HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Library & Cultural Arts; 2015-04-09RECORDS DESTRUCTION AUTHORIZATION FORM
DATE: p./o^S"
REQUESTING DEPARTMENT: C^^u^rrxl At;-ts REQUESTER: Chmr^i gy.fBi^.n. .
DESTRUCTION APPROVALS:
We certify t^t tiie records iisted below have been retained for the .scheduled retention period, required audits have been
complete/, and rm pending pr ongoing litigation or investigation involving these records is known to e.Kist
ORDS MANAGEMENT: CITY ATTORNEY:
BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS
PERIOD
TAB BARCODE
(ifapplicable)
/4rfe Gna/vChS
h30-5S
* 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
Jo be filled out once records have been destroyed.
RECORD DESTRUCTION COMPLETED BY:
CERTIFICATE OF DESTRUCTION? Q 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.
CARLSBAD Revised: 2/10/2015
^hred'l^
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