HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Human Resources; 2020-07-16jJ-
RECORDS DESTRUCTION AUTHORIZATION FORM
DATE: February 11, 2020
REQUESTING DEPARTMENT: HR REQUESTER: Marie Jones-Kirk
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.
DATE ~ ' I • . ~1/Jo
~ DATE CITY ATTORNEY: DATE
BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS TAB BARCODE
PERIOD (if applicable)
1 pack Volunteer applications 8/27/19 860-80 CL+3 -(Volunteer Programs)
*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 hove been destroyed.
Cun~ RECORD DESTRUCTION COMPLETED BY: __________ _ DATE:
CERTIFICATE OF DESTRUCTION? ~ YES 0 NO
SMEADSOFT BARCODES DELETED BY: ___________ _ DATE: ------
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program.
Ccityof
Carlsbad Revised: 2/12/2020
Last Name
[Acosta
Asaro
I Basista
Bechtel
iBodnar
Carrigan
!Endres
Gaspar
/Hensley
Inzano
llssertell
Jensk
l~awecki
Lamb
!Nelson
Pines
1Ros€1n
Sainz
l~r:iiii:
Skiver
!Tarman
Tezer
ITezer
Walker
Volunteer Application Purged Files: February 11, 2020
First Name
]Ariana 10/3/2012
Janet 2/27/2014
)Lisa 3/9/2016
Margaret 3/20/2008
i/Rlchard · 10/6/2008
Bernie 12/15/2010
li~rin 4/15/2010
Kristin 3/5/2015
:iOllver 4/21/2015
.Cara 1/21/2006
::Jaso.n 12.}io1:foi5
Jennifer 3/27/2014
'iMarlssa · 8/24/2016
Betsy 3/20/2013
'[Lyncla · S/16720i6.
Larry 10/26/2016
JPeter 4/J.61?.016 ..
Shae 1/4/2008
··.··1rshe11{I:·\ 4/1st~oif .··
Nathan 4/6/2011
1!~0Jiitf\~J~ti1JJ;z~{i!L,·D~/~/2016
Jeff 1/25/2016
.... l!U;a&:ijif,: · .. , .. fil~li.@o'9 .
Jean 3/9/2016
Archive Date
lCl/31/2016
1/15/2017
1/19/2017
10/24/2016
1()/24/2016
12/20/2016
Ul/2017
1/19/2017
10/27/2016
1/23/2017
1/13/2017 ..
1/23/2017
2/6/2op
1/23/2017
·7,/7!2017
2/7/2017
10/5/20iS . j
1/23/2017 ·. · #2s1to11
1/23/2017
'· · ... ftt/zbti
10/30/2016
10/SQ/2016
1/1/2017
·1
{ !
'j
_j
Purge Date
10/31/2019
1/15/2020
1/19/2020
10/24/2019
10/24/2019
12/20/2019
1/1/2020
1/19/2020
10/27/2019
1/23/2020
1/13/2020
1/23/2020
2/6/2020
1/23/2020
2/7/2020
2/7/2020
10/5/2019
1/23/2020
1/23/2020
1/23/2020
1/1/2020
10/30/2019
10/30/2019
1/1/2020
,·
Bl Account
Yes
Yes
No
Yes
Yes
Yes
t Yes
Yes
Ves•
Yes
i----Yes
Yes
•· Yes
Yes
[ Yes.
Yes
L;··· .• Y~i
Yes ~·t:~ . ; :-Y:ijf •....
Yes
Vi
Yes vef
Yes
Notes
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
115082
Friday, July 17, 2020
5815 EL CAMINO REAL
Jul-16-2020 thru Jul-16-2020
717926
6 -6 Boxes for Destruction.(large)
30 -42 Boxes for Destruction (standard)
• Nothing In this certificate shall be deemed lo modify the terms of the parties' Service Agreemenl(s) or Wark Ticket(s).
1:1corodata ifSSAE16
Type II Audit Completed HIPA1A