HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Housing Services; 2017-03-21RECORDS DESTRUCTION AUTHORIZATION FORM
DATE: FEBRUARY 14, 2017
REQUESTING DEPARTMENT: HNS REQUESTER: PATTI CRESCENTI
DESTRUCTION APPROVALS:
WP certify t hot the records listed below hove been re tained for the scheduled retention period, required audits hove been
completl:'d, ond no pending or ongoing litigation or investigation involving these records is known to exist
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DEPARTMENT HEAD: RECORDS MANAGEMENT: CITY ATIORNEY:
RECORDS DESCRIPTION DATED RRS NO. RRS TAB BARCODE BOX NO. PERIOD (if applicable)
94 Miscellaneous Code Enforcement /9J'5-0575-15 t!L t-~ 3 7 4483894( .Ln>-1 Files /917 M
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*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.
DATE: J/;1./ /J0/7 RECORD DESTRUCTION COMPLETED BY: __ & __ t'l_-0._~-------
CERTI FICATE 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.
,<~-; , "' ,,, Revised: 2/14/2017 ~ CARLSBAD
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CERTIFICATE OF DESTRUCTION & RECYCLING
This certificate is presented to: CITY OF CARLSBAD
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
106452
Tuesday, March 21, 2017
5815 EL CAMINO REAL
Mar-21-2017 thru Mar-21-2017
381606
• Nothing in this certificate shall be deemed to modify the terms of the parties' Service Agreement(s) or Work Ticket(s).
l:•Jcorodata SSAE16
Type II Audil Completed HIP£