HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Parks & Recreation; 2016-11-01RECORDS DESTRUCTION AUTHORIZATION FORM
DATE: 7/16/16
REQUESTING DEPARTMENT: PARKS AND RECREATION
DESTRUCTION APPROVALS:
We certify that the records listed below have been retained for the scheduled retention pe ·
completed, and no pending or ongoing litigation or investigation involving these records is know
~D: RECORDS MANAGEMENT:
BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS TAB BARCODE
PERIOD (if applicable)
LCR-201,-1 Facility Use Permits 2012 0900-43 CL+2
LCR-2011.1 CLASS Revenue Reports 2012 Noi'J~~EiCj 1Z.O
*if more spaces ore needed, cliCk m the lost box m fight hand corner of table and htt "tab". Thts wt/1 create more ftelds m the table.
To be filled out once records have been destroyed.
RECORD DESTRUCTION COMPLETED BY: etJtp ~
CERTIFICATE OF DESTRUCTION? liS] YES 0 NO
DATE: II /1 /(}()1 k
I
SMEADSOFT BARCODES DELETED BY: ___________ _ DATE: _____ _
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program.
«~~) COH o• Revised: 7/16/2016 ~CARLSBAD
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
105156
Tuesday, November01 ,2016
5815 EL CAMINO REAL
Nov-01-2016 thru Nov-01-2016
352320
*Nothing in this certificate shall be deemed to modify the terms of the parties' Service Agreement(s) or Work Ticket(s) .
t:J corodata SSAE16
Ty~-e II .O..ud il C001pleted' • HIB'\11\.
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