~p · CHECKLIST , ,--' \' \ ' ~ell Construction Permit ~p Installation Permit __ water Use Permit...
Transcript of ~p · CHECKLIST , ,--' \' \ ' ~ell Construction Permit ~p Installation Permit __ water Use Permit...
CHECKLIST
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~ell Construction Permit ~p Installation Permit
__ water Use Permit Required Also
: [ _ rl C) Island ~ Applicant~~~~~~~~~ ____ __ CJ'6v~ Consul tant IE.. 'J) ~ t L \'1
Date application received ..••••••••••..•.••••..••. 3!2~9i \/ Date acknowledged receipt/request more info ••••• ~ ~ 7 ~ ~
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V Datefilingfeedeposited .•...••••••••••••••••••.• __________________ ~~~
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Application sent t.o", following'~J L B !:.D.",.a..>:::t=e-=s=e~n..>:::t / [v5o.fe. Drin,kir'lj wo..1e.r- 1""4"t1"S;:
Corrnnents received ~ 'l.o-d-/
VDept. of Health1:~ l ___ _
ff' . . vWt1 .. +~1(.Y' BntVl£:h
. 0 1ce of Hawa11a~rfa1rs
Dept. of Hawaiian Home Lands
~ state Historic Preservation Div.
~ sierra Club Legal Defense Fund
Honelulu EOarQ of wateI SM~P~¥
Ma\:li Elept. of l'latar Supply
Kauai Dept. of Water Supply
IffrWaii 5e~L. of WaLel Suppt),
IIa\oaii OepL. at Pl:lhlic HotJt.s
~olaulaa 1113 #28 (OalIa)
Adai~ianal List (M61ok~)
Erie Hirano/ Lyann MiBuno . DIV. OF AGtl.All t. R~ S.
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~ ~~'. c~ Date agenda due···································----7~y~;~'~;~~!4"~~r~~--Date submittal due ..•.•..•••.•..•....•...•......•• _____ ~i~ __ ~9~~ __ __ Date submittal sent to applicant .••••••••.••••••••• __ -..,.. __ -:--__ -,:::-____ _
Date application __ approved OR __ disapproved ••.• is 714tl7 ?t-/:;-J/,1,11 Date applicant notif ied of decision ••••••.•••••.•• ________________ __
Remarks: -------------------------------------------------------------
t:dll';'~ Md-F,a.SSlj~ wet( V\.o. ('PeV\~i~ ~.V\ [ND£X/5U »HYl,4t2-V) L..o~ tho lo,\hook(tv\Q.Y\.ua.ON/id-r ,(q\,C{'-f ~ Lo~ \~ CAfrV\r~fe.r(wtLL PEP-MITS) f!1r(c<;-( '\:1,
DEPARTMENT OF WATER COUNTY OF KAUAI
P.O. BOX 1706 LIHUE, HAWAII 96766-5706
PHONE NO: (808) 245-6986 FAX NO. 245-5813
\. \~~
June 29, 1994
Ms. Rae Loui Deputy Director DLNR - COWARM P. o. Box 621 Honolulu, HI 96809
Re: Well Construction and Pump Installation Permit Applications for (Moloaa-Anderson Well and Moloaa-Miller Well), Moloaa, Kauai
We have no objections to these well construction and pump installation permit applications.
Engineer
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PROJECT AREA
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ISLAND OF KAUAI
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BENJAMIN J. CAYETANO GOVERNOR OF HAWAII
Mr. Mark A. Anderson P.O. Box 307 Kilauea, HI 96754
Dear Mr. Anderson:
STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES
COMMISSION ON WATER RESOURCE MANAGEMENT P. O. BOX 821
HONOLULU, HAWAII 96809
.m 13 1997
MICHAEL D. WILSON CHAIRPERSON
ROBERT G. GIAAlD DAVID A. NOBRIGA
LAWRENCE H. MilKE RICHARD H. COX
HERBERT M. RICHARDS. JR.
RAE M.LOUI, P.E. DEPUTY
Thank you for providing the elevation survey and date of the pump test for Well No. 1120-25. From a June 10, 1997 telephone conversation with your wife, Sherry Anderson, we understand that the installed PVC pipe is 4 inches in diameter, and not 6 inches, as shown on the elevation survey. This is consistent with the information on the well completion report. We also understand that the height of the PVC pipe above the ground surface is 23 inches. This information will be used to determine the elevations of the ground surface and water levels.
Your submittal of the above information completes the regulatory requirements of the well construction and pump installation permit. We sincerely appreciate your assistance and cooperation in matters related to water resources.
LN:ss
If you have any questions, please contact Lenore Nakama at 587-0218.
Sincerely,
RAE M. LOUI Deputy Director
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-ESAKI SURVEYING & MAPPING, INC.
SURVEYING/CIVIL ENGINEERING/PLANNING 1610 HALEUKANA STREET· LIHUE, KAUAI, HAWAII 96766 • TELEPHONE: (808) 246-0625 • FAX: 246-0229
CERTIFICATE OF SURVEYOR
The undersigned hereby certifies to MARK ANDERSON with regards to the private water well located on TMK: 4-9-11: 30, Moloaa, Kauai, Hawaii that the elevation on the top of the steel plate on the ~" PVC pipe is 134.5 feet above mean sea level.
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BENJAMIN J. CAYETANO GOVERNOR OF HAWAII
Mr. Mark Anderson P.o. Box 307 Kilauea. HI 96754
Dear Mr. Anderson:
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STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES
COMMISSION ON WATER RESOURCE MANAGEMENT P. O. BOX 621
HONOLULU, HAWAII 96809
JAN 21 1997
Moloaa-Anderson Well (Well No. 1120-25)
MICHAEL D. WILSON CHAIRPERSON
ROBERT G. GIRALD DAVID A. NOBRIGA
LAWRENCE H. MilKE RICHARD H. COX
HERBERT M. RICHARDS, JR.
RAE M. LOUI, P.E. DEPUTY
Thank you for submitting the as-built sketch for the well and pump installation and pump test data as requested in our letter of March 13. 1996. However. we do not have any record of the date on which the pump test was conducted.
In addition. we have not received the elevation (referenced to mean sea level) survey by a Hawaii-licensed surveyor that is required under Standard Condition 5.b. of your well construction/pump installation permit (attached). Please submit the pump test date and elevation survey within thirty (30) days from the date of this letter.
If you have any questions. please contact Lenore Nakama at 587-0218.
LN:ss Attachment
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Sincerely. .21 i - ")'1'1 ,
J RAE M. LOUI Deputy Director
c MEMORANDUM FOR THE RECORD
FROM: Lenore Nakama
SUBJECT: Elevation Survey for 1120-25
Mark Anderson called 2/10/97 regarding our 1121197 letter requesting an elevation survey and pump test date within 30 days. He said they have found a surveyor who thinks he will have time to do the survey next week. As soon as the survey is done, Mark will send in the info. I told him that I would make a note in the me that he called to let us know his progress and that he is making good faith efforts to meet the 30 day deadline.
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BeoJAMIN J. CA VET ANO GOIIERNOA ~ ..... WAlI
Mr. Mark Anderson P.O. Box 307 Kilauea, HI 96754
Dear Mr. Anderson:
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STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES
COMMISSION ON WATER RESOURCE MANAGEMENT P. O. BOX 621
HONOLULU, HAWAII 96809
JAN 2 1 1997
Moloaa-Anderson Well (Well No. 1120-25)
MICHAEL D. WILSON QWRPERSON
ROBERT G. GIRALD DAVID A. NOBRIGA
LAWRENCE H. MilKE RICHARD H. COX
HERBERT M. RICHAROS. ..P.
RAE M. LOUI, P.E. OEPVTY
Thank you for submitting the as-built sketch for the well and pump installation and pump test data as requested in our letter of March 13, 1996. However, we do not have any record of the date on which the pump test was conducted.
In addition, we have not received the elevation (referenced to mean sea level) survey by a Hawaii-licensed surveyor that is required under Standard Condition 5.b. of your well construction/pump installation permit (attached). Please submit the pump test date and elevation survey within thirty (30) days from the date of this letter.
If you have any questions, please contact Lenore Nakama at 587-0218.
LN:ss Attachment
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Sincerely,
RAE M. LOUI Deputy Director
·. COI\)sSION ON WATER RESOURCE MANAl ;1ENT (2/96)
FROM:_-+-~ ______ DATE: __ c:}..LI_'_{ ___ SUSPENSE DATE _______ _
-L BAUER, G. ~ _CHING, F.
FUJII, N. ~HARDy,R. ~ _HIGA,D. _HIRANO, E. ~ICE, C. _JINNAI,R. _ KUNIMURA, I. __
_lOUI. R. _MIZUNO, L. _NAKAMA, L.
'2.- OHYE, M. _SAKODA. E. _SUBIA, S. _ SWANSON, S. _UWAINE,J. _VODA, K.
_Approval __ Signature __ Information .;
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PLEASE:
See Me Review & Comment
__ Take Action __ Type Draft __ Type Final
File Xerox __ copies
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BENJAMIN J. CAYETANO GOVERNOR OF HAWAII
Mr. Mark Anderson P.o. Box 307
STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES
COMMISSION ON WATER RESOURCE MANAGEMENT P.O.BOX 621
HONOLULU, HAWAII 96809
MAR I 3 1996
Kilauea, Hawaii 96754
Dear Mr. Anderson:
Moloaa-Anderson Well (Well No. 1120-25)
Thank you for transmitting the well completion report for the captioned well.
MICHAEL D. WILSON CHAIRPERSON
ROBERT G. GIRALD DAVID A. NOBRIGA
LAWRENCE H. MilKE RICHARD H. COX
HERBERT M. RICHARDS, JR.
RAE M. LOUI, P.E. OEPUTY
However, we have not yet received the as-built drawings for either the well or the pump installation, nor the pump tests, as required in the permit. Please send those at your earliest convenience.
CI:ss
If you have any questions, please call Charley Ice at 587-0251
Sincerely,
RAE M. LOVI Deputy Director
FROM: ___ r+--___ _ TO:
R. LOUI J. UWAINE F. CHING S. SUBIA K. YODA
SURVEY BRANCH
E. HIRANO G.BAUER R. HARDY N. FUJII ,M.OHYE I. KUNIMURA
(. IMISSION ON WATER RESOURCE MANAG.. ':NT
DATE: ___ Jo-I_f_D __ _
REGULATION BRANCH
E.SAKODA D. HIGA L. NAKAMA
"l.- C. ICE R. JINNAl S. SWANSON
PLANING BRANCH
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S. EDMUNDS L. MIZUNO
SUSPENSE DATE: ______ _
APPROVAL SIGNATURE INFORMATION
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PLEASE:
See Me Review & Comment Take Action Type Draft Type Final File Xerox __ copies
02195
RE~RCE MGT ID,8085870~
SteW of HawaII Y PAGE
COMMISSION ON WATER RESOURCE MANAGEMENT Department of land and Natural.Resources
WELL COMPLETION REPORT
1/1
In .. ~: PIMse pnnt 01' type and $I,I~ COI'T'fl~ r~rt ~nin 30 daYs after' well ~mpletion 10 ttJ;~n on Wat. Resovrce Management. ~.,? Box 621. H¢(lQlulu. Hawu 96809. Art .-bullt dra'W11'1g 01 the well and chefT1caj analysis $hould alSO be SU.........-...... F . caJIlhe ~n RegulatIOn 9f-anch II ~7~. ... •• "...... Or USlStanee
25 1. STATE weU,. NO. 11 20...:;;z::q WELL NAME ISl,;ANO Kauai 2. LOCATION: Address Kahu Agricultural Condominium Tax Map Key 4-r-;';';9:e---:l;:-:1;:--:"1~6~-3. ORILUNG OR PUMP INSTAUAflON CONTRACTOR Wai' eliDrilling & Development 4. CONTRACTOR'S C-57 UCENSE NUMSER C-16 543 5. NAME OF DRILLER WHO PERFORMED WORK MIKE LEWELL~ ('- ) 6. TYPE OF AIG/CONSTRUcnON rotary l ~1 b \- 0o..,\(\ll 7. DATE OF WEIJ.. DRIll.lNG COMPLETION 11 130/95
(NOrE: R~j;>Qrt mllllt t>e luDtnm,,~ wItflIt\ 3C dAy. *11 ... \rill d«ttr - - ,.
S. GROUND ELEVATION (msl) 160 ft. Top of Drilling Platform (msl) ~rQund l.e.Y.e1t Height of Drilling Platform above Ground surface 0 ft.
-~--~-Bench Mark an9 Method Used to Determine Ground Elevation
9. DRIu..ER'S LOG: Wa. ~ o.ptI'I (ft.) Rode OetaiptiOl'l. AemaIb. ~ (ft.) Deptl'l (ft.)
Water L.rIe'
T~ (ft.) --'L to.1i.!L ~.l,;..C .L1 aa.,~¥-~ ____ _
89 __ 110 _____ ~-...,;, ...... ..,;,,'-. _
~ to.....g.Q.- 131\:18 rock _ to ~ _ ___ --.~J:...' ___ _ _ to __ _____ "'--_(.;;;.0_ _ 10 __ ~_~ ___ ~
~ to ________ ~ __ __ to __________ _ __ to_~ ________ _ ~~ to ________ --!:P,Li_
__ to ___________ . to Uf
(If men ~ l.nHdect, ~ 00 ~
10. TOTAL DEPTH OF WEll BELOW GROUND 9 0 ft. .. ~
11. HOLE SIZE~ 6 Inch dia. from 0 ft. to _......-..l2~Q_; ____ ft. bEllow ground Inch dill.' from ft to ft below ground
_____ inch dla. from ft to fl below ground 12. CAS1NG lNST ALLED:
4 in. 1.0. x In. waft solid sectIon to 70ft beiow ground
13. ANNULUS:
4 In. 1.0. x In. Wd perforated section to ~9...;;:.0 __ ft belOYI ground TYPe of Pertonltion 1~ sg in..L.R9. ... ft Groufed from 0 It below ground to 6 5 ~ ft.. .belO'N ground Gravel packed from 65ft below ground to 90ft.. beAO'N ground
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14. INitiAL WAT!R LEVElG9 ft. beloW ground. oate and tlll'lQ of measurement 3/30/95 9am 15. INITIAl CHLORIDE ._ZZ~-< ~\~\: \.. ppm Oata and time cl sampling _ .. ___ ....... _.~ ___ _ 16. INITlAL TEMPERATuRE 7 5 • F Date and time of sampling 3 / 30 / 9 5 lOam
11. DATE OF PUMP INSTAllATION 11i30L95 18. PUMP INSTAllATION:
Pump Type. Make, SenaI No. _~G;:.;r~u;:.;n:..:.d=.;f=-o;..:s::::-______ - capacity _---'4 ..... 0_ gpm ..
Motor type, H.P., Voltage, rpm 1 \:.;;;h;,;li;p ______ --;:-----;-:'~"7"'""~__:_-_::;_:;:_::::___~_::_ Depth of Pump Intake Setting _\..:..;;~;"..._ __ fl befow --r 0 v . which ekwaUon Is _'-':,_4_, t::;_:;> __ ft. Depth of bottom of ajrllne rt below ____ ,' which elevation is ft. Pumping Head Is ___ • ___ ft .
. 19. PUMPING TESTS: RafetenC8 Poklt (R.P.) used: ____ P.'. wNch,aewticn Is ___ .............. _ft.
Date 11 /30/9 5 Oate _-"!"'~_ Start water Ieve' --\B,!,.;9'--___ ft. bekM R.P. Start water Ievef End water kwef .-lBoI....9,,--,, ___ fl beloW R.P. End water ItW8I 0epIh of well ~9I.UO ___ tt. bekNt R.P. ~epth ~ wei
E!S*d Rdt TIme (1'Iaura) (gpm)
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wn) J • F TIme ~I (gpm) 72.5 75 _1(,- ___ -
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Contractor (print)
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w. NO. 1120 - 25 t...taUJ0i 22 II 34 t
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'! KAHU AGRICUL ruRAL CONDOMINIUM UNITS 1 rnRU 5
AND EASEMENTS A rnRU H BElNG ALLOTMENT P OF KAAPUNA HUI LANDS
BEING ALSO PORTION OF GRANT 535 TO JAMES W. SMlrn
1A000AA. KAWAJIIAU. KAUA/. /I"WAII Tox !.lop Key. 4-9-11: 16 Owner. POll Corporollon Dote: August 31, 1994
...... State of Hawaii COMMISSION ON WATER RESOURCE MANAGEMENT Department of Land and Natural Resources
WELL ABANDONMENT REPORT
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/' Instrucaona: Please print or type and subrm CO!T1)JetecI report Within 30 days after sealing co!T1)letion to the Corrnission on Water Resource Management, P,O. Box 621, Honolulu, Hawaii 96808. An as-built drawing of the well and cherrical analysis should also be subrTitted. For assistance call the Commission Regulation Branch at 587-0225.
1. 2.
3. 4. 5. 6. 7.
STATE WELL NO. it!tO - 'J. \) WELL NAME Mo \[) o.b. ~ A~'U~ ..... i.IJ4-\\ ISLAND:>. ~~ LOCATION: Address ; 00\ d- \' T~~Map Ket:l4 -9A\\ - \ v DRIWNG OR PUMP INSTALLATION CONTRACTOR o-\e- ~ 1)1" \, ",', ('t 'II CONTRACTOR'S C-57 UCENSE NUMBER e ,- I w 5" y. 3 _ '\ NAME OF DRIlleR WHO PERFORMED WORK S 1:\:0 0 k. Ll' '€.- I ( e.J.j, s· TYPE OF RI~/GONSTRUCTION f\;r {J?'\-N"+ '"0
DATE OF WELL SEAUNG COMPLETION il/l) 19 i= ~ (NOTE: Report must be s~Jbmttted within 30 days after this date) ...
Finished Grade Elevation \~ 1 ft.
Total Musured Depth 110ft.
---
C(eing O/wneter ___ in.
Check Mataial Used
Grout Seal: C Cement a-Sandlc.nent
SlndlCernart Rallo ..L/-L
'V'0"f'-~ Measured Depth Perforaled Caaing ft.
.... rad Depth ~ Boaom of Grout' ~ tOft.
'.' . ~., .. _ NlA. .. ~ UllpUl 01 ~lQ,.. ~ ' ..
-Contractor (print) Title PARTNER
Signature Date lZ']ZL9~
I I"""""""u.' For 0tIciII u.: WeI No. 1120-20 Job No. Longialde 159 20 52 ~de 22 II 38 Job~~
6/24192 WAB Form
~errClrks(cont'd): ---------------------------
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o JOHNWAIHEE
GOVERNOR OF HAWAII
STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES
COMMISSION ON WATER RESOURCE MANAGEMENT
P.O. BOX 621
HONOLULU. HAWAII 96809
WEU. CONSI'RUcnON AND PUMP INSTAUATION PERMIT
TO: Mark Anderson P.O. Box 307 Kilauea, HI 96754
for
Moloaa-Anderson Well Well No. 1120-20
Moloaa. Kauai
KEITH W. AHUE CHAIRPERSON
DR. PETER SYBINSKY ROBERT S. NAKATA
J. DOUGLAS lNG, ESQ. ROBERT G. GIRALD
DAVID NOBRIGA
RAE M. LOUI, P.E. DEPUTY
In accordance with the Department of Land and Natural Resources Administrative Rules, Section 13-168, entitled 'Water Use, Wells, and Stream Diversion Works", your application to construct, test, and install a pump in Moloaa-Anderson Well (Well No. 1120-20), is approved subject to the following conditions:
STANDARD WEll CONSTRUCTION PERMIT CONDmONS
1. The Commission on Water Resource Management (Commission), P.O. Box 621, Honolulu, HI 96809, shall be notified, in writing, before any work covered by this permit commences.
2. The well construction/pump installation permit shall be for construction, testing, and installation of a 30 gpm capacity, or less, pump in the well. The applicant shall submit the test results and permanent pump information to the Commission.
3. 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. This permit or the authorization to construct and pump water from a well shall not constitute a determination of correlative water rights. The permittee is notified and by this provision understands that the quantity of water taken from the well could be reduced by the Commission in the future. This permit is not a commitment that the pump capacity permitted here or even some lesser amount is guaranteed in the future.
4. The applicant shall provide and maintain an approved meter or other appropriate device or means for measuring and reporting total water usage. Water usage shall be measured on a monthly basis and reported to the Commission.
e o
WELL CONSTRUCTION AND PUMP INSTALLATION PERMIT Page 2 Well No. 1120-20
5. The following shall be submitted to the Commission within 30 days after completion of the work:
a. Well Completion Report. b. Elevation (referenced to mean sea level) survey by a Hawaii-licensed surveyor. c. As-built sectional drawing of the well. d. Plot plan and map showing the exact location of the well. e. Complete pumping test records; including time, pumping rate, drawdown,
chloride content, and water quality data.
6. The applicant shall comply with all applicable laws, rules, and ordinances.
7. The permit application and staff submittal approved by the Commission at its meeting on July 13, 1994 shall be incorporated by reference in the permit.
8. The permit may be revoked if work is not started within six months of the date of approval or if work is suspended or abandoned for six months. The work proposed in the permit application shall be completed within two years from the date of permit approval.
SPECIAL CONDITIONS
1. Water from the well shall not be used for drinking water unless properly tested and treated.
2. The applicant shall contact the SHPD (State Historic Preservation Division) (Telephone: Oahu 587-0047) before starting any work on the project. A qualified archaeologist shall excavate a trench near the proposed well to determine if significant historic sites are present prior to well construction. If significant historic sites are present, the site shall be documented, and soil core samples shall be taken for analysis. A report on the findings shall be submitted to the State Historic Preservation Office for review and approval. All work must stop in the area if intact human burials are found, and the SHPD must be notified to comply with Chapter 6E, H.R.S.
3. The grouted annulus of the well shall be 0 to 200 ft. instead of from 0 to 20 ft. as proposed.
KEITH W. AHUE, Chairperson Commission on Water Resource Management
SEP -8 1994
Date of Issuance
WELL CONSTRUCTION AND PUMP INSTALLATION PERMIT Page 3 Well No. 1120-20
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.
AlA I f', ~_ Applicant's Signature: _N ..... ' ~.~~' ~'-' __ Ull.. __ ~--!::~;;;..::.. ______ Date:
Printed Name: M 0, ( l Af\ J e-(S o-V\,
Firm or Title: :DJ L \ ( \)( P 6f 0._ +-; .>-1\
Please sign and return one copy of this permit to the Commission and retain a copy for your record.
cc: USGS State Historic Preservation Division Department of Health
Safe Drinking Water Branch Ground Water Protection Program Wastewater Branch
Kauai Department of Water
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-, JOHNWAIHEE
GOVERNOR OF HAWAII
KEITH W. AHUE
CHAlFll'ERSON
STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES
COMMISSION ON WATER RESOURCE MANAGEMENT
P.O. BOX 621
HONOLULU, HAWAII 96809
WELL CONSTRUCTION AND PUMP INSTALlA110N PERMIT
TO: Mark Anderson P.O. Box 307 Kilauea, HI 96754
for
Moloaa-Anderson Well Well No. 1120-20
Moloaa. Kauai
DR. PETER SYBINSKY ROBERT S. NAKATA
J. DOUGLAS lNG, ESQ. ROBERT G. GIRALD
DAVID NOBRIGA
RAE M. LOUI, P.E. DEPUTY
In accordance with the Department of Land and Natural Resources Administrative Rules, Section 13-168, entided 'Water Use, Wells, and Stream Diversion Works", your application to construct, test, and install a pump in Moloaa-Anderson Well (Well No. 1120-20), is approved subject to the following conditions:
STANDARD WELL CONSTRUCllON PERMIT CONDmONS
1. The Commission on Water Resource Management (Commission), P.O. Box 621, Honolulu, HI 96809, shall be notified, in writing, before any work covered by this permit commences.
2. The well construction/pump installation pennit shall be for construction, testing, and installation of a 30 gpm capacity, or less, pump in the well. The applicant shall submit the test results and permanent pump information to the Commission.
3. The proposed use shall not adversely affect existing or future legal uses of water in the area, including any swface water or established instream flow standards. This permit or the authorization to construct and· pump water from a well shall not constitute a determination of coxrelative water rights. The permittee is notified and by this provision understands that the quantity of water taken from the well could be reduced by the Commission in the future. This pennit is not a commitment that the pump capacity permitted here or even some lesser amount is guaranteed in the future.
4. The applicant shall provide and maintain an approved meter or other appropriate device or means for measuring and reporting total water usage. Water usage shall be measured on a monthly basis and reported to the Commission.
WEll CONSTRUCTION AND PUMP INSTALLATION PERMIT Page 2 Well No. 1120-20
5. The following shall be submitted to the Commission within 30 days after completion of the work:
a. Well Completion Report. b. Elevation (referenced to mean sea level) survey by a Hawaii-licensed surveyor. c. As-built sectional drawing of the well. d. Plot plan and map showing the exact location of the well. e. Complete pumping test records; including time, pumping rate, drawdown,
chloride content, and water quality data.
6. The applicant shall comply with all applicable laws, rules, and ordinances.
7. The permit application and staff submittal approved by the Commission at its meeting on July 13, 1994 shall be incorporated by reference in the permit.
8. The permit may be revoked if work is not started within six months of the date of approval or if work is suspended or abandoned for six months. The work proposed in the permit application shall be completed within two years from the date of permit approval.
SPECIAL CONDmONS
1. Water from the well shall not be used for drinking water unless properly tested and treated.
2. The applicant shall contact the SHPD (State Historic Preservation Division) (Telephone: Oahu 587-0047) before starting any work on the project. A qualified archaeologist shall excavate a trench near the proposed well to determine if significant historic sites are present prior to well construction. If significant historic sites are present, the site shall .be documented, and soil core samples shall be taken for analysis. A report on the findings shall be submitted to the State Historic Preservation Office for review and approval. All work must stop in the area if intact human burials are found, and the SHPD must be notified to comply with Chapter 6E, H.R.S.
3. The grouted annulus of the well shall be 0 to 200 ft. instead of from 0 to 20 ft. as proposed.
KEITH W. AHUE, Chairperson Commission on Water Resource Management
SEP -8 1994
Date of Issuance
-WELL CONSTRUCTION AND PUMP INSTALLATION PERMIT Well No. 1120-20
Page 3
I have read the conditions and tenns 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.
, Applicant's Signature: _______________ Date: ______ _
Printed Name: ___________________________ _
Finn or Tide: ___________________________ _
Please sign and return one copy of this permit to the Commission and retain a copy for your record.
cc: USGS State Historic Preservation Division Department of Health
Safe Drinking Water Branch Ground Water Protection Program Wastewater Branch
Kauai Department of Water
JOHNWAIHEE GOVERNOR OF HAWAII
STATE OF HAWAII
",.......,.,
....",J RECEIVED SAfE DRINKiNG WATER BRANCH
i! i1
.. :t;l_ KEITH W. AHUE CHAIRPERSON
JOHN C. LEWIN. M.D. ROBERT S. NAKATA
J. DOUGLAS lNG, ESQ.
DEPARTMENT OF LAND AND NATURAL RESOURCES
COMMISSION ON WATER RESOURCE MANAGEMENT
ROBERT G. GIRALD DAVID NOBRIGA
P.O. BOX 621
HONOLULU. HAWAII 96800
RAE M. LOUI, P.E.
Mr. Thomas Arizumi, Chief Environmental Management Division State Department of Health Five Waterfront Plaza 500 Ala Moana Blvd., Suite 250 Honolulu, Hawaii 96813
Attn: Mr. William Wong
Dear Mr. Arizumi:
JUN 17 1994
Well Construction and Pump Installation Permit Applications
Please review the following nlJ~t apQlications pursuant to your area of concern and submit your comments to us by J L 1 I 1894 ,
Island Well Name Well No. Application TYI2e
Hawaii Pualani Estates 3758-02 Well and Pump Maui Wailea Well6A 4026-07 Pump Installation Maui Wahikuli No.2 5439-02 Pump Installation
/Kauai Moloaa-Anderson 1120-20 Well and Pump Kauai Moloaa-Miller 1120-21 Well and Pu~np Kauai Puhi No.5 5824-08 Well Construction
Should you have any questions, please contact the Commission on Water Resource Management staff at 587-0225.
JZ:ky Ene.
Response:
Sincerely,
raut1/1~' I: ~~ :OUI Deputy Director
M We have no objections (') Nor subject to our regulatory authority & permit ( ) Comments attached
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DEPUTY
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( ) Additional irJorrnation requested ( ) Extended re,iew periO~d
Contact Person: ~~~~/~t/~r: __ ~~ __ ~~ ________________ __ Phone: 'S't'bq~s?
Signed: 6r'1f tOff-lti Date: -f-1+,;j~"+lli--L-,L.jL_-
c:c.A
JUL - 7 1994 JOHNWAIHEE
GOVERNOR OF HAWAII
~ITHW.AHUE CHAIRPERSON ,
STATE OF HAWAII
JOHN C. LEWIN, M.D. ROBERT S. NAKATA
J. DOUGlAS ING. ESQ.
DEPARTMENT OF LAND AND NATURAL RESOURCES
COMMISSION ON WATER RESOURCE MANAGEMENT
ROBERT G. GIRAlD DAVID NOBRIGA
Mr. Thomas Arizumi, Chief Environmental Management Division State Department of Health Five Waterfront Plaza 500 Ala Moana Blvd., Suite 250 Honolulu, Hawaii 96813
Attn: Mr. Dennis Tulang
Dear Mr. Arizumi:
P.O. BOX 621
HONOLULU. HAWAlI9680D
RAE M. LOUI, P.E. DEPUTY
KA:\-
i2esr"';" cw ~ 'D?L--
Well Construction and Pump Installation Permit Applications
Please review the following l?~t apQlications pursuant to your area of concern and submit your comments to us by JUL I I 1894 .
Island Well Name Well No. Application TYQe
Hawaii Pualani Estates 3758-02 Well and Pump Maui Wailea Well 6A 4026-07 Pump Installation Maui Wahikuli No.2 5439-02 Pump Installation Kauai Moloaa-Anderson 1120-20 Well and Pump Kauai Moloaa-Miller 1120-21 . Well and Pump Kauai Puhi No.5 5824-08 Well Construction
Should you have any questions, please contact the Commission on Water Resource Management staff at 587-0225.
JZ:ky Ene.
Response:
Sincerely,
~dAJI~ ;: ~~ :OUI Deputy Director
00 We have no objections ( ) Not subject to our regulatory authority & permit ( ) Comments attach~d ( ) Additional informqtion requested
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( ) Extended revi~,eri~d req~;S~ed , ",
contactxers n:, ~/h'1/jv Ilttl./{U Phone: 88L· ,-/-')-10 . '/ ')"1 ,:/1' f ' , 1\ 4 j Slgnedy ,/ if , , - ,.rl'~ i/:/ :' ........... Date: ---!1:...--_1_1 _' (;_1.-:...1/_,' _
JOHNWAIHEE GOVERNOR OF HAW""
JJN 17 1994
REF:WRM-KY
I .'
STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES
COMMISSION ON WATER RESOURCE MANAGEMENT
P.O. BOX 621
HONOLULU. HAWAII 1168011
TO: ~onorable Hoaliku L. Drake, Director Department of Hawaiian Home Lands
Mr. Clayton H.W. Hee, Chainnan & Trustee At Large Office of Hawaiian Affairs
FROM: ~ith W. Ahue. Chairperson~ SUBJECT: Well Construction & Pump Installation Permit Applications
KEITH W. AHUE CHAIRPeRSON
JOHN C. LEWIN. M.D. ROBERT S. NAKATA
J. DOUGLAS ING. ESQ. ROBERT G. GIRALD
DAVID NOBRIGA
RAE M. LOUI, P.E. DEPUTY
Please review the following permit applications pursuant to your area of concern and submit your comments to us by JUL I I 1994 . r:
«& ::;:r:. G, V-"
Island Well Name Well No. Application Type
Hawaii Pualani Estates 3758-02 Well and Pump Maui Wailea Well 6A 4026-07 Pump Installation Maui Wahikuli No.2 5439-02 Pump Installation Kauai Moloaa-Anderson 1120-20 Well and Pump Kauai Moloaa-Miller 1120-21 Well and Pump Kauai Puhi No.5 5824-08 Well Construction
Should you have any questions please contact the Commission on Water Resource Management staff at 587-0225.
JZ:ky Enc.
Response: ~ We have no objections ( ) Not subject to our regulatory authority & permit ( ) Comments attached ( ) Additional information requested ( ) Extended review period requested
Contact Pe Darrell Yagodich, Administrator Phone: __ 5_86_-_38_3_7 __ Plannlng OffIce
Signed: -k:'::$!.~~:.&~~~~:!:..£~~~--~~' ,Date: ----;7.f-~.!...:1 ,f-1-9L..:j'lI---( (
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JOHNWAIHEE GOVERNOR OF HAWA .. f:' ~?~ "-.:.. .
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DEPA'RT'MENT OF LAND AND NATURAL RESOURCES
STATE HISTORIC PRESERVATION DIVISION -- 33 SOUTH KING STREET. 6TH FLOOR
HONOLULU. HAWAII 96813
June 30, 1994
MEMORANDUM
TO:
FROM:
Rae M. Loui, Deputy Director & Edward Sakota Commission on Water Resource Management
Don Hibbard, Administrator ~
nlTH AHUB. CHAIRPERSON BOARD OF lAND AND NATURAL RESOURCE
DEPIITIES
JOHN P. KEPPELER II DONA L. HANAIKE
AQUACULTURE DEVELOPMEKT PROGRAM
AQUATIC RESOURCES CONSERVATION AND
ENVlRONMEKTAL AfFAIRS CONSERVATION AND
RESOURCESENfORCEMEKT CONVEYANCES
fORESTRY AND WlLDUFE HISTORIC PRESERVATION
OI\11SION lAND MANAGEMEKT STATE PARKS WATER AND lAND DEVELOPMEKT
LOG NO: 12010 ..DOC NO: 9406NM62
SUBJECT:
State Historic Preservation Division rr _ Historic Preservation Review -- Application for Well Construction 1120-20 • TMK: 4-9-11: 16 (Anderson) Moloaa, Hanalei, Kauai
We have reviewed the above pennit application. A review of our files indicates that possible habitation and agricultural sites exist nearby. This makes it likely that historic sites are present.
Given this infonnation we recommend the following condition:
A qualified archaeologist shall excavate a trench near the proposed well to detelmine if significant historic sites are present prior to well constIuction. If significant historic sites are present, the site shall be documented, and soil core samples shall be taken for analysis. A report on the findings shall be submitted to the State Historic Preservation Office for review and approval. All work must stop in the area if intact human burials are found, and the SHPD must be notified to comply with Chapter 6E, H.R.S.
If you have any questions, please call Ms. Nancy McMahon at 587-0006.
NM:amk
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CBR~IPIBD RB80LU~IO. or POLl CORPORATION, a Bawal1 Corporation
The following resolution was adopt d by the Board of Directors of Poli Corporation (the "Corporeti n"), by unanimous consent of the Shareholder and Director of the Corporation on May 1, 1994.
"BE IT RESOLVED, that the President 0 the Corporation, acting alone, is hereby authorized to exec te all necesaary documentation required to purchase real prop ty located on the Island of Kauai for the Corporation from one hristopher Kauahi under a contract entered into by Mark end She on Anderson as the buyers, and to further execute such additi nal documents and take such additional actions as he deems rea. nably necessary to effect closinq of the sale of the subject pro erty to the Corporation and thereafter to pursue a Condominium Property Regime on the property. Such actions and documents in lude, but are not limited to approving contracts, closing statem nts and certification of removal of all contingencies to closin j execution of the OROA and all addenda thereto or modification thereof or extensions to closing dates; execution of deed., ortyages, tax certificates and any and all other documents re uired by the DROA, as may be amended, or by the escrow agent.
FURTHER RESOLVED, all actions of the Pres dent of the Corporation taken prior hereto which further tha urpoee of the sale herein authorized are ratified, approved and dopted as the acte and deeds of the Corporation as though done by prior authority of the Board of Directors of the Corporation.
FURTHER RESOLVED, the Secretary or Acti Corporation is hereby authorized to make cs Resolution, affix the seal of the corporation same to Escrow as a requirement of closing eale."
q Secretary of the tificat10n of this hereto and forward
f the contemplated
secretary
ATTEST:
James
?; 'd ~s: :at v66t 'vt '913
I HEREBY CERTIFY that this is a true and correct copy of the original recorded in this office.
..... c.~~ ~~~ .0 .' .. ~.(' ~ / . ~ ~,,-:,j • .....",.j1. ~: / . . \ l DIRECTOR OF COMMERCE AND
CONS MER AffAIRS oj
Date:
STATE OF HAWAII
10) ~©uwmrn1 ]] JUN - 6 1994 ~
IO:~Atf Dept of Commerce & Consumer Affairs
STATE OF HAWAII
DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS
In the Matter of the Incorporation
of
POLl CORPORATION
} } } } ) }
----------------------------) ARTICLES OF INCORPORATION
KNOW ALL MEN' BY THESE PRESENTS:
That the undersigned, desiring to become incorporated and
to obtain the benefits conferred on corporations by law, hereby
enter into the following Articles of Incorporation, the terms of
which shall be equally obligatory upon the parties hereto as well
as upon all other persons who from time to time may be stockholders
in the corporation.
ARTICLE I
CORPORATE NAME
The name of the corporation shall be:
POLl CORPORATION
ARTICLE II
LOCATION OF OFFICE
The place of the principal office of the corporation
shall be in Lihue, Island of Kauai, State of Hawaii. Upon its
incorporation, the address of the corporation shall be:
4473 Pahe'e Street, suite L Lihue, Kauai, Hawaii 96754
or at such other office or offices within and without the state of
Hawaii as its business may from time to time require.
ARTICLE III
CORPORATE PURPOSE AND POWERS
The primary purpose for which this corporation is formed
is to acquire by purchase, lease or otherwise, and to improve,
develop, own, manage, lease and sell real property; including
construction of dwellings, apartment houses, commercial buildings
and other structures of all kinds; and to transact any other lawful
business for which corporations may be incorporated under Chapter
415 of the Hawaii Revised Statutes, as amended, in its corporate
capacity, in a partnership status, as part of a joint venture or in
any other capacity. The corporation has all powers necessary or
proper to carry on its business.
ARTICLE IV
DURATION
The corporation shall have perpetual duration.
ARTICLE V
DIRECTORS AND OFFICERS
The initial Board of Directors, which shall consist of
three directors, and the officers of the corporation who shall
serve until their successors are duly elected and qualified, along
with the residence address of each, are as follows:
-2-
JAMES E. HALL
SANDRA C. HALL
SHARON A. ANDERSON
position
president, Treasurer, and Director
Vice President Secretary, and Director
Director
Residence Address
5811 S. county Road Midland, Taxes 79703
5811 S. County Road Midland, Taxes 79703
6601 Koolau Road Anahola, Hawaii 96703
The Board of Directors shall be one or more in number if
the corporation has only one stockholder. If the corporation has
two stockholders, the corporation shall have two or more
directors. If the corporation has three or more stockholders, the
corporation shall have three or more directors. Directors and
officers shall be elected or appointed in the manner provided by
the By-Laws and shall have the powers given to them in the
By-Laws. Any person may hold two or more offices in the
corporation unless forbidden to do so by the By-Laws or law. The
officers of the corporation shall be a President, one or more
Vice-Presidents, a Treasurer, and a Secretary along with such other
officers as are provided for in the By-Laws. The Board of
Directors shall, except as limited in the By-Laws, have all power
necessary or proper to carry out all of the business of the
corporation, and the Directors may delegate such powers as they see
fit, so long as such delegation is not prohibited by law or in the
By-Laws.
-3-
ARTICLE VI
AUTHORIZED STOCK; NO PREEMPTIVE RIGHTS
The aggregate number of shares which the corporation
shall have authority to issue is 1,000,000, all having a par value
of One Dollar each, and all of which are of one class and
designated as common stock.
Stockholders shall have no pre-emptive rights in and to
subscribe for any additional shares of stock of any class
whatsoever nor any securities convertible into stock of any class
whatsoever. Such shares of stock or securities convertible into
stock may be issued and disposed of by resolution of the board of
directors to such persons, firms, corporations or associations, and
for such consideration and upon such terms as may be deemed
advisable by the board of directors, including the issuance thereof
as and for stock dividends.
ARTICLE VII
INITIAL SUBSCRIBERS
The initial subscribers for shares of stock in the
corporation, the number of shares subscribed for, the subscription
price for the shares and the consideration paid therefor are as
follows:
Name of Subscriber
JAMES E. HALL SANDRA C. HALL
TOTALS:
No. of Shares Subscribed
1,000 1,000
2,000
-4-
subscription Price for
Shares
$1,000 $1,000
$2,000
Amount of
Capital Manner Paid In Paid In
$1,000 Cash $1,000 Cash
$2,000 Cash
ARTICLE VIII
LIMITED LIABILITY
No stockholder shall be liable for the debts of the
corporation beyond the amount which may be due or unpaid upon any
share or shares of stock of said corporation owned by him.
ARTICLE IX
INDEMNITY
(1) The corporation shall indemnify each person who was
or is a party or is threatened to be made a party to
any threatened, pending or completed action, suit or proceeding,
whether civil, criminal, administrative or investigative (other
than an action by or in the right of the corporation) by reason of
the fact that he is or was a director, officer or employee of the
corporation, or is or was serving at the request of the corporation
as a director, officer or employee of another corporation,
partnership, joint venture, trust or other enterprise against
expenses (including attorneys' fees), judgments, fines and amounts
paid in settlement actually and reasonably incurred by him in
connection with such action, suit or proceeding if he acted in good
fai th and in a manner he reasonably believed to be in or not
opposed to the best interests of this corporation, and, with
respect to any criminal action or proceeding, had no reasonable
cause to believe his conduct was unlawful. The termination of any
action, suit, or proceeding by judgment, order, settlement,
conviction, or upon a plea of nolo contendere or its equivalent,
shall not, of itself, create a presumption that the person did not
-5-
act in good faith and in a manner which he reasonably believed to
be in or not opposed to the best interests of this corporation,
and, wi th respect to any criminal action or proceeding, had
reasonable cause to believe that his conduct was unlawful.
(2) The corporation shall indemnify each person who was
or is a party or is threatened to be made a party to any
threatened, pending or completed action or suit by or in the right
of the corporation to procure a judgment in its favor by reason of
the fact that,he is or was a director, officer or employee of the
corporation, or is or was serving at the request of the corporation
as a director, officer or employee of the corporation, or is or was
serving at the request of the corporation as a director or officer
of another corporation, partnership, joint venture, trust or other
enterprise against expenses (including attorneys' fees) actually
and reasonably incurred by him in connection with the defense or
settlement of such action or suit if he acted in good faith and in
a manner he reasonably believed to be in or not opposed to the best
interests of this corporation and, except that no indemnification
shall be made in respect of any claim, issue or matter as to which
such person shall have been adjudged to be liable for negligence or
misconduct in the performance of his duty to this corporation
unless any and only to the extent that the court in which such
action or suit was brought or in any other court having
jurisdiction in the premises shall determine upon application that,
despite the adjudication of liability but in view of all of the
circumstances of the case, such person is fairly and reasonably
-6-
entitled to indemnity for such expenses which such court shall deem
proper.
(3) To the extent that a director, officer or employee
of the corporation or a person serving at the request of the
corporation as a director, officer or employee of another
corporation, partnership, joint venture, trust or other enterprise
has been successful on the merits or otherwise in defense of any
action, suit or proceeding referred to in paragraph (1) or
paragraph (2) of this Article IX, or in defense of any claim, issue
or matter therein, he shall be indemnified against expenses
(including attorneys' fees) actually and reasonably incurred by him
in connection therewith.
(4) Any indemnification under paragraph (1) or paragraph
(2) of this Article IX (unless ordered by a court) shall be made by
the corporation only as authorized in the specific case upon a
determination that indemnification of the director, officer or
employee is proper in the circumstances because he has met the
applicable standard of conduct set forth in paragraph (1) or
paragraph (2). Such determination shall be made (a) by the board
of directors by a majority vote of a quorum consistinq of directors
who were not parties to such action, suit or proceedinq, or (b) if
such a quorum is not obtainable, or even if obtainable if a quorum
of disinterested directors so directs, by independent legal counsel
in a written opinion to the corporation or (c) by a majority vote
of the stockholders.
-7-
(5) Expenses incurred in defending a civil or criminal
action, suit or proceeding may be paid by the corporation in
advance of the final disposition of such action, suit or proceeding
as authorized by the board of directors in a particular case upon
receipt of an undertaking by or on behalf of the director, officer
or employee to repay such amount unless it shall ultimately be
determined that he is entitled to be indemnified by the corporation
as authorized in this Article IX.
(6), Any indemnification pursuant to this Article IX
shall not be deemed exclusive of any other rights to which those
seeking indemnification may be entitled and shall continue as to a
person who has ceased to be a director, officer or employee and
shall inure to the benefit of the heirs, executors and
administrators of such a person.
(7) The corporation shall have the power to purchase and
maintain insurance on behalf of any person who is or was a
director, officer or employee of the corporation, or is or was
serving at the request of the corporation as a director, officer or
employee of another corporation, partnership, joint venture, trust
or other enterprise against any liability asserted against him and
incurred by him in any such capacity or arising out of his status
as such, whether or not the corporation would have the power to
indemnify him against such liability under the provisions of this
Article IX.
-8-
ARTICLE X
AMENPMENT
These Articles may be amended by the affirmative vote of
stockholders holding not less than a majority of all the stock of
the corporation issued and outstanding and having voting power at
any annual meeting or at a meeting duly called for such purpose.
The undersigned certify under the penalties of Section
415-136, Hawaii Revised Statutes, as amended, that they have read
the above statements and that the same are true and correct.
IN WITNESS WHEREOF, the undersigned have executed these 71f
presents on the I G, day of May, 1994.
SHARON A. ANDERSON
-9-
==-----i'<- _ '~':"r='~c.:;D.;;;;ate:;;...: __ State of Hawaii _ ,",f! Reply OV'
DEPARTMENT OF LAND AND NATURAL RESOU ~=::"--V--i:~;:~;'~ ~/,'i =~=---+: ___ ~'e!~rm8tion 0
JJN 11 1994
TO: Dr. Don Hibbard, Director Historic Preservation Program
~r. Henry M. Sakuda, Administrator Division of Aquatic Resources
FISHOEV -t- _. tr,rnpAct&FiIe 0 ~L-i .. ~:!::'",,".ur::..:nto:::..; __ _
MAC -r--- ~"~)~'es,-"lO;,;..: __ _
~[_)U_CA_r_'O~--i ____ .. :: :--'-";.;;,;fk5;,;... __ _
- ~-- --------
FROM: Rae M. Loui, Deputy Directo~ Commission on Water Resou\ce Management . .,;1..1\'; 2 U 199 1
SUBJECT: Well Construction & Pump Installation Permit Applications Oiv. of ""'Inti,,: QesO\lr~-:~
Please review the following permit applications pursuant to your area of concern and submit your comments to us by . n nil 1994
Island Well Name Well No. Application Type
Hawaii Pualani Estates 3758-02 Well and Pump Maui Wailea Well 6A 4026-07 Pump Installation Maui Wahikuli No.2 5439-02 Pump Installation
vKauai Moloaa-Anderson 1120-20 Well and Pump Kauai Moloaa-Miller 1120-21 Well and Pump Kauai Puhi No.5 5824-08 Well Construction
Should you have any questions please contact the Commission on Water Resource Management staff at 587-0225.
JZ:ky Ene.
Response: ( ) We have no objections ( ) Not subject to our regulatory authority & permit to/) Comments attached (\) Additional information requested ( ) Extended review period requested
Contact Person: __________________________________ __
Signed: --tI-~ I«- MIL
'GO , .. , ...........
,("):L 'm' " , •. 1';'....-
J>::tl
c:::cc::: -"'0-
c,...jN •• --.l
.. f~ en Phone: ___________ __
Date: ~6;L-6_~_L_~"__A_~f-'-----
'" ,,'
-" ':"''';-;
f'f1 ,4J '0' -/ ._-
"
State of Hawaii Department of Land and Natural Resources
DIVISION OF AQUATIC RESOURCES
June 24, 1994
MEMORANDUM
TQ
FROM:
SUBJECT:
Rae M. Loui, Deputy Director Commission on Water Resource Management
Henry Sakuda, Administrator Division of Aquatic Resources
Comments on Well Construction and Pump Installation Permit Applications for Well Nos. 3758-02 (Hawaii), 4026-07 (Maui), 5439-02 (Maui), 1120-20 (Kauai), 1120-21 (Kauai), and 5824-08 (Kauai).
Well No. 3758-02, Well Name Pualani Estates, Well and Pump Application
The application by Pualani Estates involves drilling a new temporary well at approximately the 300 foot elevation above Puapuaa, Hawaii to supply 150,000 gallons of brackish water for dust control purposes during construction. There is no potential impact on surface water habitats.
Well No. 4026-07, Well Name Wailea Well 6A, Pump Installation Application
The application by Wailea Resort Company involves installing a larger pump than was originally permitted. The original permit was for a pumping rate of 350 gallons of brackish water per minute. Up to 500 gallons per minute is needed. The well is located near sea level in the vicnity of Makena, MauL We have no objections.
Well No. 5439-02, Well Name Wahikuli No.2, Pump Installation Application
The application by Housing Finance and Development Corporation involves installing a new pump in a well at approximately the 1,200 foot elevation above Mala, west Maui to deliver 600,000 gallons of water per day for municipal use. We have no objections.
Well No. 1120-20, Well Name Moloaa-Anderson, Well and Pump Application
The applicatio by Mark Anderson involves drilling a new well at approximately 200 feet in elevation abov Moloaa Bay, Kauai to deliver 3,000 gallons per day for domestic use. We have no objection
Well No. 1120-21, ell Name Moloaa-Miller, Well and Pump Application
The applicatio by John Miller involves drilling a new well near sea level above Moloaa
Bay, Kauai to deliver approximately 300 gallons of water per day for agricultural purposes. We have no objections.
Well No. 5824-05, W II Name Puhi No.5, Well Construction Application
The application by the Department of Water, County of Kauai involves drilling a new experimental well abo Puhi, Kauai to supply potable water for municipal use. The proposed wi ttljrawal rate will b determined after the well is operational. We have no objections.
JOHNWAIHEE GOVERNOR OF HAWAM
JJN 17 1994
REF:WRM-KY
TO:
.'
STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES
OMMISSION ON WATER RESOURCE MANAGEMENT
P.O. BOX 621
HONOlULU, HAW"" 968011
Honorab e Hoaliku L. Drake, Director Departm nt of Hawaiian Home Lands
~r. CIa on H.W. Hee, Chairman & Trustee At Large Office of Hawaiian Mfairs
FROM: ~ith W. Ahue. Chairperson~ SUBJECT: Well Co struction & Pum Installation Permit A lications
KEITH W. AHUE CHAIRPERSON
JOHN C. LEWIN. M.D. ROBERT S. NAKATA
J. DOUGLAS ING. ESQ. ROBERT G. GIRALD
DAVID NOBRtGA
RAE M. LOUt, P.E. DEPUTY
Please review t e following permit aPRlications pursuant to your area of concern and submit your comments to us by JUL I I 1994 .
Island Well No. Application Type
Hawaii 3758-02 Well and Pump Maui 4026-07 Pump Installation Maui 5439-02 Pump Installation
vKauai Moloaa- 1120-20 Well and Pump Kauai Moloaa- 1120-21 Well and Pump Kauai Puhi No. 5824-08 Well Construction
Should you hav any questions please contact the Commission on Water Resource Management staff at 5 7-0225.
JZ:ky Enc.
~:tponse: ~ We have no objecti ns ( J Not subject to our egulatory authority & permit ( ) Comments attache ( ) Additional informa ion requested ( ) Extended review p riod requested
Contact Person: ~ __ -+ ________________ ~ __________ __
LJ:~--7--tJ Signed: _-!---,o':........=....::...::--.:--+---------..L-------
Phone: 694_ / 73r
Date: CJe-Pd- )79-'"
JOHNWAIHEE GOVERNOR OF HAWAH
STATE OF HAWAII
KEITH W. AHUE CHAIRPERSON
JOHN C. LEWIN, M.D. ROBERT S. NAKATA
J. DOUGLAS lNG, ESQ.
DEPARTMENT OF LAND AND NATURAL RESOURCES
OMMISSION ON WATER RESOURCE MANAGEMENT
ROBERT G. GIRALODAVID NO~RIGA
P.O. BOX 621
HONOLULU. HAWAII 96809
RAE M. LOUI, P.E.
Ms. Marjorie Ziegler Sierra Club Legal Defe e Fund, Inc. 223 South King Street, uite 400 Honolulu, Hawaii 9681
Dear Ms. Ziegler:
JUi~ 17 1994
Well onstruction and Pum Installation Pennit A lications
Please review th following p.<:l11lit apJ2.lications pursuant to your area of concern and submit your comments t us by JUL I I 1894 .
Island Well Nan e Well No. AQQlication Type
Hawaii Pualanl E tates 3758-02 Well and Pump Maui Wailea W ll6A 4026-07 Pump Installation Maui Wahikuli No.2 5439-02 Pump Installation Kauai Moloaa- derson 1120-20 Well and Pump Kauai Molo~a- iller 1120-21 Well and Pump Kauai Puhi No. 5824-08 Well Construction
Should you have any questions, please contact the Commission on Water Resource Management staff at 58 -0225.
Sincerely,
~~ JZ:ky Ene.
Response:
Deputy Director
( ) We have no objectio s ( ) Not subject to our regulatory authority & permit ( ) Comments attached ( ) Additional infonnati n requested ( ) Extended review per od requested
Contact Person: ---4-------------------
Signed: -------t--------------
Phone: _________ _
Date: ___________ _
DEPUTY
JOHNWAIHEE KEITH W. AHUE CHAIRPERSON GOVERNOR OF HAWAII ,
JOHN C. LEWIN. M.D. ROBERT S. NAKATA
STATE OF HAWAII J. DOUGLAS lNG, ESQ.
DEPARTMENT OF LAND AND NATURAL RESOURCES
OMMISSION ON WATER RESOURCE MANAGEMENT
ROBERT G. GIRAlD DAVID NOBRIGA
P.O. BOX 621
HONOlULU. HAWAll 96809
RAE M. LOUI, P.E.
Mr. Thomas Arizurni, C 'ef Environmental Manage ent Division State Department of He Ith Five Waterfront Plaza 500 Ala Moana Blvd., Site 250 Honolulu, Hawaii 9681 .
Attn: Mr. Dennis Tula
Dear Mr. Arizurni:
Well onstruction and Pum Installation Permit A lications
Please review th following pgpnit apQlications pursuant to your area of concern and submit your comrnellts t us by JUL I I 1894 .
Island Well Na e Well No. Am2lication TYQe
Hawaii Pualani E tates 3758-02 Well and Pump Maui Wailea W ll6A 4026-07 Pump Installation Maui Wahikuli o. 2 5439-02 Pump Installation Kauai Moloaa- derson 1120-20 Well and Pump Kauai Moloaa- iller 1120-21 Well and Pump Kauai Puhi No. 5824-08 Well Construction
Should you have any questions, please contact the Commission on Water Resource Management staff at 58 -0225.
Sincerely,
~~ JZ:ky Ene.
Response:
Deputy Director
( ) We have no objectio s ( ) Not subject to our re ulatory authority & permit ( ) Comments attach~d ( ) Additional inforrnqti n requested ( ) Extended review pe 'ad requested
Contact Person: -------r---------------------------Signed: ____________ +-______________________ ___
Phone: ____________ _
Date: ______________ __
DEPUTY
JOHNWAIHEE GOVERNOR OF HAWAII
STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES
KEITH W. AHUE CHAJRPERSON
JOHN C. LEWIN. M.D. ROBERT S. NAKATA
J. DOUGLAS lNG, ESa. ROBERT G. GIRALD
DAVID NOBRIGA
C MMISSION ON WATER RESOURCE MANAGEMENT
P.O. BOX 621
HONOlULU, HAWAll 96809
RAE M. LOUI, P.E.
Mr. Thomas Arizumi, Chi f Environmental Managem nt Division State Department of Heal h Five Waterfront Plaza., 500 Ala Moana Blvd., Su' e 250 Honolulu, Hawaii 96813 .
Attn: Mr. William Wong
Dear Mr. Arizumi:
JUN 1 7 1994
Well Co struction and Pum Installation Permit A lications
Please review the f llowing p.~mit apQlications pursuant to your area of concern and submit your comments to s by JUL I I 1894 .
Island Well Name Well No. Am2lication T:we
Hawaii Pualani Est tes 3758-02 Well and Pump Maui Wailea We 6A 4026-07 Pump Installation Maui Wahikuli N .2 5439-02 Pump Installation Kauai Moloaa-An erson 1120-20 Well and Pump Kauai Moloaa-Mil er 1120-21 Well and Pump Kauai Puhi No.5 5824-08 Well Construction
Should you have a y questions, please contact the Commission on Water Resource Management staff at 587- 225.
Sincerely,
~~ JZ:ky Ene.
Response: ( ) We have no objections
. Deputy Director
( ) Not subject to 0\Jr re latory authority & permit ( ) Comments attached ( ) Additional infonmition requested ( ) Extended review perio requested
Contact Person: -------4--------------------------Signed: _____________ +-____________________ ___
Phone: ------------
Date: _____________ __
DEPUTY
JOHNWAIHEE GOVERNOR OF HAWAII
JJN 1 7 1994
REF:WRM-KY
TO:
STATE OF HAWAII DEPARTMENT OF LAND AND NATURAL RESOURCES
COMMISSION ON WATER RESOURCE MANAGEMENT
P.O. BOX 621
HONOLULU, HAWAII 06809
Honorable Hoaliku L. Drake, Director Department of Hawaiian Home Lands
'f
Mr. Clayton H.W. Hee, Chairman & Trustee At Large Office of Hawaiian Affairs
FROM: ~ith W. Ahue, Chairperson~ . SUBJECT: Well Construction & Pump Installation Permit Applications
KEITH W. liHUE CHAIRPERSON
JOHN C. LEWIN, M.D. ROBERT S. NAKATA
J. DOUGLAS lNG, ESQ. ROBERT G. GIRALD
DAVID NOBRIGA
RAE M. LOUI, P.E. DEPUTY
Please review the following permit applications pursuant to your area of concern and submit your comments to us by JUL 1 1 1994 .
Island Well Name Well No. Application Type
Hawaii Pualani Estates 3758-02 Well and Pump Maui Wailea Well 6A 4026-07 Pump Installation Maui Wahikuli No.2 5439-02 Pump Installation Kauai Moloaa-Anderson 1120-20 Well and Pump Kauai Moloaa-Miller 1120-21 Well and Pump Kauai Puhi No.5 5824-08 Well Construction
Should you have any questions please contact the Commission on Water Resource Management staff at 587-0225.
JZ:ky Ene.
Response: ( ) We have no objections ( ) Not subject to our regulatory authority & permit ( ) Comments attached ( ) Additional information requested ( ) Extended review period requested
Contact Person: ____________________________________ _
Signed: ______________________________________ __
Phone: ____________ __
Date: _____________ _
State of Hawaii DEPARTMENT OF LAND AND NATURAL RESOURCES
Commission on Water Resource Management Honolulu, Hawaii
JUN 11 1994
TO: Dr. Don Hibbard, Director Historic Preservation Program
Mr. Henry M. Sakuda, Administrator Division of Aquatic Resources
FROM: Rae M. Loui, Deputy Directo~ Commission on Water Resou\ce Management
SUBJECT: Well Construction & Pump Installation Permit Applications
Please review the following permit applications pursuant to your area of concern and submit your comments to us by .nn 1 I 1994
Island Well Name Well No. Application Type
Hawaii Pualani Estates 3758-02 Well and Pump Maui Wailea Well 6A 4026-07 Pump Installation Maui Wahikuli No.2 5439-02 Pump Installation Kauai Moloaa-Anderson 1120-20 Well and Pump Kauai Moloaa-Miller 1120-21 Well and Pump Kauai Puhi No.5 5824-08 Well Construction
Should you have any questions please contact the Commission on Water Resource Management staff at 587-0225.
JZ:ky Ene.
Response: ( ) We have no objections ( ) Not subject to our regulatory authority & permit ( ) Comments attached ( ) Additional information requested ( ) Extended review period requested
Contact Person: ________________ _
Signed: _____________________________________ __
Phone: _________ __
Date: _____________ _
·,-.....
JOHNWAIHEE
OOVE~NOA OF HAWAII KEITH W. AHUE
CHAIRPERSON
STATE OF HAWAII
JOHN C. LEWIN, M.D. ROBERT S. NAKATA
J. DOUGLAS lNG, ESQ.
DEPARTMENT OF LAND AND NATURAL RESOURCES
COMMISSION ON WATER RESOURCE MANAGEMENT
ROBERT G. GIRALD DAVID NOBRIGA
P.O.80X621
HONOLULU, HAWAIIIlS800
RAE M. LOU I, P.E.
Mr. Mud T. Nielsen Department of Water County of Kauai 4398 Pualoke Street Lihue, HI 96766
Dear Mr. Nielsen:
JUN 1 7 1994
Well Construction and Pump Installation Permit Applications
Please review the following n,E;,fmit aP.12lications pursuant to your area of concern and submit your comments to us by JUL 1 I 1894 . , .
Island Well Name . Well No. Application Type
Hawaii Pualani Estates 3758-02 Well and Pump Maui Wailea Well 6A 4026-07 Pump Installation Maui Wahikuli No.2 5439-02 Pump Installation Kauai Moloa'h-Anderson 1120-20 Well and Pump Kauai Moloaa-Miller 1120-21 Well and Pump Kauai Puhi No.5 5824-08 Well Construction
Should you have any questions, please contact the COnmllssion on Water Resource Management staff at 587-0225.
Sincerely,
Md1J1~ ;: ~~ :OUI
JZ:ky Enc.
Response: ( ) We have no objections
Deputy Director
( ) Not subject to our regulatory authority & permit ( ) Comments attached ( ) Additional information requested ( ) Extended review period requested
Contact Person: ----~------------------------------
Signed: ______________________________________ ___
Phone: ____________ _
Date: _____________ _
DEPUTY
JOHNWAIHEE GOVERNOR OF HAWA'I
KEITH W. AHUE CHAIRPERSON
JOHN C. LEWIN, M.D. ROBERT S. NAKATA
STATE OF HAWAII J. DOUGLAS lNG, ESQ.
DEPARTMENT OF LAND AND NATURAL RESOURCES
COMMISSION ON WATER RESOURCE MANAGEMENT
Mr. Mark Anderson P.O. Box 307 Kilauea, Hawaii 96754
Dear Mr. Anderson:
P.O. BOX 621
HONOlULU. HAWAII 96809
JUN I 7 1994
We have received your application and filing fee for a permit to construct and install a pump in Moloaa-Anderson Well (Well No. 1120-20) at Moloaa, Kauai, (TMK 4-9-11: 16). We are reviewing the application for completeness.
Should you have questions please call the Commission on Water Resource Management staff at 587-0225.
Sincerely,
Deputy Director
JZ:ky
ROBERT G. GIRALD DAVID NOBRIGA
RAE M. LOUI, P.E. DEPUTY
~. .~
~ate of Hawaii ...., COMMISSION ON WATER RESOURCE MANAGEMENT Department of Land and Natural Resources
APPLICATION FOR PERMIT RI Well Construction or 0 Pump Installation
''',-''::0;:. ':'. "., .. ' '.' .\
Instructions: Please print in ink or type and send completed application with sttachments to the Commissionon Water ~Source Manlgement P.O. Box 621, Honolulu, Hawaii~. Application mu~ be accompani~d ~y a non-refundable filing fee of $25.00 pay,able to ~ Dept. of, ~d and Natural Resources. The Commission may not accept Incomplete applications. For assistance, call the Regulation Bianch a2!'-022S:. ')
.. 1. APPUCANT: (may be a, b, or c, but.B!! must be filled In) . \ "
(a) WELL OWNER Firm/Name 1'-\0\,1:- ~ e,~i5'J'. Contact Person "S'6-N\.G: ptl'
Addre.. i;7~!:: Ji? otG.JS-4
2. WELL LOCATION/NAME: Mo\()Q-o- -J 6l,\eNJ Address \LbO \ G\.V\ Q d. r'\o\u~""
Island \Lo..\J\<i,.: Tax Map Key 44-9--11 -l~ ,
(Attach a USGS map, scale 1""'2OOO',and a property tax map showing well location referenced to ,established property boundaries.)
3. (a) PROPOSED WORK: (J Drill New Well 0 * Alter Location
o Modify existing Well 0 Redrill 0 Deepen 0 * Abandon/Seal
o Install New Pump 0 Replace Pump 0 Modify Pump * Be sure to complete and submit well abandonment report upon completion of work.
(b) WELL TYPE: o Dug 0 Bored 0 Driven (iJ Drilled 0 Radial
Is this well a part of a battery of wells? 0 Ve. liD No (Briefly describe and fill In the diagram on the back of thl. form.)
4. PROPOSED PUMP INFORMATION: Rated Pump Capacity:_--=-/..;::3 _____ gallons per mim.le
5.
Pump Type:
o Deep Well Turbine
iJ Submersible o Centrifugal
PROPOSED USE:
o Rotary o Propeller
o Rotary-Oisplaeement o Reciprocating
o Rotary-Gear o Impulse
o Municipal Qndudlng hotel., store., etc.}
iii Domeatlc Qndlvldual, noncommercial water .ya., o irrigation (crop)
Motor: o OIe .. 1 OQas IJ Bectric, rated horsepower of ____ _
o Military
o industrial
o Other (explain)
State Land Use OIstrlct: o Urban lSI Agriculture a Rural 0 Con .. rvation
A%- 0fC2'i\ County Zoning (describe) (If more apace is needed, continue below under remarks, explanations.)
6. (a) PROPOSED AMOUNT OF WITHDRAWAL: _-:3:::...D_ O_D __ _ gallons per day
o open-pipe o Orfflce Plate OWeiI (b) METHOD OF FLOW MEASUREMENT: II Flow-meter
7. PENDING ACTIONS: OCDUA o SMA OEIS OEA (ig NONE o Other(uplaln)
8. REMARKS, EXPLANATIONS: ----------------------
(If more apace is needed, conUnue on tMIck)
Non:: Siontng below indicates that the applicant understands that. If the permit requested Is granted b)' tile Cornmlsslun 00 Water Resource Ma."IQgemer:t. the proposed work Is to be complet withln two (2) years of the approll8l date. In addition, the contractor shall submit to the ComDllsslon a __ completion report. well abandonment report. or both, within 30 da),s etter I completion date of the permitted work. The applicant elso understands that monthly water use data shelf be submitted to the CommiSSion. The applicant further understands that IQC)I'01l8l the proposed permit shell not constitute a determination of correlative water rtghts and shelf not guarantee the pump capacity or future use up to the permitted pump capacity.
Well Owner ""'~'("'k "A'l\d-e.'f'~1S'-. Landowner fv\.,.v~ tt1¥\ J €tff\~ Contractor 1'12. \k'\\1 iv<:j Go ( $ .r~<:.
Signature ~.J.. (1.,j~ Signatur. ~ ~ Signatur. ~ e.9~~7 Date :,>/14/5. 4 Date '3 / Ij 1 '"t'-\ Date 3,"7 -
For Official Uae Only: Date Received ______ _
Date Accepted ______ _
Field Checked By _____ _ Date _________ _
Longitude _____ _
latitude
Aquifer System Narne _______ _ State WeM No, _______ _
6/24192 wePl F(
Remarks, Explainations (cont'd):
Elevlllon at top of casing fl, mal.
I Cement Grout: 2LJ It.
(
Rock Packing 2 ~o It.
Hole Diameter: In.
Total Depth 2 <;0 It.
9. PROPOSED WELL SECTION
~
-r-
II
"
=
..J .... ..... •
,
2" ...
I L .. I I~
-'0, I I III"'"
'-- r-
JIIII. .....
L--~
... Ground Elevation: Zpt) ft., msI*
Solid CUing: Material p u <=-Length 2 0-0 Diameter 4 / I Wall fl\lcl<~~ __ 5..c l/ '/0
ft. in. in.
Casing: 0 Perforated ~ Screen Material __ p,-,tJ,,--C~,-;;-________ --:-Length ___ ....... ~,-,O""--_______ ft. Diameter t-/ 'f in. Wall thickness r C:cA L/P in. Openings .. 020 s4$ sq. in'/LF.
Open Hole: Length Al ~ ft. Diameter _____________ in.
*Approximate elevation at time of filing application. Ground elevation above mean sea level (msl) by a surveyor licensed by the State must be submlned at start of construction. Final elevations of well components shall be submined in the well completion/well abandonment reports.
lJ l' 'I! I
c CHECKLIST
~ell Construction Permit
_water Use Permit Required Also
cu JlA.;l~ I~ li f c,{,-[~
Installation Permit
Well Name & Number~~o~q011jl\t1ph- (([7 c - 7 0) Island K~ Applicant Mg,fy'k ~:4flCy6~ Landowner_c~l,,-~-,-,#U.--~,,--_____ _
Consul tant TR'V y; lll'1
Date application received ....••.....•..•.•••.•. ~?i v Date acknowledged receipt/request more info .... . ,.~7'l~~ / Datefilingfeedeposited......................... ~
. 7lU-vh.<M
sent 7olication sent to/following.~J L Date [II'So..fe. Dri\'\.kil'lj wtllb- 8ra.Ylc.h
Dept. of Heal thh-~ + ____ _ \/Office of Hawaiia~aJit¥1\Tr~rt.y')th ~Dept. of Hawaiian Horne Lands
V state Historic Preservation Div.
v/sierra Club Legal Defense Fund
Honolulu goara of-Water Supp~
Maui Dept. of HatQr Supply
v Kauai Dept. of water Supply
Hawaii :5ept. of wciLer Supply
Hawaii nept. of Public Horlt-s
-Koolaulea IH~ #2B (Oaha)
Additional List (MOiok~) Erio Hirano/ Lyann MiBuno
V'PIV. OF AQUA1'1 c... Rf: S.
0;·, ~"" Comments recei ved ~.f "'-'£'
;; ,
-------_ ...........
b/ dvtl'l
D ate agenda due................................... --+tfrr-;"""'$=f'-/":"""O' {'--T' _
Date submittal due ................................ __ ~~~~~= __ ~_~{_t~ __ Date submittal sent to applicant ................... _---=-_-:-----:::;---:-__
18 !if, f,&S'JUA9,/ Date application _ approved OR _ disapproved ... .
Date applicant notified of decision .............. . ---------
Remarks: -----------------------------
ult{p"- tJ\Il-F,Il.-SSljh- wel( Y\..o. ('Pev\(.,.·ll I'~ INDEX/5UI1HYlA-(2.Y)
L.o~ I'''' \o'\hook (rr.a.KUa.O ,AI/fcH I ... n ,'v,. t..6MoL41tr(WtLL PER-MIT<;) /f1!(ct/
o State of Hawaii COMMISSION ON WATER RESOURCE MANAGEMENT Department of Land and Natural Resources
APPLICATION FOR PERMIT' '";;;, ~Y,";'~,',: ';:~i Rl Well Construction, ,or 0 Pump Installation;;:': " ' }
".' ,","" r····'· \ \'\ Instructions: Please print In !~k or type an~ send completed application with attachments to the Commission on Water ~source Man~ e P.O. Box 621, Honolulu, Hawall~, Application mu~tbe accompanied by a non-fefundable IIIlngf88 of $25,00 a able to De t ,:g ment, Natural Resources. The Commission may not accept Incomplete applications. For assistance, call the Regulatio~ Jranch a~.t22~~,~d and
1. ,1 '~:"::., APPUCANT: (may be a, b, or c, but.a!J must be filled In) \ .,.:,
.. (a) WELL OWNER (b) LANDOWNER ' .. "" i ::~ Rrm/Name {V\G\,1:- AM~lN' Rrm/Name U',./\"Q.(l Av'"lJe",>o-.... Contact Person ,,!>o.-t'V\.(.r Ph' ContactPeraon 3cA1C"-$J Address 12; t). ~:= J ';>? Address _B:o.:-""', ~gF"'o'"7v..~3:-tJ-=/::::-----.t ::
-- I~f~ _, _ OJ(;J ,;4 K. \o-\A.et:.. J l4 ~ \ q(.)~ If
Contractor's C-57 Ucense No L- q ~ ).{
2. WELL LOCATION/NAME: Mo\ ()o..C'r-.. V 0.1 \e&) Island \L.o..~ : Address k..<.> l) \ (.W\ Q d J 1'\ u \uo..o., Tax Map Key q 4 - 9 -' it _ I ~ (Attach a USGS map, scale l"=2000',and a property tax map showing well location referenced to ,established property boundaries.)
3. (a) PROPOSED WORK: iii Drill New Well 0 * Alter location
o Modify existing Well 0 Redrlll 0 Deepen 0 * Abandon/Seal
o Install New Pump 0 Replace Pump 0 Modify Pump
* Be sure to complete and submit well abandonment report upon completion of work.
(b) WELL TYPE: o Dug 0 Bored 0 Driven 141 Drilled 0 Radial
Is this well a part of a battery of wells? 0 YII m No (Briefly describe and fill In the diagram on the back of thl. form.)
4. PROPOSED PUMP INFORMATION: Rated Pump Capacity: _~I ~3*-____ gallons per minute
5.
Pump Type:
o Deep Well Turbine
'" Submerslble
o Centrifugal
PROPOSED USE:
o Rotary o Propeller
o Rotary-Displacement o Reciprocating
o Rotary-Gear o Impulse
o Municipal Qncludlng hot.,., I1or •• , etc.}
Ii1 Domestic Qndlvldual, noncomm.rclal water 'V'.) o Irrigation (crop)
Motor:
DOle .. ' Dau 13 8ectrlc, rated horsepower of ____ _
o Military o industrial
o Other (explain) State Land U.. District: o Urban iii ~rlcul1ure 0 Rural 0 Con_rvatlon
A%- 0V~f\ County Zoning (describe) (If more space Is needed, conUnue below under remarks, explanations.)
6. (a) PROPOSED AMOUNT OF WITHDRAWAL: 3 DOD
(b) METHOD OF FLOW MEASUREMENT: iI Flow-meter gallons per day o Open-pipe 0 Orftlce Plate o Weir
7. PENDING ACTIONS: DCDUA DSMA DEIS DEA IZJ NONE D Other(explaln)
8. REMARKS, EXPLANATIONS: _______________________ _
(If more space Is needed, conUnue on beck)
~on:: Signtng below indicates that the applicant understands lnat, If the permit requested Is granled by Ule Cornmlsllon (JIl Water RIIOUfC:t Mallagemer:t, the proposed work Is to be complel Yithln two (2) yea,. 01 tha approval date, In addition, tna contractOl' shill .ubmlt to tn. ~om,"llilon a weI complltlon r.port, Will abandonm.nt report, 01' both, within JO days liter I
:ompletJon date of the permitted work. The applicant allO understands thlt monthly water use data shill b. submitted to the Com million. Th. applicant lurthlr understands that apprOYf< he proposed permit shall not constitute a determlnatJon of correlative water rights and shall not guarani .. the pump capaclty 01' Mure use up to the permitted pump capacity.
Well Owner fV\o-..c-\:. 'A'{\,de..'f'~0-... Landowner r'VltV'k ~y\ de;-rl;~ Contractor 1'~ \)c-"\\irej C,,! I !'fl'-
Signeture '0.A.J. £1,.,.1,"",-= Signature ~ ~ SI;na::~ Date ?>/I~ Itty Dale 3/1j I'tLj Date d~_
For Official U98 Only: Dale Received ______ _ Dale ACcepled ______ _ Field Checked By _____ _ Longitude _____ _ Aquifer System Name _______ _ Dale _________ _ Latitude Stale Well No, _______ _
6f24m WCPI FI
Remarks. Explainatlons (conrd):
Elevation at top of casing ft, mal.
I Cement Grout: 2LJ ft
2 7 /\(ft. Rock Packing __ j(../ __
Hole Diameter: In.
Total Depth 2 S; V ft.
9. PROPOSED WELL SECTION
,.....
_III •
;] -
• ... .... ,
2// ,....
I ... I I~
... I I ... '-- r-
.... ....
'---'--
.. ;
Ground Elevation: 2IJiJ ft., msI*
SoUd Casing:
Material p L1 C-Length 2.. 0-0 ft. Diameter 4 II In. WIIJI tt>It.:Itr\09!t9 __ 5..iL-/L_r~O _____ In.
Casing: D Perforated !Sf Screen Material p V L Length «;'0 Diameter ?f " Wall thickness 'rcA c../P Openings .. 020 sldti sq. in.lLF.
Open Hole:
ft. in.
in.
Length Al ~ ft. Diameter _____________ in.
*Appro)(lmate elevation at time of filing application. Ground elevation above mean sea level (msl) by a surveyor licensed by the State must be submitted at start of construction. Final elevations of well components shall be submined In the well completlon/well abandonment reports.
o