HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Fire Prevention; 2025-05-12This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program.
Revised: 2021
Page | 1
DATE: 2/12/2025
REQUESTING DEPARTMENT: FIRE PREVENTION REQUESTER: DARCY FANT
DESTRUCTION APPROVALS:
We certify that the records listed below have been retained for the scheduled retention period, required audits have been
completed, and no pending or ongoing litigation or investigation involving these records is known to exist.
DEPT. HEAD/DIVISION MANAGER DATE RECORDS MANAGEMENT DATE CITY ATTORNEY DATE
*If more spaces are needed, click in the last box in right hand corner of table and hit “tab”. This will create more fields in the table.
BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS PERIOD TAB BARCODE
(if applicable)
23 BOXES
VIATRON SCANNING OF FIRE PREVENTION DOCUMENTS (FIRE PREVENTION PERMITS/PLANS) 23 BOXES TOTAL PJ8153 (FP PERMITS PJ8153-18 to 25 -8 BOXES); PJ8174 (FP PLANSPJ8174-35 to 49 -15 BOXES)
**ORIGINAL SCANNED DOCUMENTS UPLOADED INTO LASERFICHE AND
HARD COPIES DESTROYED
PER RECORDS MANAGEMENT PROCEDURES
RECORDS DESTRUCTION AUTHORIZATION FORM
02-13-2025 3/3/20252/12/2025
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program.
Revised: 2021
Page | 2
To be filled out once records have been destroyed.
RECORD DESTRUCTION COMPLETED BY: ___________________________ DATE: ______________
CERTIFICATE OF DESTRUCTION? YES NO
TAB BARCODES DELETED BY: _____ _______________________________ DATE: ______________
Williams Data Management 5/12/2025
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Certificate of Destruction
WILLIAMS DATA MANAGEMENT
1816 Oak Street, Los Angeles CA 90015
Issued to:
PJ8153 CITY OF CARLSBAD-FIRE PERMITS
Work Order 01608783- 8 Boxes
This certifies that all materials referenced on the above
Work Orders have been destroyed. It is further certified
The records have not been excessively handled, tampered with, or read.
Date: May 12, 2025
Issued by
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Certificate of Destruction
WILLIAMS DATA MANAGEMENT
1816 Oak Street, Los Angeles CA 90015
Issued to:
PJ8174 CITY OF CARLSBAD-FIRE PLANS
Work Order 01608783- 15 Boxes
This certifies that all materials referenced on the above
Work Orders have been destroyed. It is further certified
The records have not been excessively handled, tampered with, or read.
Date: May 12, 2025
Issued by
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