HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Fire; 2024-03-0503-14-2024 3/25/24
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CORODATA 6/13/2024
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RECORDS DESTRUCTION AUTHORIZATION FORM
DATE: MARCH 5, 2024
REQUESTING DEPARTMENT: FIRE ADMIN 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.
RECORDS MANAGEMENT DATE CITY ATTORNEY DATE
BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS TAB BARCODE
PERIOD (if applicable)
Vehicle maintenance forms
F031,F069,F099,F109,F247,F299 Surplus FD035 F312,F322,F399,F569,F571,F601 2003 -2018 FR-045
F605,F606,F820,F840,F841,F857 +2 years
F858, F859, F866
1985 -2005,
FD035 Ride-along waivers 1994 -2011, FR-035 2 years
2016 -2019
FD035 Controlled Drug Inventory 2020 FR-050 3 years
FD035 Medication Inventory Record 2020 FR-050 3 years
FD035 EMS Surveys 2021 CW-285 2 years
Separati
FD035 Individual Training Certificates 2007 -2012 FR-160 on+ 5
years
*If more spaces are needed, click m the last box m r,ght hand corner of table and hit "tab". This will create more fields m the table.
To be filled out once records have been destroyed.
RECORD DESTRUCTION COMPLETED BY: __________ _ DATE: -------
CERTIFICATE OF DESTRUCTION? 0 YES 0 NO
TAB BARCODES DELETED BY: ---~N .......... /~A _______ _ DATE: _____ _
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program.
(btyof
Carlstiad Revised: 2021
Page /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 #104470
Date Issued Tuesday, June 18, 2024
Service Locations 5815 EL CAMINO REAL
Date Range of Service Jun-13-2024 thru Jun-13-2024
Work Ticket(s)1331793
Quantity/Item 2 -2 Boxes for Destruction (odd sized)
44 -44 Boxes for Destruction (standard)
* 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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