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RECORDS DESTRUCTION AUTHORIZATION FORM
DATE: 8/15/14 --------"----'-----
REQUESTING
DEPARTMENT: HR REQUESTER: PENNY MCKAY
DESTRUCTION APPROVALS:
We certify that the records listed below have been retained for the scheduled retention period, required audits have been
completed, and no pending or ongoing litigation or investigation involving these records is known to exist.
BOX NO.
2014-00
~ 3b/Jr
RECORDS MANAGEMENT: CITY ATTORNEY:
RECORDS DESCRIPTION DATED RRS NO. RRS TAB BARCODE
PERIOD (if applicable)
Account Clerk/Scrantrons ,Jan/2014v i,--0850-25 CL+3 #/A
Jan. Administrative Secretary 9&10 / 0850-25 CL+3
' Meter Services Worker/Scrantrons ~Cll"t \ Jan.15 ✓ 0850-25 CL+3
.., .... 1 ,., . .
1./ 0850-25 ' Housing Specialist 1/11/Scrantrons Jan/2014 t CL+3 ., _ ,1L
Community Economic Dev Director
• i, Feb.11✓ 0850-25 CL+3 ..,,..,A. --.. '
Public Works Street Supervisor Feb.18✓ ,,,.., n 0850-25 CL+3
• I I Secretary to City Manager Feb.13 ✓ 0850-25 CL+3
4 ----, ·1 I Senior Network Engineer Feb.13✓ 0850-25 CL+3
~ _, ,1
-·7 I Library Programs & Venues Mar. 5v-0850-25 CL+3
4 41 ,1
--I I Utility Supervisor Water OPS M!:· ~.lv 0850-25 CL+3
City Traffic Engineer/Transport Mgr
... v • .,
~~y~2 ✓ 0850-25 CL+3 I
Inspector 1/11 Parks & Public Works
-• 1 I May 19✓ 0850-25 CL+3
'] /'1I Ll
Inspector 1/11 Parks & Public Works May ✓ 0850-25 CL+3 Scrantrons ;..014
Land Development Engineering Mgr May22 ✓ 0850-25 CL+3 ·\ .. rri.1 A _...,., "T
Utility Worker Tests May ✓ 0850-25 CL+3 ...
--•-r
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management
Program.
Revised:8/15/2014
. "
2014-00 Wastewater Utility Worker 1/11 May 22✓ 0850-25 CL+3 ,v/A-7A JI • 0850-15 HR Technician Written Exam May 22v CL+3 '\. ~ I\ J. • \ Cross Connection Control Technician fvlay ~9 ./ 0850-25 CL+3
-..
Engineering Manager/District Mgr June 3✓
,, f'\ ,~
0850-25 CL+3
-. ' Risk Manager June ✓ .. ~ ,,. 0850-25 CL+3
--·-, I HR Technician June 25 v 0850-25 CL+3 -, ,..,A . I Warehouse Technician June 25,v 0850-25 CL+3 1-,,,.,
I I Street Maintenance Supervisor July 15 11/ 0850-25 CL+3
,") -A •·
Street Maintenance Supervisor --,.,
0850-j5 J Written Test July ✓ CL+3
'JI'> I /.1
Utility Worker 1/11 j I July ✓ 0850-):'5 CL+3 Written Test 2.nll'L
Utility Worker 1/11 July 29 v' 19.,.,' ,I/
0850-25 CL+3 -I
• I I Construction Manager A~g.1~ ✓ 0850-25 CL+3
~v,~ 1>tp~fy Li b~IY, /)1kt:fo,--:zo;~ .,,-t>850-~ tlfJ 5:"r. Iv/an"-"'~ AntlyJ/-20//f-v /.J~S"lJ ,z-r e.L t-3 *If more spaces are needed, click itfthe-last b·ox in right hand corner of table andhit "tab". This will create more fields in the table.
To be filled out once records have been destroyed.
RECORD DESTRUCTION COMPLETED BY: , &-rt1 /dv
CERTIFICATE OF DESTRUCTION? ra7°YES O NO
DATE: ¥/;g/~/f ~-
-SMEADSOFT BARCODES DELETED BY: __________ _ DATE: _____ _
<~CARLSBAD
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management
Program.
Revised:8/15/2014
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
110232
Monday, April 22, 2019
5815 EL CAMINO REAL
Apr-18-2019 thru Apr-18-2019
577291
41 -41 Boxes for Destruction (standard)
• Nothing in this certificate shall be deemed to modify the terms of the parties' Service Agreement(s) or Work Ticket(s).
tJcorodata litSSAE16
Type II Audit Completed • HIP£ --