HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Parks & Recreation; 2015-04-09 (2)RECORDS DESTRUCTION AUTHORIZATION FORM
DATE: 1/11/15
REQUESTING DEPARTMENT: PARKS AND RECREATION REQUESTER^ CHAtiL^iiLBAktERTS'
DESTRUCTION APPROVALS:
1 . '< >Ki It . T t, its have been
BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS
PERIOD
TAB BARCODE
(ifapplicable)
'1.CR-2011-1 Facility Use Permits 2011 0900-43 CL+2
^LCR-2011-1 CLASS Revenue Reports 2011
Jo be filled out once records have been destroyed.
RECORD DESTRUCTION COMPLETED BY: ' V
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.
,^ , Revised: 1/11/2015
^ CARLSBAD
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