HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Senior Center; 2013-10-24thrad-H
Shred-it.
3801 Ocean Ranch Blvd
Suite 101
Oceanside CA
92056
Phone; 760- 598- 5700
SERVICE RECORD SUMMARY
CKRTIFICATE OF DKSTRUCTION
PLEASE KEEP THIS FOR YOUR RECORDS
(THIS IS NOT AN INVOICE)
Customer: 0011889293
CITY OF CARLSBAI) RECORDS MANAGEMENT
5815 EL CAMINO REAL
CARLSBAD CA 92008- 8801
Order #: 80097007S3
Order Date: 24.10.2013
Service Type: SHRED - ON- SITE PURGE
Contact: i'AT DOWNIE
Time In: 07:52 AM
Time Out: 10:49 AM
Material Collected
BANKERS/ARCHIVE BOX 141
FILE DRAWER 2
Total: 143
Service Time: 176 Min
Customer Signature: PAT DOWNIE
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CSR Signature: RUBEN JACOBO
RECORDS DESTRUCTION AUTHORIZATION FORM
DATE: 5/17/13
REQUESTING DEPARTMENT:' SENIOR CENTER REQUESTER: (jlDiatk^^
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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RECORDS MANAGEMENT: CITY ATTORNEY:
BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS
PERIOD
TAB BARCODE
(if applicable]
ICSS A.I.S. Grant 2006 0690-20 CU+5
2 CSS A.I.S. Grant 2006-07 0690-20 CU+5
3 CSS A.I.S. Grant 2007 0690-20 CU+5
4 CSS A.I.S. Grant 2001-06 0690-20 CU+5
5 CSS A.I.S. Grant 2001 0690-20 CU+5
6 CSS Daytrippers 2009 1130-53 CL+2
*// 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:.
• YES • NO
DATE:
CERTIFICATE OF DESTRUCTION?
SMEADSOFT BARCODES DELETED BY: DATE:
^ CARLSBAD
This form documents the destruction of City records in accordance with tbe City of Carlsbad Records Management Program.
Revised: 5/20/2013