HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Fire; 2011-06-28CARLSBAD
Records Management
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RECORDS DESTRUCTION AUTHORIZATION
DEPARTMENT REQUESTING DESTRUCTION: Fire Administration
Person(s) Completing Form: Christina Wilson
APPROVALS FOR DESTRUCTION
Date
, --'Records Managerr Date
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.
1
2
3
4
RECORDS DESCRIPTION
Drug usage records 2006, 2007, 2008
Pre-Hospital EMS reports 2002-patient age
25 and up
Pre-Hospital EMS reports 2003-patient age
25 and up
Records requests and Subpoenas
DATED
2006, 2007,
2008
2002
2003
1994, 1999,
2003, 2004,
2005, 2005,
2006
RRS NO.
0630-05
0650-10
0650-10
0745-30
RRS
PERIOD
CU+2
(Admin
Decision-
Linda A.)
7
7
CL+5
SMEADSOFT
BARCODE
(if applicable)
N/A
N/A
N/A
N/A
APPROVED By
City Attorney
H=HOLD
To be filled out once records have been destroyed.
RECORD DESTRUCTION COMPLETED BY:
CERTIFICATE OF DESTRUCTION?
SMEADSOFT BARCODES DELETED BY:
YES n DATE:
DATE:
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:
Shret'P. O: to #•
Vista, CAS
PHOWE 7f=
BILLED TO:
CERTIFICATE REFERS TO INVOICE NO.:
•
«
DATE:
Ctv Of Cartsbad-Recorcfc h
581 •.<> Real
**N-' :-VlOE•aad, c^
Cty OfAttni Rom* Shi-
Cartebad.CA92DOB
This is to certify that Shred-it destroyed confidential information
for the above mentioned company by
TRUCK NO TRUCK NO.:
CUSTOMER SERVICE REP.:.
TOTAL TIME:
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.
MRS.: MIN.:
L_ .
SECURING YOUR OFFICE thred-it,
AND THE ENVIRONMENT