HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Planning; 2006-11-27City Clerk/Records Management
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RECORDS DESTRUCTION REQUEST
Department Requesting Destruction: Planning
Approvals for Destruction
Michele 10/1 2/06
>artment 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: Mila Troyer
No.RECORDS DESCRIPTION
PRE 97-88 thru PRE 03-75
DATED
1997
thru
2003
BOX
No.
1
RRS No.
0515-06
RRS
Period
CU + 2
BARCODE APPROVED By
City Attorney
H=HOLD
RECORD DESTRUCTION COMPLETED BY :.
CERTIFICATE OF DESTRUCTION? Yes D No M
SMEADLINK BARCODES DELETED BY:
DATE:
DATE:
This form documents the destruction of City records in accordance with the California Public Records Act
Revised 08/25/2005
SECURE DOCUMENT DESTRUCTION
Client materials are to be destroyed off-site. Client will
receive official Certificate of Destruction upon completion
of service.
•This CERTIFICATE OF DESTRUCTION certifies the complete
destruction of all material contained as described below on the
date and at the time recorded herewith.
Date / Time of Pick up:___AM PM
Billing Address
Date / Time of Destruction//-*??- &L> l/2'Yt) AM
Service Address
Contact:Phone Number: (768 )
Type
Quantity
Service
Rate
Total
File Boxes
(L(p
^#**
Bankers
Boxes
ShredForce
Executive
100
ShredForce
250
Other
^^^4js££
7r^
{^
^v
Other Other
SHREDFOflCEID#:.
Balance Due: $.
Amount Paid: $.
SHREDFORCE Signature:
Please Invoice Client
Authorized Representative:
Comments:
TB: Hours:Other:
SHREDFORCE D PO Box 891 D San Marcos, CA 92079 D (800) 444-6209
09/05