HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Records Management; 2009-01-06 (2)RECORDS DESTRUCTION REQUEST
City Clerk/Records Management
Page 1 of2
Department Requesting Destruction: RECORDS MANAGEMENT
Approvals for Destruction
Head
i^f/^tr
Date
Records Manager ate
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.
Person(s) Completing Form:
TANYA BJORK ^7
No.RECORDS DESCRIPTION
OPERATIONS CENTER - GENERAL
INFORMATION
VISTA-CARLSBAD-BUENA-SAN MARCOS
SEWERAGE SYSTEM JOINT ADVISORY
COMMITTEE AGENDAS
VISTA-CARLSBAD-BUENA-SAN MARCOS
SEWERAGE SYSTEM JOINT ADVISORY
COMMITTEE GENERAL INFORMATION
ENCINA WATER POLLUTION CONTROL
FACILITY - GENERAL INFORMATION
SATELLITE RECLAMATION PLANTS -
GENERAL INFORMATION
ENCINA PLANT SEWAGE CAPACITY SEWER
MORATORIUM - GENERAL INFORMATION
WASTEWATER RECLAMATION MASTER PLAN
- GENERAL INFORMATION
SEWAGE TREATMENT PLANT - GENERAL
INFORMATION
SEWAGE TREATMENT PLANT - AFFIDAVIT OF
PUBLICATION - NOTICE TO BIDDERS
ENCINA JOINT POWERS JOINT ADVISORY
COMMITTEE - AGENDAS
ENCINA JOINT POWERS JOINT ADVISORY
COMMITTEE - GENERAL INFORMATION
DATED
1980-
1984
1968-
1971
1968-
1974
1961-
1990
1977-
1980
1977
1980-
1982
1959-
1966
1964
1977-
1979
1976-
1977
BOX
No.
123
123
123
123
123
123
123
123
123
123
123
RRS No.
0750-05
0305-40
0305-05
0750-05
0750-05
0750-05
0750-05
0750-05
0740-20
0305-40
0305-05
RRS
Period
CU+2
CU+2
CU+2
CU+2
CU+2
CU+2
CU+2
CU+2
CU+4
CU+2
CU+2
BARCODE
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
APPROVED By
City Attorney
H=HOLD I
RECORD DESTRUCTION COMPLETED BY:
CERTIFICATE OF DESTRUCTION? Yes 0 No D
DATE
This form documents the destruction of City records in accordance with the California Public Records Act
Revised 08/25/2005
CJNlAS
DOCUMENT MANAGEMENT
CITY OF CARLSBAD
2351 FARADAY AVE
CARLSBAD, CA 920087217
CONTACT: Tanya Bjork - Phone: (760)602-2786
SERVICE PERFORMED
Pounds
Minutes
SVC'D_ADD'L
i3.oape.Eox,
CERTIFICATE OF DESTRUCTION
SERVICE TICKET #:
DATE:
CUSTOMER #:
SERVICE/TYPE:
NEXT SERVICE DATE:
NEXT SERVICE TYPE:
Lock(s) Present/Operable:
Clasp(s) Present/Operable:
OOG36 - 66715
01/06/2009
10284
Purge/Onsite
Not scheduled.
Not scheduled.
Yes
Yes
No
No
COMMENTS:
This certificate is to certify that Cintas Document Management will shred confidential data per customer's instructions and according to HIPAA & GLBA
regulations for the above-mentioned company. Mobile destruction services are NAID certified. Non-Paper destruction services are not NAID certified.
CUSTOMER SIGNATURE:
SERVICE REP SIGNATURE: ^~^*^~
DATE : / ~~ ^ *~ <C-*p
— ___ / ^~^.'^^^~~~-~^ DATE:
9455 WAPLES ST • STE. 110 • SAN DIEGO, CA 921213924 • Phone: (858)678-0460 • Fax: (858)678-0894