HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Parks & Recreation; 2015-04-09RECORDS DESTRUCTION AUTHORIZATION FORM
DATE:
REQUESTING DEPARTMENT: PARKS AND RECREATION REQUESTER: CHARLES BALTERIA
DESTRUCTION APPROVALS:
D^ARTMtNT HEAD:
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RECORDS MANAGEMENT: CITY ATTORNEY
RECORDS DESCRIPTION DATED RRS NO. RRS
PERIOD
TAB BARCODE
(ifapplicable)
2010-1 Facility Use Permits 2010 0900-43 CL+2
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*lf 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:
CERTIFICATE OF DESTRUCTION? • YES • NO
SMEADSOFT BARCODES DELETED BY:
DATE:
DATE:
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program.
<f Revised: 1/12/2014
^ CARLSBAD
thred-n
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