Transcription

4; c""1' . I" IP'-------''5/Jil--'.; ,,,. -.I.ijKAPAA ,.::SCALEI ::::: ::--IN NIL(ISLAND OF KAUAI. . 1L "--- '-TA'-Tv,. . . . .'\I.,.,. \ ,'\,

cCHECKLIST ellConstruction Permitwater Use Permit Required AlsoPump Installation Permittilt! IAUl- kPG][[(12? 5 - tJ3) Island /(O"uAiAPplicant ldM. rrrfe5 { G I '. Landowner .;;;;;S :.-Cons u 1 tan t ilL J i) iJu).atI 11A.I 2 - a -(Well Name & NumberDate application received . . . . . /2 l9f,v . Date acknowledged receiPt/c.r!qm st-mo c f. vn r/: l, / V Date filing feedeposited. . . . . . .nV"Application sent to following. J L B Date sent. {So.fe Dr',nkir'lj wIl1tr rartc.hDept. of Health L f. Wa. .f fo.l .Y' BI"ltVl :hOfflce 0 Hawallan Atlalrsr(. ' ;.::: l:-Comments receivedDept. of Hawaiian Home Landsstate Historic Preservation Div.Sierra Club Legal Defense FundKauai Dept. of Water SupplyErio Hiranol Lyann MisunoplY. OF AQU.A11 RlE .Date agenda due . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Date submittal due . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Date submittal sent to applicant . . .Date application approved ORdisapproved. .LjZA;1l;;/ItDate applicant notified of decision . . . . --'-('Pe 0·1.1 IV\. IND X/5L.O'tlMA-YLV)Jtt'/It'l.I1CLL.o t·y. lo hook ( a.r.ua.1) ;1(/((/;!- / '!: \iL! Ci " ' . "./1")0. l CAiMP!-l1e.r(Wt LL PER. MI 7 S )/-{/, (/I jV\;,t·-,Lil{itJ\a"p , a.SSljl' -weI(Vlo.

Page 1 of 1Search ResultsAssessed Values reflect tax year 2008.Search criteria: TMK Taxkey 4-5-2-17-28 Taxkeyr.4-5-2-17-28Subdiv /CondoKalihiwai RidgeTnr AddressF005-2723 KUHIO HWYPUBLIC RECORD DATAOwner /LesseeANAINA HOU LANDBds Bthso0Land area Liv area15.17 ac0Last Sale Instr10/8/2007 DEEDPrice 2,517,200This information has been supplied by third parties and has not been independently verified by Hawaii Information Service and is, therefore, notuaranteed.Copyright 7/16/2008 by Hawaii Information rchfHIS/Searchisearch PUB.asp?NOCACHE 121623 37966257/16/2008

Search Resultso 0Page 1 of2PUBLIC RECORD DATA. TMK # 4-5-2-17-28005-2723 KUHIO HWYOwner: ANAINA HOU LANDTax Payer: ANAINA HOU LAND LLCTenure: Fee SimpleTax Bill: 3770 PUNAHELE RD, PRINCEVILLE, HI 96722 USAAnnual Tax: 17,368.68Assessed Value ExemptionSizeBuildings: 0Zoning: I-LLand: 2,517,200 0 15.17 acDwellings: 0PITT Code: 400 - IndustrialTotal Buildings: 0 00 sq ftSubdivision: Kalihiwai Ridge Land Use:Total: 2,517,200 0Project:Census Tract: 401.00Lot#: 13-A-1-ABedrooms/Baths: 0/0SALES 1,240,800 DOC 90-1148097/27/1990 QDKUNTER KLAUS IDBA: KAUAI PROFESSIONAL EXCHNG7/27/1990 QDQUARTON GARDNER C JR 1,240,800 DOC 90-1148109/19/1990 QDQUARTON GARDNER C JRKUNTER KLAUS I 650,000 DOC 90-144523 320,000 DOC 91-093925DEED-FKAUAIPROFESSIONALEXCHANGE 320,000 DOC 91-0939267/12/1991 DEED-FKRUEGER LESTER E/BETTY L 100,000 DOC 91-14076210/16/1991 DEEDVANDERWILDE ROBERT D*(2% INT)* 2,000 DOC 92-0446083/27/1992 DEED-FKUNTER KLAUS*(1/2 INT)* 428,760 DOC 92-0446093/27/1992 DEED-FFERRY JOHN C REVOC LIV TR*(15% INT)* 714,160 DOC 92-0746685/13/1992 DEED-FFERRY JOHN C*(10% INT)* 357,080 DOC 92-0746695/13/1992 DEED-FFERRY JOHN C REVOC LIV TR*(5% INT)* 0 DOC 92-0809765/22/1992 QDKUNTER KLAUS I REVOC LIV TR 100,000 DOC 92-18398911/13/1992 DEED-FQUARTON GARDNER C JR*(2% INT)* 300,000 DOC 92-18399011/13/1992 DEED-FQUARTON GARDNER C JR*(6% INT)* 250,000 DOC 92-18399111/13/1992 QD-FKUNTER KLAUS I*(5% INT)* 1,581,000 DOC 97-0094931/21/1997 COMMDLOT 13A1A 15.17 ACREAL ESTATE DELIVERY INC, A Company or Corporation*A HAWAII CORPORATION12/29/2000 DEED 1,125,000 DOC com!REsearchIHIS/Search!search PUB.asp?SRC LNK& . 7/11/2008

Page 2 of2Search ResultsFOSTER, CYNTHIA C6/6/2006DEED-X 2,700,000 DOC 06-104804EXCHANGE ACCOMMODATORS INC, A Company or CorporationBOC10/13/2006 DEED 2,700,000 DOC 06-187316PORTER, WILLIAM A, Trustee(Revocable Trust)PORTER, M JOAN, Trustee(Revocable Trust)*THE PORTER REVOCABLE TRUST DATED AUGUST 15,*1998, WITH FULL POWERSBOC10/8/2007BOCDEED 2,517,200 DOC 07-178009ANAINA HOU LAND LLC, A Company or Corporation(Tenants inSeveralty)This information has been supplied by third parties and has not been independently verified by HawaiiInformation Service and is therefore not uaranteed.Copyright 7/ 11/2008 by Hawaii Information hIHIS/Searchlsearch PUB.asp?SRC LNK&. 7/11/2008

o. .,oR-310uRJIfJ CESRECORDEDB001 OS, 200708:01 AMDoC No{S) 2007.178009JF : CESlsi CARl.(SO): 7561.60Retmn by Mail ( ) Pickup ( ) To:-m: 2oo142bbOATu Map Key: (4) S-2-017-028TRUSTEE'SLIMITED WAJtRANTY DEED1 / /WILLIAM A. PORTER aad M. JOAN PORTER, Co-1'nutees of the PorterRevocable Trust dated AIIpst l5, 1998, with full powas to sen, mortgage. lease or otherwisedeal with the land, whose address is 3770 Punahele Road, Princeville, Hawaii 96722, hereinaftercalled the "Grantors", in consideration of the sum of Ten Dollars lO.OO) and other valuableoonsideralion to the Grantors paid by ANAINA BOU LANDt LLC{a Dela)wre limited liabilityoompany. whose address is 3770 Puoahele Road, Princeville, Hawaii 96722,1tereinafter called the"Grantee", the receipt of which is hereby acknowledged. do hereby grant, bargain, sell and conveyunto the Grantee as tenant in severalty and the Granteers successors and assigns:ALL of tbat certain parcel of land situated at KaIibiwa1 and NomaJvma,IHanal Island and· County of Kauai, State of Hawaii, more fully described inExhibit "A" attached hereto and made a part hereof: subject, however9 to theencumbrances mentioned in said Exhibit nA";AND the reversions, remainders, IeD1s, issues and profits tbereot together with allim.provcmcnts, teIlcInCntst rights, casement!, privileges and appurtenances to the samebelonging or appertaining or held and enjoyed therewith. and all of the ri ·1itle andinterest ofthe Omotors both at law and in equity theIein and 1hereto;bui1 TO HAVBTO HOLD the same UDlo the Grantee, as tenant inaforesaid, fonwer, subject to the encumbranoes mentioned in said Exhibit "A";se as

".,""'""1,,1111AND the Grantors, for themselves and their successors in trust, hereby covenantwith the Grantee and the Grantee's successors and assigns, that the Grantors have good right togrant and convey said land and premises unto the Orantee as aforesaid and that the same are freeand clear of and from all encumbrances made or suffered by the Grantors.This instrument may be executed in counterparts, each of which shall be deemed anori and said COlmterparts shall together mnstitutc one and the s8.mc agremnent, binding all ofthe pmties hereto, notwithstanding all of the parties are not signatmy to the original or the samecounterparts. For all purposes, including, without limitation, recordation, filing and delivery of thisinstrument, duplicate unexecuted and lmaclmowledged pages of the counterparts may be discardedand the remaining pages assembled as one documentof . the Orantors have executed this instrument thislCfdayCo-Trustees of the Porter Revocable Trust datedAugust 15t 1998TmnR''7 1I2

/I".CHECKLIST ellConstruction Permitwater Use Permit Required AlsoWell Name & NumberApplicant YMConsultant VlkJ(i klAW- - kPG]IPump Installation Permitl ( ::: 5 -(J )K'aMAA-IslandPrrt; l G I / "Landowner---- S :.:. fA k2 - .utl Date application received. /2 /9i,a k owledged re eipt/([ quest !no c l""" fM('DateDate f 111ng fee depos 1 ted. . . . . . . . . . Application sent to following. J, {SAfeDept. of Health B Date sentL Wd 1t1(,Y'Offlce of Hawallan1Dr'.n.kit\jllVlllUd', ',: Comments receivedI-a""hBhtVlt-h rfalrsDept. of Hawaiian Home Landsstate Historic Preservation Div.Sierra Club Legal Defense FundKauai Dept. of Water SupplyErio Hirano/ Lyann MieunoDIV. OF AQUAtI c. Rf:: S.Date agenda due . . . . ----------Date submittal due . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Date submittal sent to applicant Date application approved OR disapproved. .Date applicant notified of decision Remarks :2-7Ar i/ 11---------- ------kl'- -w -&f--ff-----CJ7 / t Ji z z ".J.71.L.-3 tv\lLp,c:tSS1 l--. wel( Vto. ('Pev\0il, ,'V\ IND X/5u »nYlA-r2.V)Jt1'/IN14-L.o t\--. lo,\hook (w\ll.Y\U/l.l) j!!t7(/A-- '.Lo I UMp(,41e.r (VVtL L PER-MITS) / II {{ t1-r'!I. J ,

STATE OF HAWAIIFor OffIcial Use Only:DEPARTMENT OF LAND AND NATURAL RESOURCES t: Crz.IVF DCOMMISSION ON WATER RESOURCE MANAGEMENTAPPLICATION FOR A WELL CONSTRUCTION IPUMP INSTALLATION PERMITJJN IB ASInstructions: Please print in ink or type and send completed application with attachments to the CommissiOn onwater Resource Management, P.O. Box 621, Honolulu, Hawaii 96809. Application must be accompanied by 10copies and a non-refundable filing fee of 25.00 payable to the Dept. of Land and Natural Resources. TheCommission may not accept incomplete applications. For assistance. call the Regulation Branch at587 226. Forfurther information and updates to this application form, visit hIIp:/Iwww.hawaii.gov/dlnr/cwrm.WOII .PhoneWOII Operator'. E-mailWell Operatol's FaxLandowner'l E- l.andowner"sFax5 mI 9 1.3 (sJ 'T/l 1! LttlttPROPOSED WELL CONSTRUCTIONPROPOSED PUMP INSTALLATION1--:o7."""P ro".posed::- ::-:Wor1 - ::-----Tfts.'Cons :::tru cIio:;;·:::n:-;T"-ype::::- l"'0".p"-rop osed "Wor1 -"l'l."P;::ro posed .,pn.u m p ing ""Ra:;te:-.""'gpm ---''-');'.M"eth od:-::;-:of""ft;:r:IN III * Af)(Ql :o Construd New Well1la0 Drilled lg';::l Install New Pump0 Replace Pump(gallons per minute).:r - .' . '. . ."" Flowmeter1-:-::-::- -':'1 7. '-.,-:-- --1 0Olher(explaln)-12. Proposed Amount of'Mthdrawal, gpd (gallons per day)O Tunnel(9. Is this well part of a battery of wells? 0 Vas 0 No14. PropOll8d Surwyor name .nd 1ic8ns. number (s surveyor Is required for all w.l1 Conatructlon Permtt.nd may be required for 801'Installation Permits)"ttlbe(.1t vm!l'ldPROPOSED USEo 15. Municipal (water systems serving greater than 25 Individuals or 15 service connections)o 16. DomesticNumber of unitS to be served:o 17. Industrial (describe)o 18. Irrigation (describe aop and no. of acres)o 19. Military (describe)IQ 20. Other (deSCribe).0 Itsa;; {t'1 trILL· " 1 Q.\.t.e.S·/·iolA "' l!'Vt m I ? PIJ.v.!a.t.I'\"I . !'. "/ 0vw.I-iCA,; , n.o . 1v.( C. MeVImOTHER LEGAL REQUIREMENTS It required, items 21. and 22 must be obtained befor8 the CommISSion can legally issue a pe21. Conservation Dlstrid Use Permit (COUP)Well is in Consarvation DlslridRequired, COUP #date approvedNot Required (attach documentation from OCCL)I have not chec:ked with OCCL about whether or not a COUP is requlred. I understand that checking with OCCL prior to making thisapplicatiOn wiD expedite my review. I further understand that issues raised by this agency may delay or reault in denial of the perm issuance, or revocation of the permft after HIs issued.Ill! Well is not in Conaervation Districto I haw not checked if wallis in or out of Conservation Oistrld. I understand that checking if the well is in a Conservation Oistrid may expedite myreview. I further understand that issues raised ma dela or resuH In denial of the rmit issuance, or revocation of theafter His issued.22. Special Management Area PefTIIH (SMAP)Required. SMA'date approvedNot Required (attach dowmentation from applicable County agency)IllI. I have not checked with the county about whether or not an SMA Perm is required. I understand that checking with the County prior to making thisapplication may expedite my review. I further understand that issues raised by this agency may delay or reauH in denial of the permit issuance, orr8llOClltion of theHafter It Is issued.23. State Historic Preservation Division (SHPD) of the Department of Land and Natural ResourcesI have consulted with the HPD regarding potential impacts of well construction actiVitias on historic sites. I have attached applicable documentationfrom the HPD.il I have not consulted with the HPO regarding potential impacts of well construction actiVitias on historic sites. I undetStand that checking with the HPDpriOr to making thIS application may expedHe my review. I further understand that issues raised by this agancy may delay or result In denial Of the. issuance. or revocation of the rmit after It is issued. Additiona the h'ofland use is attached.Additional remarles, explanatiOnS, etc. (attach additional sheet if more space is needed)oooooooNOTE: Signing below indIcateS that the signatories understand and swear that the information provided Is accurate and true to the best of their knowledga.Further, the slgnatortes understand that upon permH approval: 1) the proposed work 1 to be completed within two (2) years of the approval date; 2) thecontractor shan aubmtt to the Commission a well completion/abandonment report within 60 days after the compleUon date of the permitted work; 3) In theawn! that the application ia not completed correctly, any perm" may be suspended until the Item is brought in to compliance, and any work done while theH is in sua naion ma rasult in fines of u to 500OIda .25. PUMP INSTALLER (M . be filled aut Wapplicollon i. to Pump l.-atlon)Licensee business nameSignatureC-57 Ucense No.PrintDateVq\ltr WtH PtllIlrdV' LLc """"L tf::,-:"I'T:::-,l ----".C-S7/C-S7aJA Uoense No.:M liytlw: SOPer &·J\·oaLicen busineS8 nameSignatureft::; -V(;(1DPrintDateWCPI AppIicaUon Form 0212612007

PROPOSED WELL SECTION (Plea"" attach atic if different from diagram ptOVid8d below)Elevation at top of casingl'5Z \ft., mslO-, --L.!-Hole Diameter. in.jMinimum of 2' Radius & 4" ThICk Concrete Pad (to contain benchmarksurveyed to nearest 0.01 ft.)Ground Elevation:.'11 ft., m !O1f:iJ. .'!'ICement Grout: ft.iPlease refer to ther--------- ,--- ,(min. 70% of dIStance fromground elevation to lop ofwater surface or 500 ft.,whichewr is less.)i'o Positivedisplacemento OtherJ illapplicable standards.Solid casing: (" 90% x (Ground Elev.-Waler lewl Elev»Annular space between holeand casing (1.5" for positiwdisplacement. 3" for othermethods):Groutlng method:HAWAU WELL CONSTRUCTION ANDPUMP INSTALLATION STANDARDSto ensure that your as-built is in compliance withI---r 1Total length:Nominal Diameter:Wall Thidcness:in.Bottom Elevation:ft.q '5/jin. ilin.i'1 111., msl"Rock or Gravel Packing: ft.Open Casing:Material:0 PerforatedTotal length: -:;;- q7'"z.It.o Crushed Basa o Rounded Gravel8 in.Nominal Diameter: -"fJ,,-,", .5t.V.Wall Thldcness:Estimated Warer LevelBottom Elevation:Elevation:if:;in.'g t11., msI"nole: Neither bentDnite nor mud should be used insaturated zone during drillingj,2L1I.msl"Open Hole:ft.Length:N Diameter. in.iL .Bottom Eievation: ft., mal"" The approximate elevation must be referenced 10 mean sea level (msl)at the time of application filing. Final elevations of well components shallbe submitted in the VVeli CompletionlWell Abandonment reportS andreferenced to a benchmark which has been established by a surveyorlicensed by the State.For non-safi water Basel Wells - bottom elevation of well should not be deeper than 1/4 of aquifer thickness or,Bottom Elevation of well Umn (water Elevation 41. W", "'E!ovIl1ion )Example: Estimoled 2ft. Wslerl.evel Elev. -8evationolWeiIUm . (2- (2) -IS.St!.rbon St8e compliant with (check one or more): 0 ANSIIAVWVA C2000 API Spec. 5L0 ASTM A530 ASTM A 139[J ASTM A242 (or A606)0 Type E0 Type S0 Grade B0 Othercompliant with (chedc one or more):Stainless Steel: (chedc one):0 ASTM A409 (prroduction wells)0 ASTM A312 (monner wells)ASS PIIIStic confonning to ASTM F480 and ASTM DI527: (check one)0 Schedule 400 Schedule 80PVC Plastic conforming to ASTM F480 and (ASTM D1785 or ASTM D2241): (check one):0 Schedule 40 0 Schedule 80 0 Schedule 120ThannoIIet Plastic: (chedc one)0 Rlament Wound Resin Pipe conforming to ASTM D2996o Centrifugally cast Resin Pipe conforming to ASTM 02997o Reinforced Plastic Mortar: Pressure Pipe conforming to ASTM D3517o Glass Fiber Reinforced Resin Pressure Pipe conforming to AWWA C950o PTFE Fluorocarbon Tubing conforming to ASTM D3296o FEP Fluorocarbon Tubing conforming to ASTM D3296Material:rbon Stael:mpliantwith (chedc one or more): 0 ANSVAVWVA C2000 API Spec. 5Lpliant with (check one or more):0 ASTM A242 (or A6(6)0 Type E0 ASTMA53[J ASTMA1390 Type S0 Grade B0 OtherStain. StIlet: (check one):0 ASTM A409 (production wells)0 ASTM A312 (mannor wells)ASS Plastic conforming to ASTM F480 and ASTM D1527: (chedc one)0 Schedule 400 Schedule 80PVC Plutic conforming to ASTM F480 and (ASTM D1765 or ASTM :02241): (check one):0 Schedule 40 0 Schedule 80Thermoeet Plastic: (check one)[J Filament WOund Resin Pipe conIonnlng to ASTM 02996o Centrifugally cast Resin Pipe confOrmIng to ASTht 02997o Reinforced Plastic Morta Pressure Pipe conforming to ASTM 03517o Glass Fiber Reinforced esin Pressure Pipe conforming to AWWA C9SOo PTFE Fluorocarbon Tubing conforming to ASTM 03296[JSchedule 120o FEP Fluorocarbon Tubin, conforming to ASTM D3296INCPI Application Form 02/26/2007

1/. ' @ .-II//II1/1/IIIIII320/Vi111/II/I1/II ./1. 'lr \I . . . f/ . "-:.::::- II.:1111 . ::,."IIII.IIo. . H1000 . \, ('\2000 .3000400050006000CONTOU R INTERVAL 40 FEETDOTTED LINES REPRESENT 20-FOOT CONTOURS7000 FEE

-

STATE OF HAWAIIFor OffIcial Use Only:DEPARTMENT OF LAND AND NATURAL RESOURCESRECF\VEOCOMMISSION ON WATER RESOURCE MANAGEMENTWELL CONSTRUCTION IAPPLICATION FOR A-lnstru- ctIo-ns-:-p-le-a-se-pri- -t- - -k- -rtype-IN- : - -mT p1e-1 -:- p -: : E-: tio- - -: .th IT-8t a ch me-nts-t-o-: th-e c-om-m-: is -:-iOn-on DSJUN \8 AS: 5Water Resource Management. P.O. Box 621. Honolulu. Hawaii 96809. Application must be accompanied by 10copies and a non-refundable filing fee of 25.00 payable to the Dept. of Land and Natural Resources. TheCommission may not accept incomplete applications. For assistance. call the Regulation Branch at 687-11225. Forfurther informatiOn and updates to this application form. visit http://www.hawaii.gov/dlnr/cwrm.WELL LOCATION INFORMATIONh """"''''''''' 1 STATE 'M:LL NO ( all8ady assigned)12 'M:LL.NAME3. ISLAND14. TMK .I u,s ·0\K.ilallH"q . KP I 1JI.rfiW'li2. . . OJJ OJJThe following must be attached befont this application is a : :epted as eomJllete:Portion 7.5-Minute Series USGS topographic map (scale 1:24.000) WIth well location labeled and include the name of the quad map. PlOpCrty tax map. showing weillocalion referenced to established property bOunciari." PIIcIognlpl\ 01 the proposed well site-A schematic dl8gram showing the well site. access mad and proposed well infrastructure-For dug weill. attach a gnocIi Og.plan WIth crooa section profileS showing OlCisting and finish1-.-5.;.'M:LL .!!!O(!:!P ERA T OR ·S;:T.NAM EICO !!.M"'PA:.;.NY "'T"ii1 WeU O!C:perator':::::::s s"'Contact ::?:::::lI ;;;C"'OwM;;;;PANY.,.,--.ag)t.1\'YlC 1l i"1i'VI oJ'(l V,11'0'Well Operator's Maling AddressWell OperafD(s PhonePROPOSED WELL CONSTRUCTION8. Construction TypeDrilledDOugShaftTunnel7. Proposed WorilConstruct New WellModify Existing WellAbandonJSeal WellooooooHl1'vl L"mci ,LL Micr.qd K,p hn h \ .014Pnncf',flilc HI qrl;f-u.I WeH Operator's E·malIWell operator's FaxI'Lan- downo( .""Contact ----··-At 1i, l.andowner'. Phona'OU -0·410ll.anclowne S FaxPROPOSED PUMP INSTALLATION10. Proposed Woril1llIoInstall New PumpReplace Pump11. Proposed Pumping Rate. gpm(gallons per minute)10 Q13. Method of flow measurement[g Flowmeter 12 . Pro-posed Am 0-u-nt 0 f-- 0 Other (explain)Vlllthdrawal, gpd (ga(lons per day) (.,9. Is thiS well part of a battery of wells? 0 Yes 0 No4CC14. PropOlllld Surveyor na and Ucet1ll8 number la surveyor Is required for aU Welt Conatructlon Penna and may be required for so. PumpInstallation Permits)11)bt\·\-c mll'ldPROPOSED USEo 15. Municipal (waler systems serving greater than 25 Individuals or 15 service connections)o 16. DomesticNumber of unitS to be served:D 17. Industrial (desaibe)o 18. IrrigatiOn (describe aop and no. of acres)D19. Military (desaibe)OTHER LEGAL REQUIREMENTS21. Conservation Di&tric:t Use Perm (COUP)D Well is in Conservation Distric:tD Required. COUP #If requirec/o items 21. and 22 must beobta'fned baron. til. Commrssion can legally issua a permit:date approvedo 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 thisapplication wiD expedite my review. I further understand that issues raised by this agency may delay or result In denial of the permitissuance. or revocation of the penntt after HIs Issued.IliI WeD is not in Conservation Distric:tI have not chec::ked if well is in or out of Conservation Distrlc:t. I understand that checking if the well is in a Conservation District may expedite myreview. I further understand that issues raised may delay or resuH In denial of the permit issuance. or revocation of the permH after it Is issued.22. Special Management Area PermH (SMAP)Required. SMA'date approvedNot Required (attach documentation from applicable County agency)!l!I1 have not checked w h the county about whether or not an SMA Permtt Is required. I understand that checking with the County prior to making thisapplication may expedite my review. I further understand that issues raised by this agency may delay or resuft in denial of the pennH issuance. orrevocation of the oermH after His issued.23. State Historic Preservation Division (SHPD) of the Department of Land and Natural ResourcesI have consulted with the HPD regarding potential impacts of well construc:tion ac:tivilles on historic sties. I have attached applicable documentationfrom the HPD.'iI I have not cor,sutted with the HPD regarding potential impacts of well construclion acIIvitIea on historic sites. I understand that checking with the HPDprior to making thIS application may 8Xp8dHe my review. I further understand that issues raised by this agency may delay or resutt In denial of theDermH issuance. or revocatiOn of the permH after His issued. Additionally. the history of past land use is attached.Additional remarks. explanations. etc. (attach addHional sheet if more space is needed)ooooNOTE: 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 permH approval: 1) the proposed wor! Is 10 be completed within two (2) years of \he approval date; 2) thecontractor &hall subtM to the Commission 8 weD completion/abandonment report within 60 days after the completion date of the permitted work: 3) In theevent that the application is not completed correc:tty, any permH may be suspended until the item is brought in to compliance. and any woril done while thepermit is in suspension may result in fines of uo to 5OOOJdav.24. WELL DRILLER (Must be filled out Wapplication i. for Wall Construction)25. PUMP INSTAlLER (M" be filled out WoppIic:oIIon i. fa Pump In.llalion)C-57 License No.Licensee business nameSignaturePrintDateUglY \ieU On IImsV· LLc ·Z-, 1"""q4 -,1 --,.,C-571C-57a1A Uoense No.tm.-Yrl Yt ttrtl(it :lUPerLicen business nameSignaturePrintINePI Application Form 0212612007

PROPOSED WELL SECTION,r:Z'1\(Please attach schematic if "",t from diagram provided below)msr -, :.Hole Diameter. in.iMinimum of 2' Radius & 4" TI'I1ck Concrete Pad (to contain benchmarll - - t surwyed to nearest 0.01 ft.)Ground Elevation:.'11 ft., msl*Elevation at top 01 casing ft.,j7f:iJI:""",.bS\"''W'Please refer to theHAWAU WELL CONSTRUCTION ANDPUMP INSTALLATION STANDARDSCement Grout: ft.(min. 70% of distance fromground elevation to top 01water surface or 500 ft.,whicI1ewr is less.)Grouting method:o Positivedisplacementto ensuno that your as-built is in compliance withapplicable standards.Annular space between holeand casing (1.5" for positivedisplacement. 3" for othermethods):o OtherjillSolid casing: (;;, 90% x (Ground EIev.-Water Level EIev»"1-1TDIal Length:Nominal Diameter:Wall Thickness:in.Bottom Elevation:ft.Cj "jl'iin. /'Sin.i 14ft., mal"Rock or Gravel Packing:ft.Open CaSing:0 PerforatedMaterial:o Crushed Basano Rounded GravelEstimatedwaterNominal Diameter.Wall TI'I1ckness:Levelft.tl 5/ Sin.if"'!Bottom Elevation: . . 'gElevation: Screenq1.Total Length:tin.ft., rnsI"note: Neither bentonite nor mud should be used insaturated zone during drilling-.l2.Lft. rnsI"Open Hole:Length:Diameter:.1.- .Bottom Elevation:WI\ft.in .ft., msl'* The approximate elevation must be referenced to mean sea level (msl)at the time 01 application filing. Final elevations 01 well components shallbe submilllld In the Well CompletionlWell Abandonment reports andreferenced to a benchmar1 which has been established by a surveyorlicensed by the State.For non-saft water Basal Wells - bottom elevation 01 well should not be deepar than 1/4 01 aquifer thickness or.Bottom Elevation 01 Well Um (Water Elevation 41 x w.mE!ev)!(ion )Example: Estimated 2 ft. Wear L.owI EIev. -Bottom Elevation alWelILim ( 2 (2» -18.51\.o API Spec. 5L0 ASTM A530 ASTM A 139(check one or more):0 ASTM A242 (or A606)0 Type E0 Type S0 Grade B0 OtherStain. Steel: (check one):0 ASTM A409 (production wells)0 ASTM A312 (monitor wells)ASS PIMtic: conforming to ASTM F480 and ASTM 01527: (check one)0 Scl!edule 400 Scl!edule 80PVC Plastic conforming toASTM F480 and (ASTM 01785 or ASTM 02241): (check one):0 Schedule 40 0 Scl!edule 80 0 Schedule 1201'hermocet Plastic: (check one)0 Filament Wound Resin Pipe oonfonning to ASTM 02996o Centrifugally cast Resin Pipe conforming to ASTM 02997o Reinforced Plastic Mortar Pressure Pipe conforming to ASTM 03517o Glass Fiber Reinforced Resin Pressure Pipe confonnlng to AWWA C950o PTFE Fluorocarbon Tubing conforming to ASTM D3296o FEP Fluorocarbon Tubing conforming to ASTM 03296 mpliant withMaterial:o API Spec. 5L0 ASTMA530 ASTMAl390 Type E0 Type S0 Grade B0 OtherStain. StIIeI: (check one):0 ASTM A409 (production wells)0 ASTM A312 (mon r wells)ASS Plastic conforming to ASTM F480 and ASTM 01527: (check one)IJ Schedule 400 Schedule 80PVC Plastic conforming to ASTM F480 and (ASTM 01785 or ASTM 02241): (check one):0 Schedule 40 0 Schedule 80 0 Schedule 120Thermoset Plastic: (check one)0 Filament WOund Resin Pipe confonntng to ASTM 02996IJ Centrifugally Cast ResIn Pipe conforming to ASTM 02997o Reinforced Plastic Mortar Pressure Pipe conforming to ASTM 03517o Glass Fiber Reinforced Resin Pressure Pipe conforming to AwwA C950o PTFE Fluorocarbon Tubing confonnlng to ASTM 03296o FEP Fluorocarbon Tubing conforming to ASTM D3296o ASTM A242 (or A606)WCPI Application Form 02/2612007

,).II1/1//1IIIIIIIIII--32 fvl'lII/11/IIII::::::::::;::::-.It.lr \I . "U. -";-''::::-". -.-'-IIi11II'---- "' -----.1I"II11'IIo . -. ".\1000C C"t -. 20003000.c 40005000 60007000 CONTOU R INTERVAL 40 FEETDOTTED LINES REPRESENT 20-FOOT CONTOURSFEE

.,STATE OF HAWAIIFor Offtclal Use Only:RECEIVEDDEPARTMENT OF LAND AND NATURAL RESOURCESCOMMISSION ON WATER RESOURCE MANAGEMENTAPPLICATION FOR A WELL CONSTRUCTION IPUMP INSTALLATION PERMIT08 JUN 18Instructions: Please print in ink or type and send completed application with attachments to the CommIsSion onwater Resource Management, P.O. Box 621, Honolulu, Hawaii 96809. Application must be accompanied by 10copies and a non-refundable flUng fee of 26.00 payable to the Dept. of Land and Natural Resources. TheCommission may not accept incomplete applications. For assistance, call the Regulation Branch at 58NI225. Forfurther infOrmation and updates to this application fOrm, visit http://www.hawaii.gov/dlnr/cwrm.WELL LOCATION INFORMATION1. STATE WELL NO. (W already assigned) 1 . WELL NAME1A 8:1 ,"T ETm -----------' ----" --------------------- 423. ISLANDK.il "lCq - KD 1 JICI no? -00. TMKK'l\l\'1i--.2,. - - OJJO L pa;cThe following must be attachedthis application is """"pled lIS COI1l lete:.Poo1ion ct 7.5-Minute 8erieS USGS topographic map (scale 1:24.000) with location labeled and indudethe name ctthe quad map PlOperty tax map, showing welllocaIIon referenced 10 established property ndanes Photogreph ct lhe proposed well site.A schematIC c\i8gram n g lhe wall site. reed and proposed well inhaslruoture.For dug walls, . grading pian with cross section profileS showing existi-"9 and liniah gradesI-.-S.';WE LL .OP EERA T';;OR;;:' 5r.NAMiffiEl;;;CO MiiiipAr.NY TIIvweu o/;;pe;;:rator';;;;;;;s7iContact :3i" - :.:::.::r.6'T.LANOOm'VWWNE'""""'R' r5iJNAiiMillEl,"CO Mii'iP;X; ""----'lnUwl;;;;;: downor' .:7Contact ;;;;------.-i'li'vl fW'(1CY·).,\,nC 1Swell aper.tot's Phon.IWeIAht;i.'l -1 HIiIl1 L 1I11tWell Operato(s E-mailOperator's FaxPROPOSED WELL CONSTRUCTION8. Construction TypeDrilledDugShafto Tunnel7. Proposed WorkConatruGt New WellModify Existing Wello AbandonJSeal WelloooooL.andowner'. PhoneH -04-inI,LLL \I(hqd k4P I-mLandowner's FaxPROPOSED PUMP INSTALLATION10. Proposed WorkInstall New PumpReplace Pump11o11. Proposed Pumping Rate, gpm(gallons per minute)lG 0 ,2 . P-ro-Posed-- Anw -u-rn O f------ 13. Method of flow measurement[g Flowmeter0 Other (explain)Vlllthdrawal, gpd (gallons per day)U,4 9. Is thiS well part of a battery ofwells? 0 Yes 0 No14. Propoucl Surveyor name and Dee. number Is surveyor Is required for all Well Construction Permi18 and may be required for some PumpInstallation Permits)tobt '1ttc,ymtl'1dPROPOSED USEo 15. Municipal (water systems serving greater than 25 Individuals or 15 service conne

quarton gardner c jr *(2% int)* 11/13/1992 deed-f quarton gardner c jr *(6% int)* 11/13/1992 qd-f kunter klaus i 650,000 doc 90-144523 320,000 doc 91-093925 320,000 doc 91-093926 100,000 doc 91-140762 2,000 doc 92-044608 428,760 doc 92-044609 714,160 doc 92-074668 357,