HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Police; 2019-04-25 (6)I f
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RECORDS DESTRUCTION AUTHORIZATION FORM
DATE: 03/29/19 D.ERNa I REQUESTING
REQUESTER:
DEPARTMENT: POLICE PSSD
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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7~-DEPARTMENT HEAD: ) RECORDS MANAGEMENT: CITY ATTORNEY:
BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS TAB BARCODE
PERIOD (if applicable)
-Dale Perry Evaluations 07/2018 0810-50 5 -Dale Perry Evaluations 12/02/18 0810-50 5
-Dale Perry LOR 06/17/17 0670-11 CL+2
-Dale Perry station memos 12/01/17 0670-11 CL+2
*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. ~--~z:rs--
RECORD DESTRUCTION COMPLETED BY: (-I\ I "i'~~\I I C:..1-t ,caG crn DATE: CY-( ll l 9
CERTIFICATE OF DESTRUCTION? [}j YES □ NO
SMEADSOFT BARCODES DELETED BY: DATE:
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management
~', CITY 01 Program.
w CARLSBAD Revised: 3/29/2019
, /.
·,1corodata Corodata Shredding, Inc.
12375 Kerran Street· Poway, CA 92064
(858) 7 48-1100 Fax (858) 726-6085
Shredding, Inc.,
SAN DIEGO • ORANGE COUNTl'./LA
NORTH BAY/SAN FRANCISCO -SAN JOSE/SILICON VALLEY
Thu Apr 25, 2019 next:5/9/2019/ On Site Required
CITY OF CARLSBAD -POUGE DEPT. Directions
2560 ORION WAY c---~-~------~-~.,
CARLSBAD, CA 92010
Contacts
PAULA CREWSE (760)931-2131 Special Instructions
Room Description
1 32 Gallon Console -1ST
FLOORiRECORDS
1 32 Gallon Console -1 ST
FLOOR/REPORT WRITING
1 32 Gallon Console -1 ST
FLOORlTRAFFIC
1 32 Gallon Console -2ND
FLOOR/ELEVATOR/ADM IN
1 64 Gallon Bin -1 ST
FLORR/PROCESSING
Container
------~--------·-------------·--·· ------
Service Item
32 Gallon Console
32 Gallon Console
32 Gallon Console
32 Gallon Console
64 Gallon Bin
I llllll /llll lll// /Ill/ //Ill II/II /Ill /Ill
Ticket# 579972
Routine Instructions
DRIVER: AVOID 11:00-2:00
OKAY TO PARK IN THE RED
ZONE
CHECK IN AT FRONT DESK ON
THE RIGHT
*DRIVER MUST BE ESCORTED*
Qty Actual
1.00 1 i
1.00 1 I
1.001 I
1.00 1 I
1.00 1
2 32 Gallon Console -2ND 32 Gallon Console 2.00 .._I _2.,=-----'
FLOOR/INVESTIGATIONS
-1 T_i_m_e_l_n_~_-.... --._-__ -____ -_-___ -_ _] [ri~_e_O_u_t_: ----] 1-D~iver: _____ ~~~-;_-· .. __ _j [~Ll~~!ity~ ____ '] .. _+!:_ _____ I
Service / Comments
Corodata Shredding, Inc. represents that it received the aforementioned materials for confidential
destruction and hereby certifies such materials will be confidentially handled and destroyed and
that the shredded materials will be recycled. Client represents that it has authority to provide to
Corodata Shredding, lr1,c. the aforementioned materials for confidential destruction and hereby
acknowledges and accepts the terms and conditions on the reverse side.
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SD Shred Truck Stop 99 BC SD012455 Pagel