HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Fire Prevention; 2019-07-11RECORDS DESTRUCTION AUTHORIZATION FORM
DATE: 03/15/19 ---------
RE QUE S Tl NG
DEPARTMENT: FIRE 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
completed, and no pending or ongoing litigation or investigation involving these records is known to exist. •
C1atz&~
RECORDS MANAGEMENT: CITY ATTORNEY:
RECORDS DESCRIPTION DATED RRS NO. RRS TAB BARCODE BOX NO. PERIOD (if applicable) I
~ 1 03-4297 _ 5117 CLEMENS CT 2003 0630-47 cu+ 6 v-1=P0002899 ✓
03-3400_ 6891 EL CAMINO REAL 2003 0630-47 cu +6 v1P0002900 /
03-3169 7169 WILLET CT 2003 0630-47 cu +6 ✓FP0002898 ✓
03-927 _ 1739 TAMARACK AV 2003 0630-47 cu+ 6 v!=P0002897✓
03-319_ 6704 CORINTIA ST 2003 0630-47 cu +6 ✓FP0002896 ✓.
2004 FIRE INVESTIGATION PHOTOS 2004 0630-47 cu+ 6 N/A
OS-DEC. 20_ 1120 CAMINO DEL SOL 2005 0630-47 cu +6 i/FP0003156 ✓
05-5745_ 4906 VIA AREQUIPA 2005 0630-47 cu +6 \/f=P0003139✓
05-4639 2479 OCEAN ST 2005 0630-47 cu+ 6 ✓FP0003138 .,(
~ ~..:-4b,j 9 24 79 OCEAN ST --l"lh-:tn_J1_7 CU+6 ✓i:,_,, .. { .<Z..'f7 j , ___ -
OS-MAY 2_ 2522 VA ESPARTO 2005 0630-47 cu+ 6 ...-1=P0003157 ✓
06-3699_ 3491 HIGHLAND DR 2006 0630-47 cu +6 v'J=P0003280 ✓
06-2992_ 7050 ESTRELLA DE MAR 2006 0630-47 CU+6 vfP0000221 ✓ RD
06-1031_ 1817 ASTON AV 2006 0630-47 cu+ 6 .,/FP0003170 ✓
06-FEB. 20_ 812 WINDCREST 2006 0630-47 cu +6 /FP0000465/
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program.
(cityof
Carlsbad Revised: 6/4/2019
0 (l...
06-1480_ 1700 ANDREA AV 2006 0630-47 cu+ 6 /FP0000211/
2007-005832 3001 CARLSBAD BL 2007 0630-47 cu +6 /FP0003616 ✓
07-3879 2790 LOKER AV WEST 2007 0630-47 cu+ 6 /FP0003598 ✓
07-1524 7485 MERMAID LN 2007 0630-47 cu +6 /f=P0003478 ✓
2007-0001016 2408 LA COSTA AV 2007 0630-47 cu+ 6 ✓FP0003670 ✓
08-5731 5970 AVENIDA ENCINAS 2008 0630-47 cu +6 /FP0003809 V
08-8765_ 382 ACACIA AV. "D" 2008 0630-47 cu+ 6 y"i:P0003848/
08-8338_ 7546 GIBRALTER ST 2008 0630-47 cu +6 ✓FP0003847v'
08-4726_ 2557 MONROE ST 2008 0630-47 cu+ 6 v'fP0003792✓
08-4417 3526 MADISON ST 2008 0630-47 cu+ 6 ✓FP000379y'
08-3517 2976 GLENBROOK ST 2008 0630-47 cu+ 6 0f'0003763✓
08-2892 1028 BUENA VISTA WY 2008 0630-47 cu+ 6 v1°'P000308W
4619 BUCKINGHAM LANE 2009 0630-47 cu+ 6 N/A
09-52478 LAKE CALAVERA AT SKY 20009 0630-47 cu+ 6 N/A HAVEN LANE AND LAKE BL
09-6623_ 3553 SITIO BAVA 2009 0630-47 cu+ 6 V'fP0004115 v
09-6449_ 1015 BUENA VISTA WY 2009 0630-47 cu+ 6 ✓FP0004112 V
09-5883_ 2606 EL AQUILA ST 2009 0630-47 cu+ 6 vfP0003936 ✓
09-4692_ 8033 PASEO ARRAYAN 2009 0630-47 cu+ 6 v1=P0003920 ✓
09-4309_ 6118 PASEO DEL NORTE 2008 0630-47 cu+ 6 VFP0004111 V
09-4159_ 1651 CALLINANDRA RD 2009 0630-47 cu +6 "'1:P0004110 ✓
09-57988 2300 PIO PICO 2009 0630-47 cu +6 vFP0004113✓
09 7 /31/09 _ 2862 LUCI ERNA GA ST 2009 0630-47 cu +6 v"FP0004114 ✓
09-1904 2630 PERENEOS WY 330 2009 0630-47 cu +6 .,/FP0003879 v
09-1894 1100 CAMINO DE LAS 2009 0630-47 cu+ 6 i/FP0003881v' ONDAS
09-1393_ 7100 FOUR SEASONS PT 2009 0630-47 cu +6 v1=P0003880 ✓
09-1261_ 3700 CHATHAM RD 2009 0630-47 cu +6 vFP0004109 v'
09-1156_ 7732 PALACIO DR 2009 0630-47 cu+ 6 ✓ FP0004108 ✓
09-0802) 6880 AMBROSIA LN 2009 0630-47 cu+ 6 V"'i=P0003868 ,/
09-0636_ 2855 CARLSBAD BL 2009 0630-47 cu +6 v1=P0003866/
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program.
(rnyof
Carlsbad Revised: 6/4/2019
*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: &Y1Jdi..h..J
CERTIFICATE OF DESTRUCTION? a YES O NO
DATE: -;1j//~1r
I 7
SMEADSOFT BARCODES DELETED BY: _M.4&11( , /3wz ~ DATE:
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program.
(cityof
Carlsbad Revised: 6/4/2019
Records Destruction List
Page 1
Date 06/04/2019
Time 3:20:10 PM
Date Inactive Login Name Maria Emery
Record Number External ID Records Description
PFLD-15-40400 06-1480[1700 ANDREAAV 063047 PHYSICAL RECORDS
FP211 MANAGEMENT -Fire Prevention
Fire
PFLD-15-40410 06-2992[7050 ESTRELLA DE MAR RD 063047 PHYSICAL RECORDS
FP221 MANAGEMENT -Fire Prevention
Fire
PFLD-15-3856 03-319[6704 CORINTIA ST. 063047 PHYSICAL RECORDS
FP2896 MANAGEMENT -Fire Prevention
Fire
PFLD-15-3 857 03-927[ 1739 TAMARACK 063047 PHYSICAL RECORDS
FP2897 MANAGEMENT -Fire Prevention
Fire
PFLD-15-3858 03-3169[7169 WILLET CT. 063047 PHYSICAL RECORDS
FP2898 MANAGEMENT -Fire Prevention
Fire
PFLD-15-3859 03-4297[5117 CLEJ\1ENS CT. 063047 PHYSICAL RECORDS
FP2899 MANAGEMENT -Fire Prevention
Fire
PFLD-15-3860 03-3400[6981 EL CAMINO REAL 063047 PHYSICAL RECORDS
FP2900 MANAGEMENT -Fire Prevention
Fire
PFLD-15-4005 08-2892[1028 BUENA VISTA WY 063047 PHYSICAL RECORDS
FP3088 MANAGEMENT -Fire Prevention
Fire
PFLD-15-4055 05-4639[2479 OCEAN ST 063047 PHYSICAL RECORDS
FP3138 MANAGEMENT -Fire Prevention
Fire
PFLD-15-4056 05-5745[4906 VIAAREQUIPA 063047 PHYSICAL RECORDS
FP3139 MANAGEMENT -Fire Pre;'ention
Fire
PFLD-15-4073 05-Dec. 20[1120 CAMINO DEL SOL 063047 PHYSICAL RECORDS
FP3156 MANAGEMENT -Fire Prevention
Fire
Records Destruction List
Page 2
Date 06/04/2019
Time 3:20:10 PM
Date Inactive
Login Name Maria Emery
Record Number External ID Records Description
PFLD-15-4074 05-May 212522 VIAESPARTO 063047 PHYSICAL RECORDS
FP3157 MANAGEMENT -Fire Prevention
Fire
PFLD-15-4087 06-103111817 ASTON AV 063047 PHYSICAL RECORDS
FP3170 MANAGEMENT -Fire Prevention
Fire
PFLD-15-4197 06-369913491 HIGHLAND DR 063047 PHYSICAL RECORDS
FP3280 MANAGEMENT -Fire Prevention
Fire
PFLD-15-4214 05-463912479 OCEAN ST 063047 PHYSICAL RECORDS
FP3297 MANAGEMENT -Fire Prevention
Fire
PFLD-15-4395 07-152417485 MERMAID LN 063045 PHYSICAL RECORDS
FP3478 MANAGEMENT -Fire Prevention
Fire
PFLD-15-4514 07-387912790 LOKER AV WEST 063047 PHYSICAL RECORDS
FP3598 MANAGEMENT -Fire Prevention
Fire
PFLD-15-4532 2007-00583213001 CARLSBAD BL 063047 PHYSICAL RECORDS
FP3616 MANAGEMENT -Fire Prevention
Fire
PFLD-15-4586 2007-000101612408 LA COSTA AV 063047 PHYSICAL RECORDS
FP3670 MANAGEMENT -Fire Prevention
Fire
PFLD-15-4679 08-351712976 GLENBROOK ST 063047 PHYSICAL RECORDS
FP3763 MANAGEMENT -Fire Prevention
Fire
PFLD-15-4708 08-472613557 MONROE ST 063047 PHYSICAL RECORDS
FP3792 MANAGEMENT -Fire Prevention
Fire
PFLD-15-4709 08-441713526 MADISON ST 063047 PHYSICAL RECORDS
FP3793 MANAGEMENT ~ Fire Prevention
Fire
Records Destruction List
Page 3
Date 06/04/2019
Time 3:20:10 PM
Date Inactive Login Name Maria Emery
Record Number External ID Records Description
PFLD-15-4725 08-573115970 AVENIDA ENCINAS 063047 PHYSICAL RECORDS
FP3809 MANAGEMENT -Fire Prevention
Fire
PFLD-15-4762 08-833817546 GIBRALTER ST 063047 PHYSICAL RECORDS
FP3847 MANAGEMENT -Fire Prevention
Fire
PFLD-15-4 7 63 08-87651382 ACACIAAV. "D" 063047 PHYSICAL RECORDS
FP3848 MANAGEMENT -Fire Prevention
Fire
PFLD-15-4781 09-063612855 CARLSBAD BL 063047 PHYSICAL RECORDS
FP3866 MANAGEMENT -Fire Prevention
Fire
PFLD-15-4783 09-080216880 AMBROSIA LN 063047 PHYSICAL RECORDS
FP3868 MANAGEMENT -Fire Prevention
Fire
PFLD-15-4794 09-190412630 PIRENEOS WY#30 063047 PHYSICAL RECORDS
FP3879 MANAGEMENT -Fire Prevention
Fire
PFLD-15-4795 09-139317100 FOUR SEASONS PT 063047 PHYSICAL RECORDS
FP3880 MANAGEMENT -Fire Prevention
Fire
PFLD-15-4796 09-189411100 CAMINO DE-LAS ONDAS 063047 PHYSICAL RECORDS
FP3881 MANAGEMENT -Fire Prevention
Fire
PFLD-15-4835 09-469218033 PASEO ARRAYAN 063047 PHYSICAL RECORDS
FP3920 MANAGEMENT -Fire Prevention
Fire
PFLD-15-4851 09-588312606 EL AGUILA ST 063047 PHYSICAL RECORDS
FP39-36 MANAGEMENT -Fire Prevention
Fire
PFLD-15-5023 09-115617732 PALACIO DR 063047 PHYSICAL RECORDS
FP4108 MANAGEMENT -Fire Prevention
Fire
Records Destruction List
Page 4
Date 06/04/2019
Time 3:20:10 PM
Date Inactive Login Name Maria Emery
Record Number External ID Records Description
PFLD-15-5024 Open Space 09-1261[3700 CHATHAM RD 063047 PHYSICAL RECORDS
FP4109 MANAGEMENT -Fire Prevention
Fire
PFLD-15-5025 09-4159[1651 CALLIANDRARD 063047 PHYSICAL RECORDS
FP4110 MANAGEMENT -Fire Prevention
Fire
PFLD-15-5026 09-4309[6118 PASEO DEL NORTE 063047 PHYSICAL RECORDS
FP4lll MANAGEMENT -Fire Prevention
Fire
PFLD-15-5027 09-6449[1015 BUENA VISTA WY 063047 PHYSICAL RECORDS
FP4112 MANAGEMENT -Fire Prevention
Fire
PFLD-15-5028 09-57988[2300 PIO PICO 063047 PHYSICAL RECORDS
FP4113 MANAGEMENT -Fire Prevention
Fire
PFLD-15-5029 09 7/31/09[2862 LUCIERNAGA ST 063047 PHYSICAL RECORDS
FP4114 MANAGEMENT -Fire Prevention
Fire
PFLD-15-5030 09-6623[3553 SITIO BAYA 063047 PHYSICAL RECORDS
FP4115 MANAGEMENT -Fire Prevention
Fire
PFLD-15-40653 06-FEB. 20[812 WINDCREST 063047 PHYSICAL RECORDS
FP465 MANAGEMENT -Fire Prevention
Fire
f End of Report ]'-[ C_it~y _of_C_a_rl_sb_a_d _______________________ D_a_ta_s_et_E_C_M_M_a_s_te_r___,
f
RECORDS DESTRUCTION AUTHORIZATION FORM
DATE: 05/10/19 ----------
REQUESTING
DEPARTMENT: FIRE
REQUESTER: CHRISTINA WILSON
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.
RECORDS MANAGEMENT: CITY ATTORNEY:
RECORDS DESCRIPTION DATED RRS NO. RRS TAB BARCODE BOX NO. PERIOD (if applicable)
Fire prevention VIOLATION notices, 2008to 6 labeled 'Remittance Notices' from 2012 0630-59 CL+3 N/A
2008, 2009, 2010, 2011, and 2012
*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: &-vt)tldv DATE:
CERTIFICATE OF DESTRUCTION? ~ YES O NO
SMEADSOFT BARCODES DELETED BY: __________ _ DATE: ____ _
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program.
{City of
Carlsbad Revised: 5/10/2019
RECORDS DESTRUCTION AUTHORIZATION FORM
DATE: 05/14/19 ----------
REQUESTING
DEPARTMENT: FIRE REQUESTER: CHRISTINA WILSON
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.
RECORDS MANAGEMENT: CITY ATTORNEY:
BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS TAB BARCODE
PERIOD (if applicable) j,;/ FIRE INVESTIGATION REPORTS:
2 10-54482 AT 800-849 KALPATI CR 2010 063047 cu +6 FP0004775 ✓
10-1628 AT 7733 PALACIO DR 2010 063047 cu+ 6 FP0004774 ✓
10-55567 AT 3738 JEFFERSON ST 2010 063047 cu +6 FP0004097✓
10-11663 AT 1941 DOVE LN 2010 063047 cu+ 6 FP0004103✓
10-9238 AT 2976 GREENWICH ST 2010 063047 cu+ 6 FP0004036v
10-9058 AT 1997 COST DEL MAR RD 2010 063047 cu+ 6 FP0004035✓
10-8466 AT 4320 ANN DR 2010 063047 cu+ 6 FP0004096✓
10-6719 AT 2478 IMPALA DR 2010 063047 cu +6 FP0004099v
10-5339 AT 4909 PARK DR 2010 063047 cu +6 FP0004098 v
10-5072 AT 6707 ANTI LOPE ST 2010 063047 CU+6 FP0004106 v-
10-4484 AT 7250 PONTO DR 2010 063047 cu +6 FP0004105 V
10-3757 AT 1936 KELLOGG AV 2010 063047 cu+ 6 FP0004100 ,,_
10-3577 AT 2245 CAMINO VIDA 2010 063047 cu+ 6 FP0004102 v-ROBLE
10-3575 AT 2215 CALLE BARCELONA 2010 063047 cu +6 FP0004101v-
10-2235 AT 7466 ALT.IVA PL 2010 063047 cu +6 FP0004107✓
This form documents the destruction of City records In accordance with the City of Carlsbad Records Management Program.
("btyof
Carlsoad Revised: 6/4/2019
BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS TAB BARCODE
PERIOD (if applicable)
2 FIRE INVESTIGATION REPORTS:
10-0846 at 6900 AMBROSIA LN 2010 063047 cu +6 FP0004104 V'
10-043902 AT N33°09°.220'
W117°16.521' JOHN DEERE
TRACTOR IGNITING DRY BRUSH 2010 063047 cu+ 6 N/A .,,-
WHILE CLEARING VEGETATION
SIGNED SHEET
11-2169 AT 7757 CAMINITO 2011 063047 cu +6 FP0004773V°' BONANZA
12-8975 AT 2340-2344 HOSP WY 2012 063047 cu +6 FP000434.7 $ ✓
12-8289 AT 1060 CHINQUAPIN AVE 2012 063047 cu+ 6 FP0004349 ✓
12-7360 AT 3840 MARGARET WY 2012 063047 cu+ 6 FP0004350 ✓
*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: c,,,.Yl:J ~
CERTIFICATE OF DESTRUCTION? [)(_YES O NO
SMEADSOFT BARCODES DELETED BY: ---~-~~=d-~Grkz~~~~~V
DATE:
DATE:
7/11 /J;Olf r7
1/4#1),1
I I
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program.
(city of
Carlsbad Revised: 6/4/2019
Records Destruction List
Page 1
Date 06/04/2019
Time 11:44:15AM
Date Inactive
Login Name Maria Emery
Record Number External ID Records Description
PFLD-15-4950 10-905811997 COSTA DEL MAR RD 063047 PHYSICAL RECORDS
FP4035 MANAGEMENT -Fire Prevention
Fire
PFLD-15-4951 10-923812976 GREENWICH ST 063047 PHYSICAL RECORDS
FP4036 MANAGEMENT -Fire Prevention
Fire
PFLD-15-5011 10-846613420 ANN DR 063047 PHYSICAL RECORDS
FP4096 MANAGEMENT -Fire Prevention
Fire
PFLD-15-5012 10-5556713738 JEFFERSON ST 063047 PHYSICAL RECORDS
FP4097 MANAGEMENT -Fire Prevention
Fire
PFLD-15-5013 10-533914909 PARK DR 063047 PHYSICAL RECORDS
FP4098 MANAGEMENT -Fire Prevention
Fire
PFLD-15-5014 10-671912478 IMPALA DR 063047 PHYSICAL RECORDS
FP4099 MANAGEMENT -Fire Prevention
Fire
PFLD-15-5015 10-375711936 KELLOGG AV 063047 PHYSICAL RECORDS
FP4100 MANAGEMENT -Fire Prevention
Fire
PFLD-15-5016 10-357512215 CALLE BARCELONA 063047 PHYSICAL RECORDS
FP4101 MANAGEMENT -Fire Prevention
Fire
PFLD-15-5017 10-357712245 CAMINO VIDA ROBLE 063047 PHYSICAL RECORDS
FP4102 MANAGEMENT -Fire Prevention
Fire
PFLD-15-5018 10-1166311941 DOVELN 063047 PHYSICAL RECORDS
FP4103 MANAGEMENT -Fire Prevention
Fire
PFLD-15-5019 10-084616900 AMBROSIA LN 063047 PHYSICAL RECORDS
FP4104 MANAGEMENT -Fire Prevention
Fire
Records Destruction List
Page 2
Date 06/04/2019
Time 11:44:15AM
Date Inactive
Login Name Maria Emery
Record Number External ID Records Description
PFLD-15-5020 10-448417250 PONTO DR 063047 PHYSICAL RECORDS
FP4105 MANAGEMENT -Fire Prevention
Fire
PFLD-15-5021 10-507216707 ANTlLOPE ST 063047 PHYSICAL RECORDS
FP4106 MANAGEMENT -Fire Prevention
Fire
PFLD-15-5022 10-223517466 ALTIVIA PL 063047 PHYSICAL RECORDS
FP4107 MANAGEMENT -Fire Prevention
Fire
PFLD-15-5261 12-897512340-2344 HOSP WY 063047 PHYSICAL RECORDS
FP4348 MANAGEMENT -Fire Prevention
Fire
PFLD-15-5262 12-828911060 CHINQUAPIN AV 063047 PHYSICAL RECORDS
FP4349 MANAGEMENT -Fire Prevention
Fire
PFLD-15-5263 12-736013840 MARGARET WY 063047 PHYSICAL RECORDS
FP4350 MANAGEMENT -Fire Prevention
Fire
PFLD-15-5681 11-216917757 CAMINITO BONANZA 063047 PHYSICAL RECORDS
FP4773 MANAGEMENT -Fire Prevention
Fire
PFLD-15-5682 10-162817733 PALACIO DR 063047 PHYSICAL RECORDS
FP4774 MANAGEMENT -Fire Prevention
Fire
PFLD-15-5683 10-544821800-899 KALPATI CR 063047 PHYSICAL RECORDS
FP4775 MANAGEMENT -Fire Prevention
Fire
End of Report ] [ City of Carlsbad Dataset ECMMaster
CERTIFICATE OF DESTRUCTION & RECYCLING
This certificate is presented to: CITY OF CARLSBAD -RECORDS MANAGEMENT DIVISION
Per the express request of Client, Co,rodata 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
110465
Tuesday, July 16, 2019
5815 EL CAMINO REAL
Jul-11-2019 thru Jul-11-2019
601563
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).
1:1corodata itSSAE16
Type II Audit Completed HIP.Al\