HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Utilities; 2020-07-16RECORDS DESTRUCTION AUTHORIZATION FORM
DATE: 2/27/2020
REQUESTING DEPARTMENT: PUBLIC WORKS - UTILITIES REQUESTER: MARIA EMERY
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.
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EPARTMENT HEAD DATE RECORDS MANAGEMENT DATE CITY AITORNEY DATE
BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS TAB BARCODE
PERIOD (if applicable)
1 SANITARY SEWER OVERFLOW REPORTS 1996-2007 1200-50 CU+S N/A
*If more spaces are needed, click in the last box in right hand corner of table and hit'Yab". This will create more Jields in the table.
To be filled out once records have been destroyed.
RECORD DESTRUCTION COMPLETED BY: ����GU�`-�
CERTIFICATE OF DESTRUCTION? � YES � NO
TAB BARCODES DELETED BY: �'
DATE:
DATE: ������
1��City of
Carlsbad
Revised: 2019
Page /1
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program.
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 prbcedures. 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
115082
Friday, July 17, 2020
5815 EL CAMINO REAL
Ju1-16-2020 thru Ju1-16-2020
717926
6- 6 Boxes for Destruction (large)
30 - 42 Boxes for Destruction (standard)
`Nothing in lhis certificate shall be deemed fo modify [he terms of Ihe parties' Service Agreement(s) or Work Ticket(sJ.
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