HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Fire Prevention; 2017-12-26RECORDS DESTRUCTION AUTHORIZATION FORM
DATE: 10/12/2017
REQUESTING DEPARTMENT: FIRE DEPT/PREVENTION REQUESTER: CHRISTINA WILSON
DESTRUCTION APPROVALS:
We certify that the records listed below have been retained for the scheduled retention period, required audits have been
or ongoing litigation or investigation involving these records is known to exist.
RECORDS MANAGEMENT: CITY ATIORNEY:
BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS TAB BARCODE
PERIOD (if applicable)
µ V 1 2006 PUBLIC RECORDS REQUESTS ALL IN 013050 CL+ 2 FP0003158 2006
J)l / 1 2007 PUBLIC RCORDS REQUESTS ALL IN 013050 CL+ 2 FP0003483 2007
I 1 2008 PUBLIC RCORDS REQUESTS ALL IN 013050 CL+ 2 FP0003674 jl 2008
JJl / 1 2009 PUBLIC RCORDS REQUESTS ALL IN 013050 CL+ 2 FP0003845
)ft, / 1 2010 PUBLIC RCORDS REQUESTS ALL IN 013050 CL+ 2 FP0003974
}}-L/ 1 2011 PUBLIC RCORDS REQUESTS ALL IN 013050 CL+ 2 FP0004037
JJ lJ 1 2012 PUBLIC RCORDS REQUESTS ALL IN 013050 CL+ 2 FP0004248
J).. lJ 1 2013 PUBLIC RCORDS REQUESTS ALL IN 013050 CL+ 2 FP0004805
jfl.Y 1 2014 PUBLIC RCORDS REQUESTS ALL IN 013050 CL+ 2 FP0004806
*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.
To be filled out once records have been destroyed.
RECORD DESTRUCTION COMPLETED BY: (}J)1}~ DATE:
CERTIFICATE OF DESTRUCTION? 181 YES D NO
SMEADSOFT BARCODES DELETED BY: --DATE: -~~~~~~~~~~-------
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program.
<~ ,in o, Revised: 10/12/2017
w CARLSBAD
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)
Certificate #
Date Issued
Service Locations
Date Range of Service
Work Ticket( s)
Quantity/Item
SD012455
107562
Wednesday, January 03, 2018
5815 EL CAMINO REAL
Dec-26-2017 thru Dec-26-2017
450641
4 - 4 64 Gallon Bin
* Nothing in this certificate shall be deemed to modify the terms of the parties' Service Agreement(s) or Work Ticket(s).
E•Jcorodata itSSAE16
Type II Audit Completed HIPAA