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Home My WebLink About; ; Records Destruction Authorization Form-Human Resources; 2004-04-027 bB ,L9,7D17\ ,7Z ,75,74‘;I7,7b 1’7 35 ,’5b 4% bb ,b I - %\ p - bD1 City ClerWRecords Management 5-77 61- bk Page 1 of 3 Exhibit C - Offsite Records Destruction Form F002 I OFFSITE RECORDS DESTRUCTION REQUEST - I Approved for Destruction .. 3 - /m+ Rartment Head Date City Records Manager ‘I! Date / City Attorney Date Total of records approved for destruction: I c I NOTE : Citv records on “Hold” cannot be destroyed. 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 Requc I 2 3 4 5 6 7 8 9 st by Originating Department: 1 Resources Requested Date: February 10,2004 I’S Completing Form: Jan Murray RECORDS DESCRIPTION Closed Workers’ Cornp. Files Public Self-Insurer‘s Annual Reports and Misc. Items (Workers’ Comp.) Inactive Personnel Files A-Z Workers’ Comp. Closed Working Files (A-B) Workers’ Cornp. Closed Working Files (C-D) Workers’ Cornp. Closed Working Files (E-F-G) Workers’ Cornp. Closed Working Files Workers’ Comp. Closed Working Files (L-M) Workers’ Cornp. Closed Working Files Workers’ Cornp. Closed Working Files (R) Workers’ Comp. Closed Working Files (S-T) Workers’ Comp. Closed Working Files (v-w-Y-Z) (H-I-J-K) (M-0-P) 1982-92 8’ 1993-97 IO’ 1976-93 11/ 1973-97 13 ’ 1976-97 14” 1979-97 15’ 1978-97 16 -- 1975-97 17 - 1977-97 18 I 1978-97 1978-97 1974-97 RRS No. 081 0-75 081 0-75 081 0-40 081 0-75 081 0-75 081 0-75 081 0-75 081 0-75 08 10-75 08 10-75 081 0-75 081 0-75 riginating Department Manager Initials: - d By City Attorney H=HOLD Period CL+5 TE+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 City Clerk/Records Management Page 2 of 3 California Public Records Act. unsuc-cessful applicants and recruitment materials. Office Specialist I. Job applications of unsuccessful applicants and recruitment Requl Hum2 Persa No. - - - 13 14 15 16 17 2000 1237 18 19 20 21 22 23 24 25 unsuccessful applicants and recruitment materials. Recreation Supervisor I. Job applications of unsuccessful applicants and recruitment materials. Police Chief resumes of finalist. Job applications of unsuccessful applicants and recruitment materials. Part-time applications for Cashier. Job applications of unsuccessful applicants and recruitment materials. applications of unsuccessful applicants and recruitment materials. applications of unsuccessful applicants and recruitment materials. Police Records Specialist I. Job applications of unsuccessful applicants and recruitment materials. Office Specialist It-continuous. Job Senior Office Specialist-continuous. Job 26 27 28 29 30 2000 1237 2000 2000 1238 1999-00 1238 1999-00 1238 2000 1238 31 32 33 This form documents the destruction of City records in accordi 1’s Completing Form: Jan Murray RECORDS DESCRIPTION I DATED I BOX I I No* Inactive Personnel Files A-Z 1991 1069‘ Inactive Personnel Files A-Z 1992 1070 - I I Inactive Personnel Files A-Z 1994 12 - Worker’s Compensation working files A-Co 1984-88 1- Worker’s Compensation working files Ho-Me 1982-98 4- Worker’s Compensation working files Ren-V 1992-98 6- Principal Librarian. Job applications of 2000 unsuccessful applicants and recruitment materials. Police Records Specialist. Job applications of 2000 1237 unsuccessful applicants and recruitment .. materials. Police Officer Acad. Grad. Job applications of I 2000 I 1237 unsuccessful applicants and reciuitment I I materials. Library Assistant I. Job applications of I 2000 I 1237 unsuccessful applicants and recruitment materials. Lateral Police Officer. Job applications of 2000 1237 unsuccessful applicants and recruitment materials. Library Assistant I. Job applications of I 2000 I 1237 materials. Librarian 1/11. Job applications of unsuccessful I 2000 I 1237 applicants and recruitment materials. Police Officer Lateral. Job applications of I 1998 I 1237 ice with the RRS No. c 081 0-40 08 10-40 08 10-40 0810-75 0810-75 081 0-75 0850-25 0850-25 0850-25 0850-25 0850-25 0850-25 0850-25 0850-25 0850-25 0850-25 0850-25 0850-25 0850-25 0850-25 0850-25 riginating Department Manager Initials: R a I RRS I BARCODE I STORAGE I APPROVED I Period I I I I H=HOLD TE+5 TE+5 I I I I TE+5 CL+5 CL+5 CL+5 CL+3 CL+3 CL+3 CL+3 CL+3 CL+3 CL+3 CL+3 I CL+3 CL+3 CL+3 CL+3 CL+3 CL+3 CL+3 ... . .. * City Cler!dRecords Management materials. 35 Applications and Recruitment files. 0850-25 CL+3 (END OF LIST) DOCUMENT DESTRUCTION PROVIDED BY : 01 30-25R002 CERTIFICATE OF DESTRUCTION? Yes 0 No 0 DATE : City ClerWRecords Management Page 1 of 8 6 7 Exhibit C - Offsite Records Destruction Form F002 Community Service Off. II. Job applications 5/2000 1239 0850-25 CL+3 of unsuccessful applicants and recruitment materials. Community Service Off. I. Job applications of 6/2000 1239 0850-25 CL+3 unsuccessful applicants and recruitment materials. OFFSITE RECORDS DESTRUCTION REQUEST I 2-Kd Date Approved for Destruction Date City Attorney Date Total of records approved for destruction: 8 I I NOTE : City records on “Hold” cannot be destroyed. I This form documents the destruction of Citv records in accordance with the California Public Records Act 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 ,- A City ClerWRecords Management Page 2 oft California Public Records Act. 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 This form documents the desfnrction a st by Originating Department: I Resources 1’s Completing Form: Jan Murray RECORDS DESCRIPTION Police Officer Acad. Job applications of unsuccessful applicants and recruitment materials. Webmaster. Job applications of unsuccessful applicants and recruitment materials. Communications Op. I Job applications of unsuccessful applicants and recruitment materials. Deputy City Attorney. Job applications of unsuccessful applicants and recruitment materials. Fire Captain. Job applications of unsuccessful applicants and recruitment materials. Fire Bat. Chief. Job applications of unsuccessful applicants and recruitment materials. Police Captain. Job applications of unsuccessful applicants and recruitment materials. Police Lats. & Acad. Grads. Job applications of unsuccessful applicants and recruitment materials. Fire Bat. Chief. Job applications of unsuccessful applicants and recruitment materials. Police Lieutenant. Job applications of unsuccessful applicants and recruitment materials. Police Sergeant. Job applications of unsuccessful applicants and recruitment materials. Pol. Acad. Grads. & Lats. Job applications of unsuccessful applicants and recruitment materials Senior Accountant. Job applications of unsuccessful applicants and recruitment materials. Police Recruits. Job applications of unsuccessful applicants and recruitment materials. Senior Accountant. Job applications of unsuccessful applicants and recruitment materials. System Administrator I. Job applications of unsuccessful applicants and recruitment materials. HIR Tech. Job applications of unsuccessful applicants and recruitment materials. Office Specialist II. Job applications of unsuccessful applicants and recruitment materials. Office Spec. I. Job applications of unsuccessful applicants and recruitment Cify record Reque$ Februa - DATED - 71200 812000 1212000 1 111999 312000 612000 812000 1212000 312000 912000 912000 812000 1212000 712000 1012000 712000 912000 912000 512000 in accordance with the !d Date: C 10,2004 I J BOX 1 RRSNo. No. - 0850-25 1239 0850-25 1239 0850-25 1239 0850-25 1391 0850-25 1391 0850-25 1391 1391 1391 0850-25 0850-25 0850-25 1391 1391 0850-25 0850-25 1392 1392 0850-25 0850-25 0850-25 riginating Department Manager Initials: 3 a I I I CL+3 CL+3 cL3/ CL+3 CL+3 CL+3 CL+3 CL+3 City Clerk/Records Management 0850-25 0850-25 0850-25 27 28 29 30 31 33 34 35 36 37 38 39 40 41 42 43 44 45 46 CL+3 CL+3 CL+3 RECORDS DESCRIPTION BOX unsuccessful applicants and recruitment materials. St. Maint. Worker Ill. Job applications of unsuccessful applicants and recruitment I Nom 12/1999 1398 I Office Aide -Van Driver. Job applications of I 11/2000 I 1396 materials. unsuccessful applicants and recruitment I I I materials. Applicant Data Collection Forms 9/2000 1396 materials. Office Spec. Cont. Recruit. Job applications of unsuccessful applicants and recruitment I I materials. Cont.-Off. Spec. It. Job applications of unsuccessful applicants and recruitment materials. applications of unsuccessful applicants and Application Spec. I-Doc.Mgmt. Job unsuccessful applicants and recruitment materials. Assoc. Eng.-Land Develop. Job applications of unsuccessful applicants and recruitment materials. Paramedic/FF.-Lateral. Job applications of unsuccessful applicants and recruitment materials. Fingerprint Evidence Spec. Job applications of unsuccessful applicants and recruitment materials. Records Management Sup. Job applications of unsuccessful applicants and recruitment materials. Public Works Supervisor. Job applications of unsuccessful applicants and recruitment 11/1999 1011 999 1 1/1999 12/1999 1 1/1999 11/1999 1011 999 11/1999 1398 1396 1396 E 1398 1398 1398 1398 0850-25 CL+3 materials. Principal Librarian. Job applications of I 2/2000 I 1398 .. recruitment materials. unsuccessful applicants and recruitment materials. unsuccessful applicants and recruitment materials. unsuccessful applicants and recruitment materials. unsuccessful applicants and recruitment materials. unsuccessful applicants and recruitment mat. Application Spec. I-Web. Job applications of Application Spec. II. Job applications of Administrative Secretary. Job applications of Account Clerk 11. Job applications of Sr. Management Analyst. Job applications of 11/1999 1398 0850-25 CL+3 1011 999 1398 0850-25 CL+3 3/2000 1398 0850-25 CL+3 10/1999 1398 0850-25 CL+3 9/1999 1398 0850-25 CL+3 unsuccessful applicants and recruitment I I I Period I H=HOLD 0850-25 CL+3 0850-25 CL+3 0850-25 0850-25 0850-25 0850-25 0850-25 0850-25 0850-25 - City ClerklRecords Management Pagk 4 of I * This form documents the destnrcfion of City records in accordance with the California Public Records Act. Person’s Completing Form: Jan Murray - No. - 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 RECORDS DESCRIPTION Accounting Supv. . Job applications of unsuccessful applicants and recruitment materials. Senior Librarian. Job applications of unsuccessful applicants and recruitment materials. Pol. Records Spec. I. Job applications of unsuccessful applicants and recruitment materials. Parks Maint. Worker Ill. Job applications of unsuccessful applicants and recruitment materials. Sr. Circulation Supervisor. Job applications of unsuccessful applicants and recruitment materials. Senior Civil Engineer. Job applications of unsuccessful applicants and recruitment materials. Engineering Tech. I I 11. Job applications of unsuccessful applicants and recruitment materials. Management Analyst. Job applications of unsuccessful applicants and recruitment materials. Office Spec. I. Job applications of unsuccessful applicants and recruitment materials. Associate Engineer. Job applications of unsuccessful applicants and recruitment materials. Associate Engineer-Traffic. Job applications of unsuccessiul applicants and recruitment materials. Construction Inspector I. Job applications of unsuccessful applicants and recruitment materials. Cross Connection Control Tech. Job applications of unsuccessful applicants and recruitment materials. Custodian. Job applications of unsuccessful applicants and recruitment materials. Deputy City Attorney. Job applications of unsuccessful applicants and recruitment materials. Environmental Programs Manager. Job applications of unsuccessful applicants and recruitment materials. Fire Captain. Job applications of unsuccessful applicants and recruitment materials. Gallery Coordinator. Job applications of unsuccessful applicants and recruitment materials. Librarian I I 11. Job applications of unsuccessful applicants and recruitment materials. DATED I BOX I No. 1211 999 911 999 712000 211 999 1011 999 1398 1398 1211 999 7 911 999 911 998 1398 1398 512000 7 212000 1398 1211 999 1011 999 $ij 1012000 1 112000 1211 999 1407 312000 - L 0850-25 0850-25 0850-25 0850-25 0850-25 0850-25 0850-25 0850-25 0850-25 0850-25 0850-25 0850-25 0850-25 0850-25 0850-25 0850-25 0850-25 0850-25 0850-25 Period I By City Attorney H=HOLD CL+3 CL+3 CL+3 CL+3 CL+3 CL+3 I I CL+3 CL+3 CL+3 I I I CL+3 .- A City ClerklRecords Managemen Page 5 of E * This form documents the destruction of City records in accordance with the California Public Records Act. - February IO, 2004 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 I Person's Comdetina Form: Jan Murrav materials. unsuccessful applicants and recruitment materials. unsuccessful applicants and recruitment materials. unsuccessful applicants and recruitment materials. unsuccessful applicants and recruitment materials. unsuccessful applicants and recruitment materials. unsuccessful applicants and recruitment materials. unsuccessful applicants and recruitment materials. unsuccessful applicants and recruitment materials. unsuccessful applicants and recruitment materials. unsuccessful applicants and recruitment materials. applications of unsuccessful applicants and recruitment materials. applications of unsuccessful applicants and recruitment materials. unsuccessful applicants and recruitment materials. of unsuccessful applicants and recruitment materials. applications of unsuccessful applicants and recruitment materials. unsuccessful applicants and recruitment materials. applicants and recruitment materials. Management Assistant. Job applications of 11/2000 1407 0850-25 CL+3 Utility Worker Ill. Job applications of 9/2000 1407 0850-25 CL+3 Sys. Administrator I. Job applications of 8/2000 1407 0850-25 CL+3 Sanit. Sys. Op. Ill. Job applications of 7/2000 1407 0850-25 CL+3 Building Maint. Worker I. Job applications of 10/2000 1407 0850-25 CL+3 Library Assistant I. Job applications of 5/2000 1407 0850-25 CL+3 MessengerlMail Clerk. Job applications of 3/2000 1407 0850-25 CL+3 Fire Battalion Chief. Job applications of 712000 1407 0850-25 CL+3 Meter Services Worker I. Job applications of 5/2000 1407 0850-25 CL+3 Administrative Secretary. Job applications of 9/2000 1407 0850-25 CL+3 Community Service Officer II. Job 5/2000 1407 0850-25 CL+3 Community Services Officer I. Job 6/2000 1407 0850-25 CL+3 Account Clerk 11. Job applications of 7/2000 1407 0850-25 CL+3 Sanitation Systems Oper. I. Job applications 10/2000 1407 0850-25 CL+3 Human Resources Technician. Job 9/2000 1407 0850-25 CL+3 Recreation Supervisor I. Job applications of 6/2000 0850-25 CL+3 Rec.Spec.. Job applications of unsuccessful 10/2000 1408 0850-25 CL+3 unsuccessful applicants and recruitment City Clerk/Records Management 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 This form documents the destruction c St by Originating Department: 1 Resources 1’s Completing Form: Jan Murray RECORDS DESCRIPTION I Rec.Spec-Facility OD. Job applications of unsuccessful applicants and recruitment materials. Police Sergeant. Job applications of unsuccessful applicants and recruitment materials. Deputy Fire Marshall. Job applications of unsuccessful applicants and recruitment materials. Associate Engineer. Job applications of unsuccessful applicants and recruitment materials. Bldg. Maint. Worker II. Job applications of unsuccessful applicants and recruitment materials. Park Maint. Worker I. Job applications of unsuccessful applicants and recruitment materials. Police Recruit. Job applications of unsuccessful applicants and recruitment materials. Senior Accountant. Job applications of unsuccessful applicants and recruitment materials. Storekeeper. Job applications of unsuccessful applicants and recruitment materials. Comm. Operator II. Job applications of unsuccessful applicants and recruitment materials. Acad. Grad.-Pol. Officer. Job applications of unsuccessful applicants and recruitment materials. Acad. Grad.-Pol. Officer. Job applications of unsuccessful applicants and recruitment materials. Acad. Grad.-Pol. Officer. Job applications of unsuccessful applicants and recruitment materials. Lateral Police Officer. Job applications of unsuccessful applicants and recruitment materials. Lateral Police Officer. Job applications of unsuccessful applicants and recruitment materials. Lateral Police Officer. Job applications of unsuccessful applicants and recruitment materials. Lateral Police Officer. Job applications of unsuccessful applicants and recruitment materials. Sr. Office Specialist. Job applications of unsuccessful applicants and recruitment materials. Admin. Secretary. Job applications of unsuccessful applicants and recruit. materials. City records in accord I DATED n BOX ~ I No* T 912000 1408 612000 912000 1012000 1408 1 1 12000 1408 712000 7 1012000 1408 1 a2000 312000 1a2000 812000 312000 1408 1408 1408 1a2000 1408 912000 312000 611 999 1408 1408 1408 7ce with the 3 RRS No. - 0850-25 0850-25 0850-25 0850-25 0850-25 0850-25 0850-25 0850-25 0850-25 0850-25 0850-25 0850-25 0850-25 0850-25 0850-25 0850-25 0850-25 0850-25 0850-25 Page 6 of I California Public Records Act. riginating Department Manager Initials: - a 1 RRS 1 BARCODE I STORAGE I APPROVED ~ Period 1 I I I H=HOLD cL+3 I - Citv Cler!dRecords Management 1411 1411 1411 page 7 oft This form documents fhe destruction of City records in accordance with the California Public Records Act. Person’s ComDletina Form: Jan Murrav 0850-25 CL+3 0850-25 CL+3 0850-25 CL+3 104 105 106 107 108 unsuccessful applicants and recruitment materials. Assistant Planner. Job applications of unsuccessful applicants and recruitment materials. Associate Planner. Job applications of unsuccessful applicants and recruitment materials. Comm. Oper. I. Job applications of unsuccessful applicants and recruitment 109 110 611 999 611 999 412000 111 1411 112 113 114 115 116 117 118 119 120 121 122 0850-25 CL+3 RECORDS DESCRIPTION DATED Application Spec. I (GIs). Job applications of I 411999 1411 1411 1411 1411 1411 unsuccessful applicants and recruitment I 0850-25 CL+3 0850-25 CL+3 0850-25 CL+3 0850-25 CL+3 0850-25 CL+3 materials. Application Spec. I (Lib). Job applications of I 511999 unsuccessful applicants and recruitment materials. Construction Manager. Job applications of unsuccessful applicants and recruitment 711 999 materials. Code Enforc. Off. I Job applications of I 2/1999 applicants and recruitment materials. Deputy City Clerkllech. Job applications of unsuccessful applicants and recruitment materials. Eng. Tech. II. Job applications of unsuccessful applicants and recruitment materials. unsuccessful applicants and recruitment materials. Fire Engineer. Job applications of unsuccessful applicants and recruitment materials. Graphic Artist. Job applications of unsuccessful applicants and recruitment Equip. Tech. II. Job applications of 211999 1111998 911 999 311 999 511 999 materials. Custodian. Job applications of unsuccessful I 711 999 1411 0850-25 CL+3 materials. Housing Spec. I. Job applications of I 1011998 unsuccessful applicants and recruitment materials. Housing Specialist II. Job applications of unsuccessful applicants and recruitment materials. Lead Comm. Oper. Job applications of unsuccessful applicants and recruitment materials. Lead Equip. Tech. Job applications of unsuccessful applicants and recruitment materials. Library Asst. II. Job applications of unsuccessful applicants and recruitment 1011 998 1211 998 911 999 711 999 materials. I Maint. Worker I. Job applications of I 911999 unsuccessful applicants and recruit. materials. I 1411 0850-25 CL+3 ~ 0850-25 CL+3 City ClerklRecords Management Page 8 of 8 ‘ This form documents the desfnrcfion of City records in accordance with the California Public Records Act Person’s Completinn Form: Jan Murray - No. - 123 1 24 125 125 126 127 128 129 130 131 132 133 134 135 136 137 138 - RECORDS DESCRIPTION BOX No. 1 Management Analyst. Job applications of 411 999 141 1 unsuccessful applicants and recruitment materials. Management Analyst (HR). Job applications 811998 141 1 of unsuccessful applicants and recruitment materials. I Management Analyst (H& R). Job I 811998 I 1411 applications of unsuccessful applicants and recruitment materials. Planning Tech. I. Job applications of unsuccessful applicants and recruitment + 911 999 materials. I Police Lieutenant. Job applications of 1 1211998 I 141 1 unsuccessful applicants and recruitment materials. Police Officer. Job applications of 1211 998 141 1 unsuccessful applicants and recruitment materials. 1 Police Recruit. Job applications of I 511999 I 1411 unsuccessful applicants and recruitment materials. Recreation Spec. Job applications of unsuccessful applicants and recruitment materials. Secretary. Job applications of unsuccessful applicants and recruitment materials. Senior Accountant. Job applications of unsuccessful applicants and recruitment materials. Senior Planner. Job applications of unsuccessful applicants and recruitment materials. Sr. Police Officer. Job applications of unsuccessful applicants and recruitment materials. Systems Administrator I. Job applications of unsuccessful applicants and recruitment materials. Systems Admin. II. Job applications of unsuccessful applicants and recruitment I I1 999 611 999 911 998 511 999 Zl999 411 999 811 999 141 1 141 1 141 1 141 1 141 1 141 1 141 1 materials. Systems Admin. Ill. Job applications of I 511999 I 1411 unsuccessful applicants and recruitment materials. Util. Worker 1/11. Job applications of 9/1999 141 I unsuccessful applicants and recruitment materials. Police Sergeant. Job applications of 1211 998 141 1 unsuccessful applicants and recruitment materials. -I- . RRS No. c 0850-25 0850-25 0850-25 0850-25 0850-25 0850-25 0850-25 0850-25 0850-25 0850-25 0850-25 0850-25 0850-25 0850-25 0850-25 0850-25 0850-25 I RRS I BARCODE 1 STORAGE 1 APPROVED I Period I I I I I H=HOLD CL+3 I I I I r/N v DOCUMENT DESTRUCTION PROVIDED BY : 0 130-25E002 CERTIFICATE OF DESTRUCTION? Yes 0 No 0 DATE : CERTIFICATE OF DESTRUCTION This certificate is to certify that Shred-it destroyed confidential information on-site for the above mentioned company by TRUCKNO.: 43;) TRUCK NO.: TOTAL TIME HRS. MIN. Bs.4 rn I- MOBILE CUSTOMER SERVICE REP.: &{f CLIENT 4‘ /)~b$ *iL,,f.‘> , (/=’$! tsJLd, ENVIRONMENTAL IMPACT Shred-it is committed to helping save the environment. All shredded material that is recyclable is brought to a recycling centre to be processed into recycled paper products. @ D SAVED THROUGH @ THIS YEAR YOUR FIRM’S S SHRED-IT’S RECYCLING P TS TO 0 TREES. MISSION STATEMENT Shred-it is dedicated to being the World’s leading Mobile Shredding and Recycling Company. We will achieve this goal on the strengths of our people. Shred-it will consistently deliver the greatest security, cost-effectiveness, convenience and environmentally-friendly service available. We will earn ;I fair return on the investment in our systems, our equipment and our people. Above all, we will earn the confidence of our clients through a continued commitment to total customer satisfaction. SECURING YOUR OFFICE AND THE ENVIRONMENT # PRINTED ON aLClCLED PIPER