HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Utilities; 2011-06-28 (2)CITY OF
CARLSBAD
Records Management
Page 1 of 1
RECORDS DESTRUCTION AUTHORIZATION
DEPARTMENT REQUESTING DESTRUCTION: Utility
Person(s) Completing Form: Jayme Foster
APPROVALS FOR DESTRUCTION
Department Head
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Date
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Records Manager Date
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City Attorney Date
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.
BOX
NO.
892
RECORDS DESCRIPTION
City Hall Climate Control System Modification,
Elm Ave-Beach Access, Library Modifications,
Library Mezzanine, Elm ave crossings, Signal at
Tamarack & pio Pico, city Tennis Courts, temp
sidewalk- Tamarack/Jefferson/Carlsbad BLVD,
Cannon Road Sewer, Highland Drive Sewer,
Cannon Road Assessment District, James Dr
Storm Drain, Stagecoach Park, Buena Vista
Channel QfA^AraJ U-Cfl OjZ(3&^ p.
3494 - Chinquapin Sewage Lift Station, 3533 -
Jefferson St 12" Water Main, 3583-2 SAHI Ph II
Rch III Sta 15-73, 3388 - Maerkle Dam Covering
& Liner GȣA^T2L.f f/r^O G0rr0S,p .
Certificates of insurance
DATED
1975-1986
1997-2002
1989-1999
RRS NO.
1000-05
1000-05
0470-33
To be filled out once records have been destroyed.
RECORD DESTRUCTION COMPLETED BY: . * SK-'V & >^fc
CERTIFICATE OF DESTRUCTION? F| YES Q NO
^/SMEADSOFT BARCODES DELETED BY: */ / A_
1
PERIOD
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CU+2
CU+2
SMEADSOFT
BARCODE
(if applicable)
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DATE:
DATE:
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APPROVED By
City Attorney
H=HOLD
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This form documents the destruction of City records in accordance with the City of Carlsbad Records
Management Program
Revised 12/23/2009
WE RECYCLE
SERVICE LOCATION:
PHC
BILLED TO:
Of Carload-Records Man •••,
5 B Camfco Real
CERTIFICATE REFERS TO INVOICE NO.:
DATE:
•-.,'
"=if? Faraday Ave
A 92006
PUf
This is to certify that Shred-it destroyed confidential information
for the above mentioned company by
TRUCK NO.:TRUCK NO.:TOTAL TIME:HIRS.: MINI.:
CUSTOMER SERVICE REP."
CLIENT:
PRINT CUSTOMER'S
NAME:
This year, through Shred-it's
recycling program, your firm
has saved trees from destruction.
CERTIFICATE OF
DESTRUCTION
THANK YOU FOR
YOUR BUSINESS.
SECURING YOUR OFFICE Shred-it,
AND THE ENVIRONMENT