HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Library & Cultural Arts; 2009-05-19RECORDS DESTRUCTION REQUEST
City Clerk/Records Management
Page 1 of I
Department Requesting Destruction: LIBRARY
Approvals for Destruction
riD|5artment Head Date
ecors Manager
Attorney
Date
- 26 -
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: —
Cissie Sexton , Administrative Secretary to the Library Director £>
No.RECORDS DESCRIPTION
Library Board of trustees agenda
Historic Preservation Commission agenda
DATED
2003
2003
BOX
No.
W?
i-
RRS No.
033540
032540
RRS
Period
CU+5
Cu+5
BARCODE
LD000002
LD000006
APPROVED By
City Attorney
H=HOLD
1
j
I
RECORD DESTRUCTION COMPLETED BY :
CERTIFICATE OF DESTRUCTION? Yes H No fj
SMEADLINK BARCODES DELETED BY: TX
DATE:
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:
SERVICE PERFORMED
Pounds
Minutes
(760)602-2786
3VC ' 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 1 IIPAA & GLBA
regulations tor the above-mentioned company. Mobile destruction services are NAID Certified. Non-Paper destruction services are not NA1D Certified.
CUSTOMER SIGNATURE: ^~--'~~l-->^--'" "
SERVICE REP SIGNATURE: ^X_ ^__ ~^2
DATE: O^/ l^/c?-'-^-^)
^--^ Z^; - ^E^ DATE: ^^'0*7
9455 WAPLES ST • SIT;. I 10 • SAN DIEGO, CA 921213924 • Phone: (858)678-0460 • Fax: (858)678-0894