and distribution systems of public water systems. The approval authority for projects ovmed and operated by a County Board or Department of Water or Water Supply has been delegated to them.

All public water systems must be operated by certified distribution system and water treatment plant operators as defined by Hawaii Administrative Rules, Title 11, Chapter 11-25 titled; Rules Pertaining to Certification o! Public Water System Operators.

All projects which propose the use of dual water systems or the use of a non-potable water system in proximi~y to an existing potable water system to meet irrigation or other needs must be carefully design and operate these systems to prevent the cross-connection of these systems ana prevent the possibility of backflow of water from the non-potable system to the potable system. The two systems must be clearly labeled and physically separated by air gaps or reduced pressure principle backflow prevention devices to avoid contaminating the potable water supply. In addition backflow devices must be tested periodically to assure their proper operation. Further, all non-potable spigots and irrigated areas should be clearly labeled with warning signs to prevent the inadvertent consumption on non-potable water. Compliance with Hawaii Administrative Rules, Title 11, chapter ll-21 titled; Cross-connection and Backflow Control is also required.

All projects which propose the establishment of a potentially contaminating activity (as identified in the Hawai~i Source Water Assessment Plan) within the source

CWRM r-le11 Application SCandard Comments (SDWiJ)

Vers. 4/8/08

APP-30-2008 06:28AM FAX: 8085864351 ID:DLNP CNPM PAGE: 006 P=94:~

.-'APP~30-2008 05:12 From:DOH/SAFE,~8JER BRANH 8085854351 To:8~R,,587 0219

" .. ' "'i .J

water protection area of an existing source o! water for a public water supply should address this potential and activities that will be implemented to prevent or reduce the potential fo~ contamination of the drinking water source.

For further information concerning the application of capacity, new source approval, operator certification, source water assessment, backflow/cross-connection prevention or other regulated public water system programs, please contact the Safe Drinking Water Branch Engineering Section at 586-4258.

SDWB Undergroupd Injection Control (DIC) Section

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

CWRM Well Application Standard Comments (SDWB) Vers. 4/8/08

P.T'7

APR-30-2008 06:28AM FAX: 8085864351 ID:DLNR CWRM PAGE:007 R=94%

r~ Apr-24-2008 lZ:16pm From-DEPT OF HEALT)oI~ENVI RONMENTAL IANGMT 8085864352 T-Z87 P.OOZ/004 F-041

LINDA LINGLe EK'NfrtNOA 0., hAW~1 ::;::~~:: -(td1

JAMES A. FRAZIER NfAL S. FUJIWJ\AA

CHlYOI.4E L FUt<lillO, MO. 01 DONNA FAY I( KIYOSAKI. P. E. LAwReNCE: H. MilKE, MD, J,D,

81 ATE OF HAWAII KION C. AAWAHAAA. P .E.

PIif'lTY~IA&ClOil

DEPAI\TMENf OF LAND AND NATURAL RESOlJRCeS COMMISSION ON WATER RESOURCE MANAGEMENT

PO. BOX621 HONOLULU. HAWAII 96809

28S8APR 9 April 4, 2008

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

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

FROM: 1kiLaura H. Thielen, Chairperson e.. 'l'L--J Alec Wong, Chief, Clean Water B n t I

~~ Commission on Water Resource Management

SUBJECT: Well Consnuction/Pump Installation Penn it Appl cation KauJlQ-Ramey Well (Well No, 3807-02)

Transmitted for your review and COmment is a copy ofthe captioned Well ConstructionJPwnp lnstallation permit a.pplication.

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 b! returnioi this cover memo form by April 30, :1008, Ifwe do not receive comments or a request for additiona review time by this date, we will assume that you have no comments.

Please fmd the attached maps to locate the proposed welL If you have any questions about this permit application, request additional information, or request additional review time, please contact Charley Ice of the Commission staff at 587·0251.

CI:ss Anachment(s)

RESPONSE: [ I

[ I

[ J

[ I

( 1

[ I (v( [ 1

( I

This Will qualifiCli 18 a IIOIIroC which willlCrYC as a SOIIttB of P014bl/j WlI!~r 10 iI publiQ water syStem (defil'lt4 11$ ~JVI1Il! 2~ III' IDOIC people atle/Ul6() days pot yellt Ot Ilils l~ Ot mOre $.f'!ic. OQIl~=} ~nd IDIIlt r;,;iv; Director DfHcalth approWll pri.r to its IISllD IlOIIlply with Hawllil AdllliniSIJativc Rule. (HAR). Tide 11, Cb"ptcr 20, Rules Rclllling to Potabl. Water Syn""", § 1],2.0.29.

Tbis wcD does "ot 'lualify 8S.t. iOW't .. SIIt'IoinS a /,ubli<: w.,er 'YOlOm (:&cIV~ leBa than 25 people at mOt. poopl"lUl_1iO diy. pcr}'C8i Ot IS ...."jc~ COIl1'1~o&)..,d iftt.. wtli w"",," '" u",,4 to< 4rllllclllg, 1Il00 pnv~1e owner .hokold tCOt {O( b.., ..... 'ologlc'll ""d chemic.1 ~"'DC. flefu .... jaiti .. ",s ~uQb use md lQlltinoly lI1olli1Dr III" "'iIWr qll;))ily morroa1ter. However. if fumrc plaMICd u~ from thi$ 50\1r<. illorellleS to lIIectlhe jlUblic w.w .)'$10'll <Iofinirion llien Director onlo~lth approval ia [O((uircd IlIiAI: [0 implement.t,M.

lfthc well ia used to .upply both poJahle ~lld tIOn.pocabl. purpc~e~ in A ~iD!!le 8~·st=. the uStt shaD dimin2ltlo "r""~""onll"Otiona ad bacldlow cOIII\~Cli~$ by pby!1.ically s6pAt!ltillg p01llbI~ ;!lid nOIl'f'01llble sY8lcms by an air sap ~r 3J\ approv.<llxsdcnow pm-;nter. and by cleatly labeling ~I nonpo",bl. spiJlDl' wilh wiIllling >l1ll\O to provont inoo"Crtcllt ~Onslltl1J>ri"" of ncn-po ... bl. w .... r. S"oldlow prevmtioo devices should btl lOullncly illBpcctcd and IeSled.

For (be applicann infunnatjo4, a ~outt.. o{possibio "'_;" .... C<>IlIl\minati()n I Iii Ills Dot 100000ad no¥ th" !"'0PQ~4 ~I aite (infOJll'&8liOn ~).

An l\'POllS p!nnil i~ "''luiroli.

Olbar 1'lI1~ POll ruleslr.I!~~onS, i"fcmn;tliQII, <If R'Qommcnciatioru are al1achBd.

In the event that tlie IlIQIItion cftlu: wcll cbangts bill is stili witllin lb. p;If~ .. 1 \IIIsr;1f\b~d o:llhis applicatic"l, Out di .. isiDP oOn$i~r:s til; ;ommcota 10 ~11 be appIicablll,lIrI4 we do j)O( noed 10 t~vitw 1/1 .. pow loulloD.

Contact Person: ~ l-, ~ Phone: ~(Q -4''7'0~

Signed: ~~ ( ;f~L4~ Date:

OfbS33 AF'R-24-2008 12:00PM FAX: 8085864352 ID:OLNR CWRM PAGE:002 R=96%

/' # '.

~ APr-24-Z008 lZ:15pm From-DEPT OF HEALT~~ENVIRONMENTAL ~GMT 808586435Z T-Z87 P,OOl/004 F-041

Fax to: Company:

Fax No.:

FAX TRANSMITTAL State of Hawaii Department of Health En'9'ironmental Management Division

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

Fax No.: (808) 586-4352

Mr. Ryan lmata i Ms. Lenore Nakama I€ cO§rler:i5> Commission On Water Resource Management Department of Land and Natural Resources

Date: +:z.~ -oS Fax from: Joanna L. SetO tt Total Pages, incl. cover: -4 587-0219

Subject: Well Construction/Pump Installation Permit Application(s) Wen No(s). :$e01· 02..;141 2..7- (0) 0 ec"Z..o -0 I

The Department of Health, Clean Water Branch (CWB) has the following comments:

1. ror Wcl1~Drilling Activities

Any discharge to State waters of treated process wastewater effluent associated with well drilling activities i~ regulated by Hawaii Administrative Rules, Title 11, Chapter 55, Appendix 1, effective October 22, 2007. Treated process wastewater effluent covered by this general permit includes well drilling slurries, lubricating fluids wastewater, and well purge wastewater. This general permit does not cover well pump testing. The applicable Notice of Intent (NOI) Form~ and filing fee shall be submitted at l~ast thirty (30) calcn(iar days hefore the start of discharge to the;

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

The CWB-NOl Forms are available online at htm:flwww.hawaii.govlhealth/environmentallwater/cleanwilterIformsfgenl-index.html. Inquiries may be directed to the eWB at (808) 586·4309 or by fax (808) 586-4352.

2. For Well Pump Testing

The discharger shall take all measures necessary to prevent the discharge of poll utants from entering State waters. SUch measures shall include, if necessary, containment of initial discharge until the discharge is essentially free of pollutants. If the discharge is entering a stream or river bed, best management practices shall be implemented to prevent the di~charge from disturbing the clarity of the receiving W8rer. if the discharge is entering a storm drain, the discharger must obtain writl~n p~rmission tJ.·om the owner of the storm drain prior to discharge. Furthermore, best management practices shall be implemented to prevent the discharge from collecting sediments and other pollutants prior to entering the SIorm drain.

APR-24-2008 11:59AM FAX: 8085864352 ID:OLNR CWRM PAGE:001 R=96%

j


TO:

o o ,

jfo-: ~' STATE OF HAWAII

DEPARTMENT OF LAND AND NATURAL RESOURCES



April 4, 2008

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

A'omas See, Chief, Wastewater Branch Stuart Yamada, Chief, Safe Drinking Water Branch Alec Wong, Chief, Clean Water B

APR - 9



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



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

SUBJECT: Well ConstructionlPump Installation Permit Appl cation Kaupo-Ramey Well (Well No. 3807-02)


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 30, 2008. Ifwe do not receive comments or a re~t for additional review time by this date, we will assume that you have no comments. :x; . CX)

-~. "j ,1 ~,

Please find the attached maps to locate the proposed well. If you have any questions a~t this:::l permit application, reque~t ~dditional information, or request additional review timerplease comct I'll Charley Ice of the CommISSIon staff at 587-0251. . ,., ()

'1 CI:ss Attachment( s) "\ ~. -0 ......, <

In ,:J

RESPONSE: I ~ , I':)

[ I

[ I

[ I

This well qualifies as a source which will serve as a source of potable water to a public water system (defined as serving 2jlor~ore peo~least 60 days per year or has 15 or more service connections) and must receive Director of Health approval prior to its use to comply with Hawaii Administrative Rules (HAR), Title II, Chapter 20, Rules Relating to Potable Water Systems, §11-20-29.

This well does not qualify as a source serving a public water system (serves less than 25 people or more people at least 60 days per year or IS service connections) and if the well water is used for drinkiog, 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 iocreases 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 io a siogle system, the user shall eliminate cross-connections and backflow connections by physically separating potable and non-potable systems by an air gap or an approved backflow preventer, and by clearly labeling all nonpotable spigots with warning signs to prevent inadvertent consumption of non-potable water. Backflow prevention devices should be routinely inspected and tested.

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

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

[ I An NPDES permit is required. M n/-,' '-J..." ,,1- J • J /_ ~ Other relevant DOH ruleslregulations, information, or recommendations are attac hed. V'Vf''' ,0 J CIlJ ,,...-- Drt/./} te--[ I In the event that the location of the well changes but is still withio the parcel described on this application, our division considls ~e comments to still be

applicable, and we do not need to review the new location.

~ntac~~ on fI18U1' Phone qett- CO~B:(; Signe~ r~ &l(}ihu Date: tfr--ffr-(Jt)

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

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COASION ON WATER RESOURCE MANAGEMENT Q ROUTE SLIP FOR NEW APPLICATIONS

FROM: CHARLEY DATE: ii·Feb·08 SUSPENSE DATE:

CHING, F. KUNIMURA, I. FUJII, N. -- --NAKAMA, L. \ (/ GOODING, K. -- -3-0HYE, M.\

-1-HARDY,R. lit ==SAKODA,E. \-"-"-HIGA, D. SWANSON, S. ,

-2-HOAGBIN, S. --UYENO, D. ---4-ICE,C. --YODA,K.--

1 Approval -1-Signature -3-lnformation

IMATA, R. -- --YOSHINAGA, M.--

KAWAHARA,K.== == j / == \ _

/'" ~ g"c/ f-VW\IIW\ •

1S-Feb-OS

PLEASE:

See Me -1-Review & Comment

Take Action Type Draft acknow letter

-2-Type Final, label file folder, update People. db -4-File

Xerox copies

WELL NUMBER 6 ~01 "-D).. WELL NAME Ramey/Foley/Hyde

o WELL CONSTRUCTION o PUMP INSTALLATION

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

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.

S CONTRACTOR VERIF.

9 ALL INFO FILLED IN

10 BACKGROUND CHECK

11 $25 FEE DEPOSIT SLIP

MLS PRINTOUT DCCA LICENSE SCREEN PRINTOUT

~ BOTH

12 DHP/CDUP/SMA pre·screen (SMA map printout http://gis.hicentral.comlwebsite/parcelzoning/viewer.htm.,or INGRID'S SMNCD MAP) (LUC map printout http://luc.state.hi.uslluc_maps.htm., or INGRID'S SMNCD MAP)

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

INCOMPLETE ACTION DATES:

DATE

o


Mr. Michael Robertson Wailani Drilling. Inc. P.O. Box 790299 Paia, HI 96779

Dear Mr. Robertson:

o Q




April 4, 2008


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.


3807-02.wcpia.ack

Well ConstructionIPump Installation Permit Application for Well No. 3807-02

We acknowledge receipt, on February 5,2008, of your completed Well ConstructionIPump Installation permit application and filing fee for the Kaupo-Ramey Well (Well No. 3807-02). You can expect your application to be processed within ninety (90) days from this date. However, if the review warrants the issuance of a permit, a letter of assurance will be issued in lieu of the permit. The letter of assurance will indicate that a permit will be issued when the contractor signs the application, and the following conditions are met: a) the contractor has no outstanding issues with the Commission; b) there have been no significant changes to the application; c) there have been no significant changes to applicable laws, rules, regulations; d) there have been no significant changes to hydrologic conditions.

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 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 Charley Ice of the Commission staffat 587-0251.

CI:ss Attachment

c: Tom Ramey


o o




April 4, 2008


MEREDITH J. CHING JAMES A FRAZIER NEAL S. FUJIWARA



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 ~n-cv

FROM: WLaura H. Thielen, Chairperson W ~ - \ Commission on Water Resource Management

SUBJECT: Well ConstructionlPump Installation Permit Appl cation Kaupo-Ramey Well (Well No. 3807-02)


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 30, 2008. If we do not receive comments or a request for additional review time by this date, we will assume that you have no comments.


CI:ss Attachment( s)

RESPONSE: [ I

[ I

[ I

[ I

[ I

[ I

[ I

[ I

[ )

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

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

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

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

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


TO:

FROM:

SUBJECT:

o o




April 4, 2008

Morris Atta, Acting Administrator

Land Division t Ken C. Kawahara, P.E., Deputy Director t (!.. Commission on Water Resource Management

Well Construction/Pump Installation Permit Appli ation Kaupo-Ramey Well (Well No. 3807-02) TMK 1-7-002:026



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

KEN C. KAWAHARA P.E. DEPUTY DIRECTOR

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



CI:ss Attachment(s)

RESPONSE:

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

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

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

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

[ ] No objections

[ ] Other comments:

Contact Person: _________________ _ Phone: ___________ _

Signed: ____________________________________ _ Date: _______ _


TO:

FROM:

SUBJECT:

o o




April 4, 2008

Nancy McMahon, Acting Archeology Branch Chief



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



Ken C. Kawahara, P .E., Deputy Director ~(!. '(I L---Historic Preservation t Commission on Water Resource Management

Well ConstructioniPump Installation Pennit AP1ion Kaupo-Ramey Well (Well No. 3807-02) TMK 1-7-002:026



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 Charley Ice of the Commission staff at 587-0251. 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.

CI:ss Attachment(s)

RESPONSE:

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

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

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

Contact Person: --------------------------~---------

Phone: -------------

Signed: __________________ _ Date:, _______ _


Mr. Ian Costa, Director Planning Department County of Kauai 4396 Rice Street Lihue, Hawaii 96766

Dear Mr. Costa:

o o




April 4, 2008

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

Kaupo-Ramey Well (Well No. 3807-02)






We would appreciate your comments on the captioned application with regard to the SMA permitting requirements specific to your division. Please respond by returning this cover memo form by April 30, 2008. If we do not receive comments or a request for additional review time by this date, we will assume you have no comments.


CI:ss

RESPONSE:

Sin~re~,

~er f2/ L '. H. THI LEN ~ C lTperson

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

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

[ ] No objections

[ ] Other comments:

Contact Person: ___________________ _ Phone: _______ _

Signed: ___________________ _ Date: _______ _

DOCUMENT NO cQ.RTMENT OF LAND AND NATURAL RESOI OS

UAC OR ATTACHED WORKSHEET DATE F b 7 2008 .. e ruary ,

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

S 08 326 C 1026 0752 (1 ) $25.00 Wailani Drilling Inc.

" " " " " " (2) $25.00 Thomas Ramey

(3)

(4)

(5)

(6)

(7)

(8)

(9)

(10)

TOTAL $ 50.00

REMARKS: LINE (1) TMK: 3-8-77 LINE (2) TMK: 1-7-002:026 LINE (3 LINE (4) LINE (5) LINE (6) LINE (7) LINE (8) LINE (9) LINE (10)

.,

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

APPLICATION FORA WELL CONSTRUCTION I PUMP INSTALLATION PERMIT

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 587.0225. For further Information and updates to this appllcadon form, visit http://www.hawaii.gov/dlnr/cwrm.

WELL LOCATION INFORMATION

DB fEB 5 AlO: I S

3. ISLAND

f'I\ f.\V- \ 4.TMK(2) ...,

-L ---' -QQ2..: ~ 1. STATE WELL NO. (If already assig~) 2. WELL NAME

zone sec t

PROPOSED WELL CONSTRUCTION 7. Proposed Work ~ Construct New Well o Modify Existing Well o Abandon/Seal Well

8. Construction Type ~Drilled DOug o Shaft o Tunnel

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

10. Proposed Work 01 Install New Pump tJ Replace Pump

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

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

3<0000

!.;. Method of flow measurement !.If Flowmeter o Other (explain)

14. Proposed Surveyor name and license number (a surveyor Is required for all Wellstructlon Permits ancfmay be reqUired for some Pump Installation Permits) LL ..... C!o!> 1" "'"

~'"\) c..e. Le..e. .-:po. We w ~ *t> PROPOSED USE

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

16. Domestic Number of units to be served: I - ~

o 17. Industrial (describe)

o 18. Irrigation (describe crop and no. of acres)

o 19. Military (describe)

ri 20. Other (describe)

OTHER LEGAL REQUIREMENTS If required, items 21. and 22. must be obtained before the Commission can legally issue a permit:

21. Conservation District Use Permit (COUP) 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 COUP is required. I understand that checking with OCCL prior to making this

application will expedite my review. I further understand that Issues raised by this agency may delay or result In denial of the permit ~ issuance, or revocation of the permit after It is issued. AfII Well is not in Conservation District o 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 ma dela or result In denial of the rmit issuance or revocation of the it after it Is issued. 22. Special Management Area Permit (SMAP) o Required, SMA # date approved

"H" Not Required (attach documentation from applicable Coun-:-ty-a-ge-n-cy7") tJ 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 ermit after it is issued.

~~ State Historic Preservation Division (SHPD) of the Department of Land and Natural Resources J!} I have consulted with the HPO regarding potential Impacts of well construction activities on historic sites. I have attached applicable documentation

from the HPD. o I have not consulted with the HPO regarding potential Impacts of weil 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 ermit issuance or revocation of the it after it is Issued. Additional the hist of st land use is attached. .

Additional remarks, explanations, etc. (attach additional sheet if more spaca 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 apptolfal date; 2) the contractor shall submit to the Commission a well completion/abendonment 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 ermlt is in sus nsiOn ma result In fines of u to $5000/da .

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)

W V\(:... 'd.. 0\ \ S" S ~ --....a..() \ \ 5 c-57L~se~0,~\ 101> ~~Iilk ~7aJA~ji~NlO~~

-::V-\/J<rJ~""""*~»...:!::::::3.C!o!~p'~u...!....l:~Y.....- Date Signature Print OJte

WCPI Application Form 0212612007

/

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

Hole Diameter: \ !l.S-in.

Elevation at top of casing 6"a, ft., msl* \_r .. -....~~+t Minimum of'Z Radius & 4· Thick Concrete Pad (to contain benchmark ---.L surveyed to nearest 0.01 ft.) y::0 y~ r Ground Elevation:5'.!lO ft., msl*

//_, :.::. •• .. 'un.." "''''''' ,-----------, ; .••... : :.:::. Cement Grout: 'i 00 ft. :.:;'. .'. (min. 70% of distance from .~. '.: ~/:' ground elevation to top of ,:: ;, , "

:::e:~~!C:s:.) 500 ft., F !}~

Please refer to the HAWADW1LLCONSRYCTIONANP PUMP INSTAI.LATION STANDARDS to ensure that your as-built is in compliance with

applicable standards,

~.~~ : ~.~::.

Grouting method:

CI PositiVe d9Placement

gOther

Annular space between hole and casing (1,S" for positive displacement, 3" for other methods):

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

~ ¥----t Solid Casing: (2 90% x (Ground Elev.-Water Level Elev»

Total Length: SS-O ft.

/ ':::: Nominal Diameter: __ ....:CO~ ______ in.

i.'; ..

- :;:: ~in. Wall Thickness: __ --'-, ..::~:..;;:'&.:O:::.-____ ,in. - -::t"

.... T-o-ta-I-o-ep-th-......,'---R-Ock-u-r-l-ra-v-e-I :-~-c-ki-n-g:-... ~c-I; Bottom Elevation: ___ -=".7'J'-___ ft., msl*

Open Casing: ~rforated CI Screen £' '"7 Oft. Material:

CI Crushed Basalt Total Length: ___ ~__::O,..------_ft. Nominal Diameter:" in. CI Rounded Gravel

~======='-.. I4H§i "~~t-1bl'\9fEstimated Water Level ~ , ~ Elevation: ~ _ .... ,, __ ft. msl· "'" --

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

Wall Thickness: • as'" In.

Bottom Elevation: - 5"0 ft., msl·

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

Length: k ft. Open Hole: ~

Diameter: ""li - in.

Bottom EleVation:_ ..... NL..:.... ..... A...;;... ____ ft., msl*

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 Wa1etLe~el Elevatjon )

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

Solid Casing Material: /' Carbon steel: compliant with (check one or more): CI ANSIlAWWA C200 0 API Spec. SL trASTM AS3 )4 ASTM A139

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

Stainless Steel: (check one): 0 ASTM AA09 (production wells) CI ASTM A312 (monitor wells)

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

PVC Plastic confonning to ASTM F480 and (ASTM 0178S or ASTM 02241): (check one): 0 Schedule 40 0 Schedule 80 0 Schedule 120

Thermoset Plastic: (check one) CI Filament Wound Resin Pipe confonning to ASTM 02996

CI Centrifugally Cast Resin Pipe confonnlng to ASTM 02997

CI Reinforced Plastic Mortar Pressure Pipe conforming to ASTM 03S17

CI Glass Fiber Reinforced Resin Pressure Pipe confonning to AWWA C950


CI FEP Fluorocarbon Tubing confonning to ASTM 03296

Open Casing Material: /' Carbon steel: compliant with (check one or more): CI ANSIlAWWA C200 CI API Spec. SL I!I"ASTM A53 "..rJ ASTM A139

And compliant with (check one or more): CI ASTM A242 (or A606) CI Type E CI Type S t!"Grade B CI Other

Stainless Steel: (check one): CI ASTM AAOO (production wells) CI ASTM A312 (monitor wells)

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

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

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

CI Centrifugally Cast Resin Pipe confonning to ASTM 02997

CI Reinforced Plastic Mortar Pressure Pipe conforming to ASTM 03S17

CI Glass Fiber Reinforced Resin Pressure Pipe conforming to AWWA C9S0

CI PTFE Fluorocarbon Tubing conforming to ASTM 03296

CI FEP Fluorocarbon Tubing conforming to ASTM 03296

WCPI Application Fonn 0212612007

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Feb. 1.2008 1:32PM SCIENTIFIC CONSULTANT SVCS INC No.8695 p. 2

711 Kapiollud Blvd .. Suite 975 HOlIol ..... U.w.ri 9QU3

Ms. Jenny Pickett February 1,2008 SHPD-Maui 130 Mahalani Street Wailuku, HI 96793

Re: Proposed Well Construction in KaupO, Kepio Ahupua' a, Hanl. District, Maul Island, Hawafi [TMK (2) 1-7-002: 026].

Dear Ms. Pickett:

Scientific Consultant Services. Inc. (SeS) bas conducted multiple phases of work related to the above noted parcel in Kauao, Maui. As of today, an Archaeological Inventory Survey of the parcel has been completed and accepted by your office (February 6,2007; LOG NO.: 2007.0371; DOC NO.:0702MK(02). Following acceptance of this docwnent, SCS produced a Preservation Plan (submitted to your office in May, 2007) and sent a letter of verification that orange construction fencjng was placed around the Preservation features on December 19. 2007. ses also submitted an Archaeological Monitoring Plan (AMP) to your office on June 21. 2007.

At present. the client is moving forward with permitting agencies to install a water wen jn the southeastern portion of the parcel. This location occurs in an op~ grassy field far removed (c. 160 meters) from the nearest point ora Preservation site. Please also note that the Preservation site fencing remains in place, as was shown in the December 19, 2007 verification letter.

It is our estimation that the proposed undertaking would not have an adverse impact on any significant historic properties. As a side notet both the contractor and field crew have been apprised of the Inventory Survey results and the tenets outlaid in the Preservation Plan..

Thank you again for reviewing this docwnent and please call (597-1182) if you have any questions or concerns about this letter.

B~~0 Michael Dega, Ph.D. ~ Senior Archaeologist Scientific Consultant SeMces, Inc.

PIll 808-597·.182 SCS ... saVINe A'.I. V01I114RCHAhVUlQ/C4L H/tJ!.I)S "'Ul lI0II-597-1193

Ntiahbvr tala ... Offices • H.",.i'i IIlaad • MIIul • KIIu.·'

Feb. 1.2008 1:32PM SC1ENTIFIC CONSULTANT SVCS lNC

711 KapioJaai Blvd .. Suite 975 HOIIObdu, UawQfi 96813

Ms. Jenny Pickett February 1,2008 SHPD-Maui 130 Mahalani Street Wailuku. HI 96793

p. 2

Re: Proposed Well Construdion in Kaup6, Kepio Ahupua'a, Hans. Distrid, Maui Island, Hawai'i [TMK (2) 1-7-002: 026].

Dear Ms. Pickett:

Scientific Consultant Services, Inc. (SCS) has conducted multiple phases of work related to the above noted parcel in Kauao, MauL As of today, an Archaeological Inventory Survey of the parcel has been completed and accepted by your office (February 6,2007; LOG NO.: 2007.0371; DOC NO.:0702MK02). Following acceptance of this document, SCS produced a Preservation Plan (submitted to your office in May; 2007) and sent a letter of verification that orange construction fencing was placed around the Preservation features on December 19. 2007. SCS also submitted an Archaeological Monitoring Plan (AMP) to your office on June 21. 2007.

At present. the client is moving forward with permitting agencies to install a water we)) in the southeastern portion of the parcel. This location occurs in an open, brrassy field far removed (c. 160 meters) from the nearest point of a Preservation site. Please also note that the Preservation site fencing remains in place, as was shown in the December 19, 2007 verification letter.

It is our estimation that the proposed undertaking would not have an adverse impact on any significant historic properties. As a side notet both the contractor and field crew have been apprised of the Inventory Survey results and the tenets outlaid in the Preservation Plan.

Thank you again for reviewing this document and please call (597-1182) if you have any questions or concerns about this letter.

B~~0 Michael Dega, Ph.D, ~ Senior Archaeologist Scientific Consultant Servjces, Inc.

Pia: 80&-597.1182 SCS ... SIRVINC AI.I. Y01'R ARCYAI;,QL()QIC4!, . .,RItOl> "'nl 1M)8.597.l193

Neiebbu~ blaod Offices • H.w.i·! hlalld • Mllul • KaulI'l

PRINTED JUN 0 92006

NEWCOMER· LEE LAND SURVEYORS, INC.

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3/4-IN PIPE SET

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GRANT 2826, APANA 2 TO POEPOE

SITUATED AT POHOULA. KAUPO. MAUl. HAWAII

PREPARED FOR: PREPARED BY:

GILBERT M. DENMAN. JR. NEWCOMER - LEE

THlS PLAT WAS PREPARED BY ME OR

711 NAVARRO ST.. SUITE 535 SAN ANTONIO. TX 78205

LAND SURVEYORS. INC. 1498 LOUR MAIN STREET. SUITE D.

MY HAWAII 96793

PRINTED JUN 0'9.

NEWCOMER;; LEE LAND SURVEYORS, INC.

-=a ~ 1.494.04 FT. NORTH ~ 11.710.84 FT. M:ST ~REF. TO -MOKUIA-2-

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GRANT 2826, APANA 2 TO POEPOE

SITUATED AT POHOULA. nupo. MAUl, HAWAII

PREPARED FOR: PRIPARIJ) BY:

GILBERT M.DENMAN, JR. 711 NAVARRO ST., SUITE 535 SAN ANTONIO, TX 78205

NEWCOMER - LEE LAND SURVEYORS. INC.