HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Fire Prevention; 2009-01-06RECORDS DESTRUCTION REQUEST
City Clerk/Records Management
Page 1 of 1
Department Requesting Destruction: _ > < f*L
Approvals for Destruction
Date
' Records Manager
Attorney
Date
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:
No.RECORDS DESCRIPTION DATED BOX
No.
RRS No.RRS
Period
BARCODE APPROVED By
City Attorney
H=HOLD
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RECORD DESTRUCTION COMPLETED BY :
CERTIFICATE OF DESTRUCTION? Yes
ODES DELETED BY:SMEADL
77)/s form documents the destruction of City records In accordance with the California Public Records Act
Revised 08/25/2005
RECORDS DESTRUCTION REQUEST
City Clerk/Records Management
Page 1 of I
Department Requesting Destruction: _ > c
Approvals for Destruction
We-eertify 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:/?
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No.RECORDS DESCRIPTION DATED BOX
No.
RRS No.RRS
Period
BARCODE APPROVED By
City Attorney
H=HOLD
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RECORD DESTRUCTION COMPLETED BY
CERTIFICATE OF DESTRUCTION? Yes D H
DES DELETED BY:SMEADLIN
This form documents the destruction of City records in accordance with the California Public Records Act
Revised 08/25/2005
RECORDS DESTRUCTION REQUEST
City Clerk/Records Management
Page 1 of 1
Department Requesting Destruction:r~((f£
Approvals for Destruction
Department Head Date
Records Manager Date
Attorney Date
iat the records listed below have been retained for the scheduled retention period, required audits have
completed, and no pending or ongoing litigation or investigation involving these records is known to exist.
Person(s) Completing Form:
8 fX. ^
No.RECORDS DESCRIPTION DATED BOX
No.
RRS No.RRS
Period
BARCODE APPROVED By
City Attorney
H=HOLD
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5~(e~lo £
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51^-10 e. eft-f
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RECORD DESTRUCTION COMPLETED BY
CERTIFICATE OF DESTRUCTION? Yes
SMEADLIN
This form documents the destruction of City records in accordance with the California Public Records Act
Revised 08/25/2005
RECORDS DESTRUCTION REQUEST
City Clerk/Records Management
Page 1 of 1
Department Requesting Destruction:
Approvals for Destruction
Department Head
Records Manager
Attorney Date
We cerJWy^nat the records listed below have been retained for the scheduled retention period, required audits have
5en completed, and no pending or ongoing litigation or investigation involving these records is known to exist.
Person(s) Completing Form:
No.RECORDS DESCRIPTION DATED BOX
No.
RRS No.RRS
Period
BARCODE APPROVED By
City Attorney
H=HOLD
l?sf /
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RECORD DESTRUCTION COMPLETED BY :
CERTIFICATE OF DESTRUCTION? Yes
SMEADLINK B
This form documents the destruction of City records in accordance with the California Public Records Act
Revised 08/25/2005
RECORDS DESTRUCTION REQUEST
City Clerk/Records Management
Page 1 of 1
Department Requesting Destruction:
Approvals for Destruction
Department Head Date
Records Manager Date
Attorney Date
iat the records listed below have been retained for the scheduled retention period, required audits have
completed, and no pending or ongoing litigation or investigation involving these records is known to exist.
Person(s) Completing Form:
No.RECORDS DESCRIPTION DATED BOX
No.
RRS No.RRS
Period
BARCODE APPROVED By
City Attorney
H=HOLD
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21
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RECORD DESTRUCTION COMPLETED BY
CERTIFICATE OF DESTRUCTION? Yes D No.
SMEADLINK B
This form documents the destruction of City records in accordance with the California Public Records Act
Revised 08/25/2005
RECORDS DESTRUCTION REQUEST
City Clerk/Records Management
Page 1 of 1
Department Requesting Destruction: >(<-o-
Approvals for Destruction
Department Head Date
Records Manager Date
Attorney Date
We certify-thaTthe records listed below have been retained for the scheduled retention period, required audits have
bpeffcompleted, and no pending or ongoing litigation or investigation involving these records is known to exist.
Person(s) Completing Form:
No.RECORDS DESCRIPTION DATED BOX
No.
RRS No.RRS
Period
BARCODE APPROVED By
City Attorney
H=HOLD
C
2%-55-
Of, ?&•
30
26
RECORD DESTRUCTION COMPLETED BY
CERTIFICATE OF DESTRUCTION? Yes
SMEADLINK B
This form documents the destruction of City records in accordance with the California Public Records Act
Revised 08/25/2005
RECORDS DESTRUCTION REQUEST
City Clerk/Records Management
Page 1 of 1
Department Requesting Destruction: < t (£- ///
Approvals for Destruction
Department Head
Records Manager.Date
Attorney Date
iat the records listed below have been retained for the scheduled retention period, required audits have
completed, and no pending or ongoing litigation or investigation involving these records is known to exist.
Person(s) Completing Form:
No.RECORDS DESCRIPTION DATED BOX
No.
RRS No.RRS
Period
BARCODE APPROVED By
City Attorney
H=HOLD
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RECORD DESTRUCTION COMPLETED BY
CERTIFICATE OF DESTRUCTION? Yes
SMEADLINK
This form documents the destruction of City records in accordance with the California Public Records Act
Revised 08/25/2005
RECORDS DESTRUCTION REQUEST
City Clerk/Records Management
Page 1 of 1
Department Requesting Destruction: ' (
Approvals for Destruction
Attorney Date
We certifyjhatihe records listed below have been retained for the scheduled retention period, required audits have
beefTcompleted, and no pending or ongoing litigation or investigation involving these records is known to exist.
Person(s) Completing Form:
O/^ ,/v. </( <2_ [sJ&si
No.
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31
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RECORDS DESCRIPTION
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City Attorney
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RECORD DESTRUCTION COMPLETED BY :
CERTIFICATE OF DESTRUCTION? YesD_JiO-Q- —
SMEADLINK-BA«eoCESDELETED BY:
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_— — ^DATE:
DATE:
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7/j/s form documents the destruction of Crty records in accordance with the California Public Records Act
Revised 08/25/2005
RECORDS DESTRUCTION REQUEST
City Clerk/Records Management
Page 1 of 1
Department Requesting Destruction: ]jf£ \i
Approvals for Destruction
Department Head
Records Manager
Attorney Date
We certifyjfratthe records listed below have been retained for the scheduled retention period, required audits have
"completed, and no pending or ongoing litigation or investigation involving these records is known to exist.
Person(s) Completing Form:
No.RECORDS DESCRIPTION DATED BOX
No.
RRS No.RRS
Period
BARCODE APPROVED By
City Attorney
H=HOLD
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RECORD DESTRUCTION COMPLETED BY
CERTIFICATE OF DESTRUCTION?
ODES DELETED BY:SMEADLI
This form documents fne destruction of City records in accordance with the California Public Records Act
Revised 08/25/2005
RECORDS DESTRUCTION REQUEST
City Clerk/Records Management
Page 1 of 1
Department Requesting Destruction: M
Approvals for Destruction
Department Head Date
Records Manager Date
Attorney Date
We certjJy^tHat the records listed below have been retained for the scheduled retention period, required audits have
beeffcompleted, and no pending or ongoing litigation or investigation involving these records is known to exist.
Person(s) Completing Form:
No.RECORDS DESCRIPTION DATED BOX
No.
RRS No.RRS
Period
BARCODE APPROVED By
City Attorney
H=HOLD
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RECORD DESTRUCTION COMPLETED BY
CERTIFICATE OF DESTRUCTION? Yes n No
SMEADLIN
T/J/S form documents (he destruction of C/ty records /n accordance ivrth fhe California Public Records Act
Revised 08/25/2005
RECORDS DESTRUCTION REQUEST
City Clerk/Records Management
Page 1 of 1
Department Requesting Destruction: T t
Approvals for Destruction
Department Head Date
Records Manager Date
Attorney Date
We certifyjbartne records listed below have been retained for the scheduled retention period, required audits have
be^rr-rJompleted, and no pending or ongoing litigation or investigation involving these records is known to exist.
Person(s) Completing Form:
No.RECORDS DESCRIPTION DATED BOX
No.
RRS No.RRS
Period
BARCODE APPROVED By
City Attorney
H=HOLD
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RECORD DESTRUCTION COMPLETED BY :
CERTIFICATE OF DESTRUCTION? Yes
SMEADLIN
777/s form documents the destruction of City records in accordance with the California Public Records Act
Revised 08/25/2005
RECORDS DESTRUCTION REQUEST
City Clerk/Records Management
Page 1 of 1
Department Requesting Destruction:
Approvals for Destruction
Department Head Date
Records Manager Date
Attorney Date
We certifjrtbatlfie records listed below have been retained for the scheduled retention period, required audits have
beefrtompleted, and no pending or ongoing litigation or investigation involving these records is known to exist.
Person(s) Completing Form:
No.RECORDS DESCRIPTION DATED BOX
No.
RRS No.RRS
Period
BARCODE APPROVED By
City Attorney
H=HOLD
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ODES DELETED BY:
RECORD DESTRUCTION COMPLETED BY :
CERTIFICATE OF DESTRUCTION? Yes D N
SMEAD
This form documents fne destruction of City records in accordance with the California Public Records Act
Revised 08/25/2005
City Clerk/Records Management
Page 1 of 1
RECORDS DESTRUCTION REQUEST
Department Requesting Destruction:
Approvals for Destruction
Department Head Date
Records Manager,
We
b«
Date
Attorney Date
ce lit the records listed below have been retained for the scheduled retention period, required audits have
completed, and no pending or ongoing litigation or investigation involving these records is known to exist.
Person(s) Completing Form:
No.RECORDS DESCRIPTION DATED BOX
No.
RRS No.RRS
Period
BARCODE APPROVED By
City Attorney
H=HOLD
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RECORD DESTRUCTION COMPLETED BY :
CERTIFICATE OF DESTRUCTION? Yes Fl No T
DATE
SMEADLINK
This form documents the destruction of City records in accordance with the California Public Records Act
Revised 08/25/2005
RECORDS DESTRUCTION REQUEST
City Clerk/Records Management
Page I of 1
Department Requesting Destruction: \(f£ ' CJ\J*^-L
Approvals for Destruction
Department Head Date
Records Manager Date
\ttorney Date
We certify-tffaf the records listed below have been retained for the scheduled retention period, required audits have
£n completed, and no pending or ongoing litigation or investigation involving these records is known to exist.
Person(s) Completing Form:
o r/ .^ c
No.RECORDS DESCRIPTION DATED BOX
No.
RRS No.RRS
Period
BARCODE APPROVED By
City Attorney
H=HOLD
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RECORD DESTRUCTION COMPLETED BY :
CERTIFICATE OF DESTRUCTION? Yes D N
SMEADLIN
Th/s form documents f/?e destruction of C/ty records ;n accordance wrth the California Public Records Act
Revised 08/25/2005
RECORDS DESTRUCTION REQUEST
City Clerk/Records Management
Page 1 of 1
r^.' &Department Requesting Destruction: r i c£ t
Approvals for Destruction
Department Head Date
Records Manager,Date
Attorney Date
We certifyJ=rat1he records listed below have been retained for the scheduled retention period, required audits have
beeifcompleted, and no pending or ongoing litigation or investigation involving these records is known to exist.
Person(s) Completing Form:
o
No.RECORDS DESCRIPTION DATED BOX
No.
RRS No.RRS
Period
BARCODE APPROVED By
City Attorney
H=HOLD
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RECORD DESTRUCTION COMPLETED BY :
CERTIFICATE OF DESTRUCTION? Yes D No
SMEADLINK DATE:
T/7/s form documents the destruction of City records in accordance with the California Public Records Act
Revised 08/25/2005
RECORDS DESTRUCTION REQUEST
City Clerk/Records Management
Page 1 of 1
Department Requesting Destruction: \ t
Approvals for Destruction
Department Head
Records Manager
Cttorney
Date
Date
Date
We certify thatjtherecords 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:
o f£ ^ £-( O\ \s\J d r <?\^\J st/V t-~
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City Attorney
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RECORD DESTRUCTION COMPLETED BY :_
CERTIFICATE OF DESTRUCTION? Yes D No D
SMEADLINK BARCODE
This form documents the destruction of City records in accordance with the California Public Records Act
Revised 08/25/2005
RECORDS DESTRUCTION REQUEST
City Clerk/Records Management
Page 1 of 1
Department Requesting Destruction: t i
Approvals for Destruction
Department Head
Records Manager,
Attorney
Date
Date
Date
We certify^tfrafthe records listed below have been retained for the scheduled retention period, required audits have
be^jrcompleted, and no pending or ongoing litigation or investigation involving these records is known to exist.
Person(s) Completing Form:
D /^<f ^ c (' £\ k^ ^ '" i?\'is\J stA/ *—•
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APPROVED By
City Attorney
H=HOLD
RECORD DESTRUCTION COMPLETED BY :
CERTIFICATE OF DESTRUCTION? Yes D
SMEADLINK
This form documents the destruction of City records in accordance with the California Public Records Act
Revised 08/25/2005
RECORDS DESTRUCTION REQUEST
City Clerk/Records Management
Page 1 of 1
Department Requesting Destruction: r / r£ ' '
Approvals for Destruction
Department Head Date
Records Manager Date
utorney Date
We certify thaHhe records listed below have been retained for the scheduled retention period, required audits have
beej>ecJmpleted, and no pending or ongoing litigation or investigation involving these records is known to exist.
Person(s) Completing Form:
o
No.RECORDS DESCRIPTION DATED BOX
No.
RRS No.RRS
Period
BARCODE APPROVED By
City Attorney
H=HOLD
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£. c.
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RECORD DESTRUCTION COMPLETED BY :
CERTIFICATE OF DESTRUCTION? Yes H No F
SMEADLINK
777/s form documents the destruction of C;'fy records ;'n accordance with the California Public Records Act
Revised 08/25/2005
RECORDS DESTRUCTION REQUEST
City Clerk/Records Management
Page 1 of 1
Department Requesting Destruction: r /
Approvals for Destruction
Records Manas Date
Attorney Date
We certify^rTat the records listed below have been retained for the scheduled retention period, required audits have
b§£ficompleted, and no pending or ongoing litigation or investigation involving these records is known to exist.
Person(s) Completing Form:
o C£ ^ c\
No.RECORDS DESCRIPTION DATED BOX
No.
RRS No.RRS
Period
BARCODE APPROVED By
City Attorney
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RECORD DESTRUCTION COMPLETED BY
CERTIFICATE OF DESTRUCTION? Yes D No
SMEADLINK
7/7/s form documents the destruction of C/fy records in accordance with the California Public Records Act
Revised 08/25/2005
RECORDS DESTRUCTION REQUEST
City Clerk/Records Management
Page 1 of 1
Department Requesting Destruction: r '/ f£ >
Approvals for Destruction
Department Head Date
Records Manager Date
Date
We certify thaJUrrS'records listed below have been retained for the scheduled retention period, required audits have
beefl-co'fnpleted, and no pending or ongoing litigation or investigation involving these records is known to exist.
Person(s) Completing Form:
o c
No.RECORDS DESCRIPTION DATED BOX
No.
RRS No.RRS
Period
BARCODE APPROVED By
City Attorney
H=HOLD
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RECORD DESTRUCTION COMPLETED BY :
CERTIFICATE OF DESTRUCTION? Yes
SMEADLINK
This form documents the destruction of City records in accordance with the California Public Records Act
Revised 08/25/2005
RECORDS DESTRUCTION REQUEST
City Clerk/Records Management
Page 1 of 1
Department Requesting Destruction: r /.'
Approvals for Destruction
Department Head Date
Date
Date
We certify^tbafthe records listed below have been retained for the scheduled retention period, required audits have
bepffcompleted, and no pending or ongoing litigation or investigation involving these records is known to exist.
Person(s) Completing Form:
c c\a r
No.RECORDS DESCRIPTION DATED BOX
No.
RRS No.RRS
Period
BARCODE APPROVED By
City Attorney
H=HOLD
61 C i-4r 3
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RECORD DESTRUCTION COMPLETED BY :
CERTIFICATE OF DESTRUCTION? Yes D No
SMEADLINK BARCO
This form documents the destruction of City records in accordance with the California Public Records Act
Revised 08/25/2005
RECORDS DESTRUCTION REQUEST
City Clerk/Records Management
Page I of 1
Department Requesting Destruction:
Approvals for Destruction
Attorney Date
We certifyjkarfhe records listed below have been retained for the scheduled retention period, required audits have
sn completed, and no pending or ongoing litigation or investigation involving these records is known to exist.
Person(s) Completing Form:
6 C.
No.RECORDS DESCRIPTION DATED BOX
No.
RRS No.RRS
Period
BARCODE APPROVED By
City Attorney
H=HOLD
10 <<>/ &t^ U^(
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V ^fc 30 -•5<T
o i. •} c, ~ a f
RECORD DESTRUCTION COMPLETED BY
CERTIFICATE OF DESTRUCTION? Yes
SMEADLINK
/s form documents (he destruction of City records In accordance with the California Public Records Act
Revised 08/25/2005
RECORDS DESTRUCTION REQUEST
City Clerk/Records Management
Page 1 of 1
Department Requesting Destruction: \ i r£ > i1"-/i>^"v~L<' <
Approvals for Destruction
Department Head Date
Records Manager Date
TOrney Date
We certifyjbatfne records listed below have been retained for the scheduled retention period, required audits have
bee*rt5brnpleted, and no pending or ongoing litigation or investigation involving these records is known to exist.
Person(s) Completing Form:
D C<£ S* c (
No.RECORDS DESCRIPTION DATED BOX
No.
RRS No.RRS
Period
BARCODE APPROVED By
City Attorney
H=HOLD
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RECORD DESTRUCTION COMPLETED BY :
CERTIFICATE OF DESTRUCTION? Yes H No ~~
SMEADLINK BA
77)/s form documents the destruction of City records in accordance with the California Public Records Act
Revised 08/25/2005
RECORDS DESTRUCTION REQUEST
City Clerk/Records Management
Page 1 of 1
Department Requesting Destruction: \\ f£ 1
Approvals for Destruction
Department Head
Records Manas Date
Attorney Date
We cerjifytfiat the records listed below have been retained for the scheduled retention period, required audits have
be-en completed, and no pending or ongoing litigation or investigation involving these records is known to exist.
Person(s) Completing Form:
No.RECORDS DESCRIPTION DATED BOX
No.
RRS No.RRS
Period
BARCODE APPROVED By
City Attorney
H=HOLD
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t.c,/e.
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RECORD DESTRUCTION COMPLETED BY
CERTIFICATE OF DESTRUCTION? Yes D No
SMEADLINK
This form documents the destruction of City records in accordance with the California Public Records Act
Revised 08/25/2005
RECORDS DESTRUCTION REQUEST
City Clerk/Records Management
Page 1 of 1
Department Requesting Destruction:' r
Approvals for Destruction
Department Head Date
Records Manager Date
Attorney Date
We certify^tbaTthe records listed below have been retained for the scheduled retention period, required audits have
'completed, and no pending or ongoing litigation or investigation involving these records is known to exist.
Person(s) Completing Form:
6
No.RECORDS DESCRIPTION DATED BOX
No.
RRS No.RRS
Period
BARCODE APPROVED By
City Attorney
H=HOLD
1.2 (f^'rt ("•Sflds'-t-". (^ £6 hi - if ii,<
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1 2 <r
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CODES DELETED BY:
RECORD DESTRUCTION COMPLETED BY
CERTIFICATE OF DESTRUCTION? Yes_H—No
SMEADLI
T7)/s form documents the destruction of City records in accordance with the California Public Records Act
Revised 08/25/2005
RECORDS DESTRUCTION REQUEST
City Clerk/Records Management
Page 1 of 1
Department Requesting Destruction:
Approvals for Destruction
Department Head Date
Records Manager Date
Attorney Date
the records listed below have been retained for the scheduled retention period, required audits have
n completed, and no pending or ongoing litigation or investigation involving these records is known to exist.
Person(s) Completing Form:
O
No.RECORDS DESCRIPTION DATED BOX
No.
RRS No.RRS
Period
BARCODE APPROVED By
City Attorney
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RECORD DESTRUCTION COMPLETED BY :
CERTIFICATE OF DESTRUCTION? Yes D No Q
SMEADJUa«€^AT?CODETDELETED BY:DATE:
7/7/s form documents the destruction of City records in accordance with the California Public Records Act
Revised 08/25/2005
RECORDS DESTRUCTION REQUEST
City Clerk/Records Management
Page 1 of 1
Department Requesting Destruction: r'i (•£ ' i
Approvals for Destruction
Department Head Date
Records Manas Date
Attorney Date
We certjfy-tnat 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:
6
No.RECORDS DESCRIPTION DATED BOX
No.
RRS No.RRS
Period
BARCODE APPROVED By
City Attorney
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RECORD DESTRUCTION COMPLETED BY
CERTIFICATE OF DESTRUCTION? Yes D No
SMEADLINK BA
TWs form documents the destruction of C/fy records in accordance with the California Public Records Act
Revised 08/25/2005
RECORDS DESTRUCTION REQUEST
City Clerk/Records Management
Page 1 of'l
Department Requesting Destruction: r /
Approvals for Destruction
Department Head Date
Records Manager Date
Attorney Date
We certjfy^ftat the records listed below have been retained for the scheduled retention period, required audits have
beeficompleted, and no pending or ongoing litigation or investigation involving these records is known to exist.
Person(s) Completing Form:
6 r
No.RECORDS DESCRIPTION DATED BOX
No.
RRS No.RRS
Period
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RECORD DESTRUCTION COMPLETED BY :
CERTIFICATE OF DESTRUCTION? Yes D No
SMEADLINK
This form documents the destruction of City records in accordance with the California Public Records Act
Revised 08/25/2005
RECORDS DESTRUCTION REQUEST
City Clerk/Records Management
Page 1 of 1
Department Requesting Destruction: P / (£ \
Approvals for Destruction
Department Head Date
Records Manager,Date
Attorney Date
We cej*nYthat the records listed below have been retained for the scheduled retention period, required audits have
5een completed, and no pending or ongoing litigation or investigation involving these records is known to exist.
Person(s) Completing Form:
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No.RECORDS DESCRIPTION DATED BOX
No.
RRS No.RRS
Period
BARCODE APPROVED By
City Attorney
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RECORD DESTRUCTION COMPLETED BY
CERTIFICATE OF DESTRUCTION? Yes D No
SMEADLINK
7/j/s form documents the destruction of Crty records ;n accordance with the California Public Records Acf
Revised 08/25/2005
RECORDS DESTRUCTION REQUEST
City Clerk/Records Management
Page 1 of 1
— -,Department Requesting Destruction: r" /
Approvals for Destruction
Department Head
Records Man Date
Attorney Date
iat the records listed below have been retained for the scheduled retention period, required audits have
completed, and no pending or ongoing litigation or investigation involving these records is known to exist.
Person(s) Completing Form:
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No.RECORDS DESCRIPTION DATED BOX
No.
RRS No.RRS
Period
BARCODE APPROVED By
City Attorney
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RECORD DESTRUCTION COMPLETED BY
CERTIFICATE OF DESTRUCTION? Yes D No
SMEADLINK
Th/s form documents the destruction of City records in accordance with the California Public Records Act
Revised 08/25/2005
RECORDS DESTRUCTION REQUEST
City Clerk/Records Management
Page 1 of 1
Department Requesting Destruction: r / r£ 'Li' O-
Approvals for Destruction
Department Head Date
Records Manager Date
Attorney Date
We cej3tf7uiat the records listed below have been retained for the scheduled retention period, required audits have
completed, and no pending or ongoing litigation or investigation involving these records is known to exist.sen
Person(s) Completing Form:
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No.RECORDS DESCRIPTION DATED BOX
No.
RRS No.RRS
Period
BARCODE APPROVED By
City Attorney
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RECORD DESTRUCTION COMPLETED BY :
CERTIFICATE OF DESTRUCTION? Yes D No Q
SMEADLINK B^RCOBE^TJELETED BY:DATE:
7/i/s form documents (he destruction of City records in accordance with the California Public Records Act
Revised 08/25/2005
RECORDS DESTRUCTION REQUEST
City Clerk/Records Management
Page 1 of 1
Department Requesting Destruction:» <
Approvals for Destruction
Department Head Date
Records Manager Date
Attorney Date
We certify^tfi^fthe records listed below have been retained for the scheduled retention period, required audits have
bejerTcompleted, and no pending or ongoing litigation or investigation involving these records is known to exist.
Person(s) Completing Form:
D C\a r c
No.RECORDS DESCRIPTION DATED BOX
No.
RRS No.RRS
Period
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RECORD DESTRUCTION COMPLETED BY
CERTIFICATE OF DESTRUCTION? Yes D No
SMEADLIN
r/i/s form documents fhe destruction of City records /n accordance with the California Public Records >4c<
Revised 08/25/2005
RECORDS DESTRUCTION REQUEST
City Clerk/Records Management
Page 1 of 1
Department Requesting Destruction:
Approvals for Destruction
Department Head Date
Records Manager Date
\ttorney Date
We certifjUhtifthe records listed below have been retained for the scheduled retention period, required audits have
be^ficompleted, and no pending or ongoing litigation or investigation involving these records is known to exist.
Person(s) Completing Form:
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No.RECORDS DESCRIPTION DATED BOX
No.
RRS No.RRS
Period
BARCODE APPROVED By
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RECORD DESTRUCTION COMPLETED BY :
CERTIFICATE OF DESTRUCTION? Yes
SMEADLINK
T/7/s form documents the destruction of City records in accordance with the California Public Records Act
Revised 08/25/2005
City Clerk/Records Management
Paae 1 of 1
RECORDS DESTRUCTION REQUEST
Department Requesting Destruction: r / (£ I r/U s>-i•£.< <:
Approvals for Destruction
Department Head Date
Records Manager Date
Attorney Date
We certify-tnat 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:
o a r
No.RECORDS DESCRIPTION DATED BOX
No.
RRS No.RRS
Period
BARCODE APPROVED By
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RECORD DESTRUCTION COMPLETED BY :
CERTIFICATE OF DESTRUCTION? Yes
ODES DELETED BY:SMEAD
T/7/s form documents the destruction of City records in accordance with the California Public Records Act
Revised 08/25/2005
RECORDS DESTRUCTION REQUEST
City Clerk/Records Management
Page 1 of 1
Department Requesting Destruction:I r/t-'r, -i-^, • f,
Approvals for Destruction
Department Head Date
Records Mana Date
Attorney Date
We cgcttfyThat 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:
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APPROVED By
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RECORD DESTRUCTION COMPLETED BY : -^vvQ.^0rcfl_J/C\MHA DATE: c^/ofe/30^
CERTIFICATE OF DESTRUCTION? Yes HZ No D
SMEADLINK BARCODES DELETED BY: *& DATE:
This form documents the destruction of City records in accordance with the California Public Records Act
Revised 08/25/2005
ciNiAs
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
o<
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: /
DATE:
9455 WAPLES ST • STE. 110 • SAN DIEGO, CA 921213924 • Phone: (858)678-0460 • Fax: (858)678-0894