HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Public Works; 2009-01-06RECORDS DESTRUCTION REQUEST
City Clerk/Records Management
Page 1 of 1
Department Requesting Destruction: Public Works M&O
roals for Destruction
Department Head Date'
/^/"Records Manager Date
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.
Gail Jones
Person(s) Completing Form:
No.RECORDS DESCRIPTION
Sewer lift stations-general information
Sewer overflow prevention/response plan
Flow monitoring Bi-annual report
Work orders-Meter Shop
RFA's
RFA's
RFA's
RFA's
DATED
1990-
2001
2001
2001
1997-
1999
2000-
2003
1999-
2000
2003-
2004
2004-
2005
BOX
No.
CMWD1
CMWD1
CMWD1
CMWD2
CMWD3
CMWD4
CMWD5
CMWD6
RRS No.
01230-05
01230-72
01230-72
0900-70
0600-25
0600-25
0600-25
0600-25
RRS
Period
CU+5
CL+5
CL+5
CU+2
CL+2
CL+2
CL+2
CL+2
BARCODE APPROVED By !
City Attorney
H=HOLD
RECORD DESTRUCTION COMPLETED BY : <£jNaA £csr<^</C\*\s\
CERTIFICATE OF DESTRUCTION? Yes F*T No D
SMEADLINK BARCODES DELETED BY: * /a
DATE :
DATE:
This form documents the destruction of City records in accordance with the California Public Records Act
Revised 08/25/2005
DOCUMENT MANAGEMENT
CITY OF CARLSBAD
2351 FARADAY AVE
CARLSBAD, CA 920087217
CONTACT: Tanya Bjork - Phone: (760)602-2786
SERVICE PERFORMED
Pounds
Minutes
C' D ,_ADD' L
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 H1PAA & 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:
DATE:
9455 WAPLES ST • STE. 110- SAN DIEGO, CA 921213924 • Phone: (858)678-0460 • Fax: (858)678-0894