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RECORDS DESTRUCTION AUTHORIZATION FORM
^^^^^^^^^^^^^^^^^^^^^^^^^^^^
DATE: 3/7/14
REQUESTING DEPARTMENT: HUMAN RESOURCES REQUESTER: PENNY MCKAY
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 knowr,
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DEPARTMENT HEAD: RECORDS MANAGEMENT:
BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS
PERIOD
SMEADSOFT BARCODE
(if applicable)
2010-7 Parks & Rec Director-
Applicant Data Forms 10/2010 0850-25 CL+3
^ Senior Management Analyst-
Applicant Data Forms 12/2010 0850-25 CL+3
3 Deputy City Clerk Tech
/ Applicant Data Forms
11/2010 0850-25 CL+3
^ Management Analyst 9/2010 0850-25 CL+3
Parks & Rec Director 10/2010 0850-25 CL+3
3.
To be filled out once records have been destroyed.
RECORD DESTRUCTION COMPLETED BY:
CERTIFICATE OF DESTRUCTION?
SMEADSOFT BARCODES DELETED BY:
YES • NO
DATE:
DATE:
This form documents the destruction of City records In accordance with the City of Carlsbad Records Management
Program.
CARLSBAD Revised: 3/10/2014
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CINIAS. 0G36 - San Diego
9455 Waples St. Suite 110
San Diego, CA 92121
Phone # (858) -678-0460
Fax # (858) -678-0894
Certificate of Destruction
City of Carlsbad
1635 FARADAY AVE
CARLSBAD, CA 92008-7314
Document # 8005499713
Document Date 06/23/2014
Cintas Route/SSR R0G36.0046/Luis Anzueto
Customer* 10213041
Service Type Purge
Customer Group On-Site
Next Service Date
Material #
SV0000326
Description
Purge Svc (P/0n)-Legal (Large) Box
Quantity
99/00 EA
Order Notes
Quantity Serviced
112 sm
Has 100- 150 Boxes at: 5816 El Camino Real, Carlsbad, 92008. Hours: 8
am - 5 pm. Contact is Pat Downie 760-602-2738. Please call ahead of
time if you will be there between 11:30 and 1 pm. There will be a box
truck here collecting blue prints as well. Will invoice. Scheduled per
Sales Rep. Liz.
MANUAL PUSH 20140617 212016
This certificate is to certify that Cintas Document Management shreds confidential data per customer's instructions for the above-mentioned company.
The following services are NAID certified: Hard Drive Destruction, Mobile Destruction and Offsite Destruction. The following services are not NAID
certified: Non-paper Destruction.
Service Representative Signature Date
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