HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Housing Services; 2013-10-24Shred- il.
3801 OLeaii Ranch Blvd
Suite 101
Oceaiisidt CA
92056
Phone: 760- 598- 5700
SKKVICE RECORD SUMMARY
CKRTIVICATK OP OKSTRUCTION
PLEASE KEEP THIS FOR YOUR RECORDS
(THIS IS NOT AN INVOICE)
Customer: 0011889293
CITV OF CARLSBAD- RECORDS MANAOKMENT
5815 EL CAMINO REAL
CARLSBAD CA 92008- 8801
Order#: 8009700753
Order Date; 24.10.2013
Service Type: SHRED - ON- SITE PURGE
Coiilact:PAT DOWNIE
Time In: 07:52 AM
Time Out: 10:49 AM
MaterlBl Collected
BANKERS/ARCHIVE BOX 141
FILE DRAWER 2
Total: 143
Service Time: 176 Min
Customer Signature: PAT DOWNIE
CSR Signature: RUBEN JACOBO
RECORDS DESTRUCTION AUTHORIZATION FORM
DATE: 9/9/2013
REQUESTING DEPARTMENT: HNS REQUESTER: PATTI CRESCENTI
DESTRUCTION APPROVALS:
We certify that the records listed fae/ow have been retained for the scheduled retention period, required audits have been
completed, and no pending or ongo/ng litigation or investigation involving these records is known to exist.
DEPARTMENT HEAD:
V
RECORDS MANAGEIVIENT: CITY ATTORNEY:
BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS
PERIOD
TAB BARCODE
(if applicable)
298
CDBG: BOYS & GIRLS CLUB TEEN;
BROTHER BENNO CIR; BROTHER
BENNO HOUSE OF DBF; CATHOLIC
CHARITIES; CASA DE AMPARO;
COMM RES CTR; FROM THE INSIDE
OUT; INTERFAITH SRVCS; LIFELINE
COMM SRVCS; MEALS ON WHEELS;
NC COMM SRVCS; NC HEALTH
SRVCS; WOMENS RES CTR; BOYS &
GIRLS CLUB FACILITY
IMPROVEMENTS; TERI INC; COC
LIBRARY; HEARTLAND FAIR HSG;
ADMINISTRATION
2006 056530 TE+3
•// more spaces ore needed, click in tiie 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
CERTIFICATE OF DESTRUCTION?
SMEADSOFT BARCODES DELETED BY:
YES • NO
DATE: /C)-c2^/3
DATE:
^- CARLSBAD
This form documents the destruction of City records in accordance with tbe City of Carlsbad Records Management Program.
Revised: 9/9/2013