HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Parks & Recreation; 2009-05-19 (4)RECORDS DESTRUCTION REQUEST
City Clerk/Records Management
Page 1 of 1
Department Requesting Destruction: Park & Recreation - Aquatics
Approvals 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.
Person(s) Completing Form: /
Majka Penner J) ^*
No.
1
2
3
4
5
6
RECORDS DESCRIPTION
Lifeguard Accounting Sheets
Daily Lane Use Forms
Lagoon Permits/Files
Aquatics Registration Waivers
User Group Billing
Payment Requests for Services
DATED
2005-
2006
2005-
2006
2006
2005-
2006
2005-
2006
2005-
2006
BOX
No.
1
2
2
2
2
2
RRS No.
0900-40
oRoo-u\C>
1130-60
1130-55
1130-05
1130-05
RRS
Period
CU+2
CW-2
CL+2
CL+2
CL+2
CL+2
BARCODE APPROVED By
City Attorney
H=HOLD
RECORD DESTRUCTION COMPLETED BY ; CM as TSococvQ.fU
CERTIFICATE OF DESTRUCTION? Yes [*J No D
SMEADLINK BARCODES DELETED BY: r> /&
DATE :
DATE:
This form documents the destruction of City records in accordance with the California Public Records Act
Revised 08/25/2005
CITY OF CARLSBAD
2351 FARADAY AVE
CARLSBAD, CA 920087217
CONTACT: Tanya Bjork - Phone: (760)602-2786
SERVICE PERFORMED
Pounds
Minutes
VC'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 - 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 IIIPAA & GLBA
regulations for the above-mentioned company. Mobile destruction services are NAID Certified. Non-Paper destruction services are not NA1D Certified.
CUSTOMER SIGNATURE:
SERVICE REP SIGNATURE:
DATE:
DATE:
0 ^
'J455 WAPLES ST • STR. I 10 • SAN DIEGO, CA 92I2I.W24 • Phono: (X58)67X-0460 • Fax: (858)678-0894