HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Parks & Recreation; 2018-08-09RECORDS DESTRUCTION AUTHORIZATION FORM
DATE: 7/\~/f~
REQUESTING DEPARTMENT: _.p_q....._~----=-e_=-·-------REQUESTER: 1zt.rQ ~J:t~
DESTRUCTION APPROVALS:
We certify that the records listed belo w 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.
• CITY ATTORNEY:
BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS TAB BARCODE
PERIOD (if applicable)
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2. 1'11~ 1/30-os CU-t2
~ !'111 /130 ---05 · 6U.-f 2-
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*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: t!tJJZJd/lfl_/ DATE:
CERTIFICATE OF DESTRUCTION? 12K_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.
«~'>'> cm o, Revised: 7/16/2018 ~ CARLSBAD
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
108788
Thursday, August 09, 2018
58 15 EL CAMINO REAL
Aug-09-20 18 thru Aug-09-2018
508375
* Nothing in this certificate shall be deemed to modify the terms of the parties' Service Agreement(s) or Work Ticket(s).
Et corodata a l9~ ~~ (~~~ ~· :••·,-
_ SSAE16
Type II Audit Completed • HIPAlA.
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