HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Fire; 2026-01-2609-30-2025 11/11/2025
Corodata 1/26/2026
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RECORDS DESTRUCTION AUTHORIZATION FORM
DATE: 09/15/25 .
REQUESTING DEPARTMENT: FIRE ADMINISTRATION REQUESTER: VANESSA MARTINEZ
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.
DATE RECORDS MANAGEMENT DATE CITY ATTORNEY DATE
BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS TAB BARCODE
PERIOD (if applicable)
FD040 Controlled Drug Inventory Rec. Jan 2021-FR-050 3 years Dec 2021
II II Ambulance Medication Logs Jan 2021 -FR-050 3 years Dec 2021
II II EMS Surveys JAN 2022-CW-285 2 years Dec 2022
*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.
To be filled out once records have been destroyed.
RECORD DESTRUCTION COMPLETED BY: DATE:
CERTIFICATE OF DESTRUCTION? -0~-YE-S---□--N-O __ _ -------
TAB BARCODES DELETED BY: DATE: ------------------------
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program. ("Cityof
Carlsbad Revised: 2021
P a ge /1
CERTIFICATE OF DESTRUCTION & RECYCLING
This Certificate is presented to: CITY OF CARLSBAD - RECORDS MANAGEMENT DIVISION
Per the express request of Client, Corodata has received the Material referred to below and has/will destroy and then
recycle said Material in accordance with its standard procedures. As the parties have agreed, Corodata will not
inventory, record or track any information contained within or related to the Material.
Account #(s)SD012455
Certificate #105599
Date Issued Thursday, January 29, 2026
Service Locations 5815 EL CAMINO REAL
Date Range of Service Jan-26-2026 thru Jan-26-2026
Work Ticket(s)1616978
Quantity/Item 100 -100 Boxes for Destruction (standard -
10x12x15)
* Nothing in this certificate shall be deemed to modify the terms of the parties’ Service Agreement(s) or Work Ticket(s).
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