HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Utilities; 2015-04-09 (4)RECORDS DESTRUCTION AUTHORIZATION FORM
DATE: MARCH 17,2015
REQUESTING
DEPARTMENT: PW-UTIL REQUESTER:
JEANETTE BROWN
DESTRUCTION APPROVALS:
We certify tnat the records listed below have been retained for the scheduled retention period, required audits have been
completed, and no pendir^g or ongoing litigation or Investigation involving these records Is known to exist.
-/CITY ATTORNEY:
BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS
PERIOD
TAB BARCODE
(ifapplicable)
1021 Inspection Logs/Daily Reports-
Squires Tank & Pipeline
1989-
1990 1000-77 CL+2 n/a-permanently
removed from Iron Mtn
*// 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.
Jo be filled out once records have been destroyed.
RECORD DESTRUCTION COMPLETED BY: ^ ' ^ DATE:
CERTIFICATE OF DESTRUCTION? ^ YES • NO
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management
!*t Program.
^CARLSBAD Revised: 3/17/2015
Shred-it
3801 Ocean Ranch Blvd
Suite 101
Oceanside CA
92056
Phone: 760- 598- 5700
SERVICE RECORD SUMMARY
CERTIFICATE OF DESTRUCTION
PLEASE KEEP THIS FOR YOUR RECORDS
(THIS IS NOT AN INVOICE)
Customer: 0013185878
CITY OF CARLSBAD
5816 EL CAMINO REAL
CARLSBAD CA 92008- 8816
Order #: 8015065327
Order Date: 04.09.2015
Service Type: ON- SITE PURGE
Contact: PAT DOWNIE
Time In: 07:30 AM
Material Collected
BANKERS/ARCHIVE BOX 163
LARGE ARCHIVE BOX 7
Total: 170
Customer Signature: PAT
CSR Signature: BRIAN SHEPLEY
Shred- it is committed to the secure destruction of its customers'
confidential information. This certification will affirm that
Shred- it destroys the customer confidential material, pursuant to
our customers request and instructions.
The following services are NAID certified:
Hard Drive Destruction
Mobile Destruction
The following services are not NAID certified:
Offsite Destruction
Non- Paper Destruction