HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Fire Prevention; 2026-04-23
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program. Revised: 2/23/2026 P a g e | 1
DATE: 2/23/2026
REQUESTING REQUESTER:
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.
DEPARTMENT EAD ATE ECORDS ANAGEMENT ATE ITY TTORNEY
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 (if applicable)
12 BOXES
VIATRON SCANNING OF FIRE PREVENTION DOCUMENTS (FIRE
PREVENTION PERMITS/PLANS) 12 BOXES TOTAL PJ8153 (FP PERMITS PJ8153-26 to 29 – 4 BOXES); PJ8174 (FP PLANS
**ORIGINAL SCANNED
DOCUMENTS UPLOADED
INTO LASERFICHE AND HARD COPIES DESTROYED PER RECORDS
MANAGEMENT
PROCEDURES
To be filled out once records have been destroyed.
RECORD DESTRUCTION COMPLETED BY: ___________________________ DATE: ______________
CERTIFICATE OF DESTRUCTION? YES NO
TAB BARCODES DELETED BY: _____ ________________________ DATE: ______________
RECORDS ESTRUCTION UTHORIZATION ORM
3/11/2026 03-11-2026 3/30/26
Paper Recycling Shredding Specialists, Inc. 4/23/2026
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City of
Carlsbad
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Certificate of Destruction
Paper Recycling Shredding Specialists, Inc.
1391 E. Mission Blvd, Pomona. CA 91766
Receipt of this Certificate guarantees that all records _documents received from:
~ (:ity Of Carlsbad
located at:
18233 S. Hoover St.
Gardena, CA 90248
by Paper Recycling Shredding Specialists, Inc. was shredded at the address noted on this certificate.
In addition, the Customer acknowledges that they were given the opportunity to witness
the destruction of their paper, by the on-site shredding process. A.2:tttJ; Date Q 1.tl 'l,,:) !__u
Customer Acknowledgement ________ Date ____ _
Customer Printed Name
Arrival time: ______ Departure time:. ____ _
Item description of products shredded
______ Security Containers
__ 4 ____ Boxes PJ8153
______ Executive Security Consoles
_ _____ Weight ~1"napplu:able)
Paper kcyding J;hredt6ng Sp«Jall,u, Inc. u NND «rrljWfor lxnh OtNhe and off-site datnn:tlrm of paper and prlntm malmah. Weare not lWD cutljld/ortlll}'OIMr type of medkldatntt:tton.
........................................................... --..--. ••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• ii ii""""'
Certificate of Destruction
Paper Recycling Shredding Specialists, Inc.
1391 E. MwionBlwJ, Pomona, CA 91766
Receipt of this Certificate guarantees that all records _documents received from:
·.City Of Carlsbad
located at:
18233 S. Hoover St.
Gardena, CA 90248
by Paper Recycling Shredding Specialists, Inc. was shredded at the address noted on this certificate.
In addition, tire Customer acknowledges that they were given the opportunity to witness
the destruction of their paper, by tire on-site shredding process.
Customer Acknowledgement ________ Date ____ _
Customer Printed Name
Arrival time:. ______ Departure time:. ___ _
ott I~; /u
Date
Item description of prodads shredded
_ _____ Security Containers
8 Boxes PJ8154
______ Executive Security Consoles
______ Weight (whmappllcal,le)
Poper Recycling }ihredt6r,g Sp«laftsU, hrc. u HAID «rtl/Wfor both 111MUe and o.lf-slte dotntction cr/popr:rottd prlntm malaials. We lllf/ not HAID «ttlf/d/orany otlwrlJfM af medladutrw:tlon.