HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Transportation Engineering; 2009-05-19RECORDS DESTRUCTION REQUEST
City Clerk/Records Management
Page 1 of 1
Department Requesting Destruction:Engineering (Traffic)
Approvals for Destruction
Date
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.
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Person(s) Completing Form: James Gale r^\
No.RECORDS DESCRIPTION
Traffic Safety Commission agendas & notices
Traffic Safety Coordinating Committee agendas
DATED
2003
2003
BOX
No.
Scz
i/
RRS No.
0365-40
0365-70
RRS
Period
CU+5
CU+5
BARCODE APPROVED By
City Attorney
H=HOLD
RECORD DESTRUCTION COMPLETED BY ; C\M AS T>^o
CERTIFICATE OF DESTRUCTION? Yes Ef No D
fr\DATE :
SMEADLEVK BARCODES DELETED BY:A/a 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
VC ' 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 - 80924
05/19/2009
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 tor the above-mentioned company. Mobile destruction services are NAID Certified. Non-Paper destruction services are not NA1D Certified.
CUSTOMER SIGNATURE:
SERVICE REP SIGNATURE:
O •£
9455 WAPLHS ST • STH. 110 • SAN DIRGO. CA 921213924 • Phone: (S58)67X-()460 • Fax: (K5S)678-08'M