HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Police; 2020-01-30RECORDS DESTRUCTION AUTHORIZATION FORM
DATE: 01/20/2020
REQUESTING POLICE -TRAFFIC
DEPARTMENT: DIVISION
DESTRUCTION APPROVALS:
REQUESTER:
JERRY SERAFINI
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.
)~--t---+n~r~I':V--------,---_
D1EPARTMENT HEAD: VE~RDs MANAGEMENT: CITY ATTORNEY:
BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS TAB BARCODE
PERIOD (if applicable)
-------Prior to ---------
DUI BILLING 01/20/2014 0670-20 5 YRS
LIDAR CERTIFICATIONS (ELECTRONIC} Prior to 0670-63 CU+2 01/20/2017
LIDAR CERTIFICATIONS (PAPER) Prior to 0670-63 CU+2 01/20/2017
*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.
RECORD DESTRUCTION COMPLETED BY:_ .
To be filled out once records have been de.stroye~d. -~
CERT! FICA TE OF DESTRUCTION? --Y-E -----□-.-N-0 __ _
DATE: o I /30 /:i.o2-o
-SMEADSOFT BARCODES DELETED BY: DATE:
<~;'> CITY Of
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management
Program.
~ CARLSBAD Revised:
II
1:-:1coroctlata
Shredding, Inc.
I SAN DIEGO • ORANG
1
E COUNTY/LA
NORTH BAY/SAN FRANCISCO· SA~ JOSE/SILICON VALLEY
I
Thu Jan 30 2020 : I next:211312020I , i
I
Corodata Shredding, Inc.
12375 Kerran Street· Poway, CA 92064
(858) 7 48-1100 Fax (858) 726-6085
I 1111111111111111 IIIII 111111111111111111 First Available T ket # 666160 IC
CITY OF CARLSBAD -POLICE DEPT. Directions Routine Instruptions
2560 ORION WAY I
CARLSBAD, CA 920W
I
I Contacts i PAULA CREWSE (760)931-2131
I Special Instructions
I
Room
l Time In:
j
I I
I
!
I
I
j Description
j 1 32 Gallon Console -1 ST
I FLOOR/RECORDS
i 1 32 Gallon Console • 1 ST
i FLOOR/REPORT WRITING
I
11 32 Gallon Console -1 ST
I FLOOR/TRAFFIC
I 11 32 Gallon Console • 2ND
I FLOOR/ELEVA TOR/ADM IN
,1· 1 64 Gallon Bin -1 ST
1 FLORR/PROCESSING
1
2 32 Gallon Console -2ND
I FLOOR/INVESTIGATIONS
i 1i Time Out:
·-1 11 ..... -·-·-....
I
Container Service Item
32 Gallon Console
32 Gallon Console
32 Gallon Console
32 Gallon Console
64 Gallon Bin
---------------·----···------------------·-· -·--·
32 Gallon Console
: D~iver: A\e 'I.
Service / Comm.ents
i DRIVER: AVOID 11 :00 -2:00
I OKAY TO PARK IN THE RED
I ZONE
I CHECK IN AT FRONT DESK ON
i THE RIGHT
*DRIVER MUST BE ESCORTED*
I
I I
I
I
Qty Actual
1.00 1
1.001
1.00 1 I
1.001 I
1.001 I
2.0012
Quantity: 7 +/-
Corodata Shredding, Inc. represents that it received the aforementioned materials for confidential
destruction and hkreby certifies such materials will be confidentially handled and destroyed and
that the shreddedlmaterials will be recycled. Client represents that it has authority to provide to•
Corodata Shreddipg, Inc. the aforementioned materials for confidential destruction and hereby
acknowledges an<fj accepts the terms and conditions on the reverse side.
I
I
I X
SD Shred Truck Stop 99 BC SD012455 Page 1