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HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Risk Management; 2006-11-27City Clerk/Records Management Page 1 of8 Exhibit C - Onsite Records Destruction Form F005 ONSITE RECORDS DESTRUCTION LIST Approved for Destruction 10/16/06 Department Head Date - t>L City Records Manager Date o - i City Attorney Total of records approved for destruction: Date Note: City 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 to exist. This form documents the destruction of City records in accordance with the California Public Records Act. Request by Originating Department: RISK MANAGEMENT Requested Date: 3/3/06 Originating Department Manager Initials: Erin Letsch Person's Completing Form: Erin Letsch - Risk Manager No. 1 2 3 4 5 6 7 8 9 RECORDS DESCRIPTION ALDRIDGE, Daniel - Hit Plant Material Loss Recovery ALVAREZ, Anulfo - Hit Traffic Signal Loss Recovery AYOUB, Daryl - Hit Light Standard Loss Recvoery BROWN, Debra - Hit Guard Rail Loss Recovery DAVISON, Philip -Hit Fire Hydrant Loss Recovery HAMIDEH, Jamil - Hit Traffic Signal Loss Recovery HARDING AUDITORIUM DAMAGE - Damage due to fight at party. Event insured through Diversified Risk Loss Recovery KOEHLER, Ray - Hit Street Light Loss Recovery LARSON, Gladys - Hit City Vehicle Loss Recovery DATE Closed Date 8/6/96 Closed Date 10/28/96 Closed Date 10/28/96 Closed Date 7/10/97 Closed Date 5/7/97 Closed Date 1/22/97 Closed Date 5/27/97 Closed Date 2/28/97 Closed Date 8/6/96 BOX No. 1095 1095 1095 1095 1095 1095 1095 1095 1095 RRS No. 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 RRS Period CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 BARCOD E Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt PDF APPROVED By City Attorney H=HOLD City Clerk/Records Management Page 2 of 8 This form documents the destruction of City records in accordance with the California Public Records Act Request by Originating Department: RISK MANAGEMENT Requested Date: 3/3/06 Originating Department Manager Initials: Erin Letsch Person's Completing Form: Erin Letsch - Risk Manager No. 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 RECORDS DESCRIPTION MESA DISTRIBUTING - Hit Fire Hydrant Loss Recovery NELSON, Ronda - Hit Guard Rail Loss Recovery ORTIZ, Jose - Hit City Vehicle Loss Recovery PEGG, Molly - Hit City Vehicle Loss Recovery PERRIS, Lawrence - Hit Plant Material Loss Recovery RILEY, James - Hit Street Light Loss Recovery STOCKHAM, Jerome - Hit Street Light Loss Recovery THORPE, Travis - Hit Light Pole Loss Recovery VAN PLEW, LISA - Hit City Vehicle Loss Recovery WEAR, Harry - Hit Traffic Signal Loss Recovery ANGEL, Josefina - Trash was not picked-up by City's contractor for 3 months Claim ARUGON, Joel - Vehicle Damage Claim BANTZ, Thomas - Vehicle Damage Claim BATT, Michael - Vehicle Damage Claim BATTAGLIA, Marylea - Vehicle Damage Claim BENTON, Stacy - Personal Items Lost Claim BICE, Barbara - Vehicle Damage Claim BICE, Barbara - Impound Fees Claim CICCARELLI, Joseph & Mary - Damaged Property Claim DATE Closed Date 11/6/96 Closed Date 2/18/97 Closed Date 7/24/96 Closed Date 11/21/96 Closed Date 7/30/96 Closed Date 8/13/96 Closed Date 9/17/96 Closed Date 4/8/97 Closed Date 7/24/96 Closed Date 10/24/96 Received 5/3/96 Closed Date 11/26/96 Received 10/29/96 Closed Date Received 7/22/96 Closed Date 8/20/96 Received 4/30/96 Closed Date 11/30/96 Received 5/22/96 Closed Date 11/26/96 Received 7/24/96 Closed Date 1/31/97 Received 1/2/96 Closed Date 7/31/96 Received 1/2/96 Closed Date 7/31/96 Received 6/24/96 Closed Date 8/16/96 BOX No. 1095 1095 1095 1095 1095 1095 1095 1095 1095 1095 1095 1095 1095 1095 1095 1095 1095 1095 1095 RRS No. 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 RRS Period CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 BARCOD E Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt PDF APPROVED By City Attorney H=HOLD City Clerk/Records Management Page 3 of 8 This form documents the destruction of City records in accordance with the California Public Records Act. Request by Originating Department: RISK MANAGEMENT Requested Date: 3/3/06 Originating Department Manager Initials: Erin Letsch Person's Completing Form: Erin Letsch - Risk Manager No. 29 30 31 32 33 34 35 36 37 38 39 40 41 42 RECORDS DESCRIPTION C N A INSURANCE (Hall) - Vehicle/City Vehicle Accident Litigation COHEN, Robert -Vehicle Damage Claim THE COLONY AT CALAVERA HILLS - Damaged Irrigation Lines Claim COOPER, Alvin - Lost Property Claim DEFAGO, Ronald - Vehicle/City Accident Claim EHLERS, Wayne - Fire and Excessive Water Use Claim EKLAND, Arnold & Ann - Vehicle Damage Claim FARMERS (Blyth) - Vehicle/City Vehicle Accident Claim FARNUM, Melissa - Vehicle/City Vehicle Accident Claim FERGUSON, Wayde & Stacey - City Vehicle Accident Claim FIREMAN'S FUND (Angus Asphalt) - Vehicle Accident Claim GALAVIZ, Melissa - Police Misconduct Litigation GALINDO, Chris - Vehicle Damage Claim GRG MGMT., INC. (Hillgate) - Damaged Water Pipe Claim DATE Received 1/28/91 Closed Date 4/18/97 Received 8/27/96 Closed Date 3/31/97 Received 5/31/96 Closed Date 7/2/96 Received 3/15/96 Closed Date 10/2/96 Received 1/8/97 Closed Date 2/6/97 Received 1/10/96 Closed Date 7/31/96 Received 12/10/96 Closed Date 6/27/97 Received 5/22/96 Closed Date 9/20/96 Received 3/13/97 Closed Date 4/18/97 Received 7/2/96 Closed Date 9/10/96 Received 2/21/96 Closed Date 10/25/96 Received 2/1/95 Closed Date 4/29/97 Received 8/19/96 Closed Date 3/31/97 Received 5/20/96 Closed Date 11/26/96 BOX No. 1095 1095 1095 1095 1095 1095 1095 1095 1095 1095 1095 1096 1096 1096 RRS No. 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 RRS Period CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 BARCOD E Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt PDF APPROVED By City Attorney H=HOLD City Clerk/Records Management Page 4 of8 This form documents the destruction of City records in accordance with the California Public Records Act Request by Originating Department: RISK MANAGEMENT Requested Date: 3/3/06 Originating Department Manager Initials: Erin Letsch Person's Completing Form: Erin Letsch - Risk Manager No. 43 44 45 46 47 48 49 50 51 52 53 54 55 56 RECORDS DESCRIPTION HANDS, Camille - Vehicle Damage Claim HARRIS, Josephine - Vehicle Damage Claim HATEM, Cynthia -Vehicle Damage Claim HAZELTON, John W. - Windshield damage Claim HENNESSY, Evan - Vehicle/City Accident Litigation HENSON, James - Police Misconduct Claim HERMAN, Roxanne - Vehicle/City Accident Claim HOEFER, Don - Sewer Back-Up Claim HOOVER, Charles - Trip and Fall Claim HUGGINS, Catalina - Vehicle Damage Claim JACOBSEN, Kathleen - Vehicle/City Accident Claim JONES, Robert R. - Vehicle/Bike Accident Litigation KEATING, Nancy - Vehicle/City Accident Litigation KENT, John L. - Vehicle Damage Claim DATE Received 7/15/96 Closed Date 1/31/97 Received 12/26/95 Closed Date 7/31/96 Received 4/22/96 Closed Date 11/26/96 Received 9/24/96 Closed Date 4/29/97 Received 2/23/95 Closed Date 9/25/96 Received 8/19/95 Closed Date 4/29/97 Received 10/30/96 Closed Date 11/22/96 Received 3/18/97 Closed Date 4/29/97 Received 9/25/96 Closed Date 4/29/97 Received 11/22/96 Closed Date 5/27/97 Received 3/14/97 Closed Date 3/31/97 Received 2/16/94 Closed Date 8/16/96 Received 12/1/95 Closed Date 2/26/97 Received 1/26/96 Closed Date 9/27/96 BOX No. 1096 1096 1096 1096 1096 1096 1096 1096 1096 1096 1096 1096 1096 1096 RRS No. 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 RRS Period CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 BARCOD E Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt PDF APPROVED By City Attorney H=HOLD City Clerk/Records Management Page 5 of 8 This form documents the destruction of City records in accordance with the California Public Records Act Request by Originating Department: RISK MANAGEMENT Requested Date: 3/3/06 Originating Department Manager Initials: Erin Letsch Person's Completing Form: Erin Letsch - Risk Manager No. 57 58 59 60 61 62 63 64 65 66 67 68 69 70 RECORDS DESCRIPTION KING, Kerry - Vehicle Damage Claim KNOX, Richard - Vehicle/City Accident Litigation LANGLOIS, Linda - Ambulance Charges Claim LATINO, Roc- Vehicle Damage Claim LEE, Jonathan - Vehicle/City Accident Claim LINDSAY MGMT. SVCS. - Water Line Damaged Claim LOPEZ, Richard - Glasses Damaged Claim MALINSKI, Edward - Vehicle Damage Claim MAY, Carole - Roof Damage Claim McDERMED, Paul - Vehicle/City Accident Claim McENTIRE, Charles - Vehicle/City Accident Claim METTEN, Stacey - Vehicle Accident Claim O'KEEFE, Dawna - Vehicle/City Accident Claim ORTEGA, Laura - Vehicle Damage Claim DATE Received 4/19/96 Closed Date 11/26/96 Received -. 10/8/96 Closed Date 3/31/97 Received 5/28/96 Closed Date 7/3/96 Received 7/16/96 Closed Date 1/31/97 Received 1/16/97 Closed Date Received 1/8/96 Closed Date 7/31/96 Received 12/26/95 Closed Date 7/31/96 Received 8/19/96 Closed Date 3/3/97 Received 1/16/97 Closed Date 6/27/97 Received 4/10/97 Closed Date 6/11/97 Received 8/30/96 Closed Date 11/18/96 Received 8/30/96 Closed Date 4/29/97 Received 7/8/96 Closed Date 8/21/96 Received 3/25/96 Closed Date 11/26/96 BOX No. 1096 1096 1096 1096 1096 1096 1096 1096 1096 1097 1097 1097 1097 1097 RRS No. 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 RRS Period CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 BARCOD E Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt PDF APPROVED By City Attorney H=HOLD City Clerk/Records Management Page 6 of8 This form documents the destruction of City records in accordance with the California Public Records Act. Request by Originating Department: RISK MANAGEMENT Requested Date: 3/3/06 Person's Completing Form: Erin Letsch - Risk Manager No. 71 72 73 74 75 76 77 78 79 80 81 82 83 84 RECORDS DESCRIPTION PACIFIC BELL (Clm. No. C0568) - Indemnification Litigation PACIFIC BELL (Clm. No. C9441) - Cable Cut Litigation PETERSON, Jerry - Vehicle Damage Claim RADSICK, Ronald - Vehicle Damage Claim RANCHO PONDEROSA HO ASSOC. - Damaged Irrigation Lines Claim RICE, Gregory - Vehicle Accident Claim RICHMOND, Bill -Vehicle/City Accident Claim ROMERO, Leslie Ann - Trip/Fall Claim SCHUDEL, Conrad - Vehicle Damage Claim SEAHOLM, Dennis - Vehicle Damage Claim SILLEN, Connie- Indemnification Claim STATE FARM (Seaholm) - Vehicle Damage Claim STATE FARM (Van Dorn) - Vehicle/City Accident Claim SUN, Xiuying - Glasses Broken Claim No Action Taken on Claim DATE Received 11/2/95 Closed Date 3/31/97 Received 7/15/94 Closed Date 1/31/97 Received 8/19/96 Closed Date 3/31/97 Received 3/25/97 Closed Date 5/6/97 Received 8/16/96 Closed Date 9/27/96 Received 9/9/96 Closed Date 3/31/97 Received 10/16/96 Closed Date 11/25/96 Received 1/29/96 Closed Date 9/27/96 Received 10/11/96 Closed Date 4/29/97 Received 8/22/96 Closed Date 4/29/97 Received 7/8/96 Closed Date 2/26/97 Received 10/28/96 Closed Date 4/29/97 Received 12/9/96 Closed Date 1/10/97 Received 10/5/95 Closed Date 12/26/96 BOX No. 1097 1097 1097 1097 1097 1097 1097 1097 1097 1097 1097 1097 1097 1097 RRS No. 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 Originating Department Manager Initials: Erin Letsch RRS Period CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 BARCOD E Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt PDF APPROVED By City Attorney H=HOLD City Clerk/Records Management Page 7 of8 This form documents the destruction of City records in accordance with the California Public Records Act. Request by Originating Department: RISK MANAGEMENT Requested Date: 3/3/06 Originating Department Manager Initials: Erin Letsch Person's Completing Form: Erin Letsch - Risk Manager No. 85 86 87 88 89 90 91 92 93 94 95 96 97 98 RECORDS DESCRIPTION 20tn CENTURY - Vehicle/City Accident Claim TAGUE, Sarah - Vehicle Damage Claim TREASURES UNLIMITED - Gasoline Pump Damaged Claim TURNER, David - Harassment by Police Claim TURNER, David - False Arrest Claim TURNMIRE, Janeen - Trip and Fall Litigation USAA (J. Harris) - Vehicle Damage Claim USAA (R. Pegg) - Vehicle/City Accident Claim VAN DORAN, Elisabeth - Vehicle/City accident Claim VORCE, Cynthia - Vehicle Damage Claim VOLPE, Dennis - Vehicle Damage Claim WAWANESA (Knox) - Vehicle/City Accident Claim WOODS, Pamela - Vehicle Damage Claim XYZ SKATE SUPPLY - Inverse Condemnation Claim DATE Received 5/7/97 Closed Date 5/13/97 Received 8/6/96 Closed Date 5/27/97 Received 4/23/97 Closed Date 6/11/97 Received 3/28/96 Closed Date 11/26/96 Received 3/28/96 Closed Date 11/26/96 Received 3/7/95 Closed Date 3/3/97 Received 12/14/95 Closed Date 7/31/96 Received 11/1/96 Closed Date 11/21/96 Received 10/11/96 Closed Date 12/24/96 Received 8/23/96 Closed Date 3/31/97 Received 3/4/96 Closed Date 9/26/96 Received 11/12/96 Closed Date 3/31/97 Received 12/10/96 Closed Date 6/27/97 Received 5/30/96 Closed Date 1/31/97 BOX No. 1097 1097 1097 1097 1097 1097 1097 1097 1097 1097 1097 1097 1097 1097 RRS No. 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 RRS Period CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 BARCOD E Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt PDF APPROVED By City Attorney H=HOLD City Clerk/Records Management Page 8 of8 This form documents the destruction of City records in accordance with the California Public Records Act. Request by Originating Department: RISK MANAGEMENT Requested Date: 3/3/06 Person's Completing Form: Erin Letsch - Risk Manager No. 99 RECORDS DESCRIPTION ZIE, Deborah. Candace & Ross - Vehicle Accident Litigation DATE Received 5/31/97 Closed Date 10/8/96 BOX No. 1097 RRS No. 0745-20 Originating Department Manager Initials: Erin Letsch RRS Period CL+5 BARCOD E Risk Mgmt PDF APPROVED By City Attorney H=HOLD ~/mc£~ n fa/els DOCUMENT DESTRUCTION WILL BE PROVIDED BY SJKWC^COMPANY, mobile paper shredding and recyclin End of List 0 1 30-25/F005 F:\WORD\STORAGE\Riskmgm Des of 96-97files.doc Exhibit C - Onsite Records Destruction Form F005 City Clerk/Records Management Page 1 of 17 ONSITE RECORDS DESTRUCTION LIST Approved for Destruction 10/16/06 Department Head Date iQ-n-oc. City Records Manager Date Co - i % - City Attorney Total of records approved for destruction: Date Note: City 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 to exist. This form documents the destruction of City records in accordance with the California Public Records Act. (3^ -7^ Request by Originating Department: RISK MANAGEMENT Requested Date: 3/3/06 Originating Department Manager IniticHs: Erin Letsch Person's Completing Form: Erin Letsch - Risk Manager No. 1 2 3 4 5 6 7 8 9 10 RECORDS DESCRIPTION COAST WASTE MGMT. - Hit City Vehicle Loss Recovery EAGEN, Jeanne - Hit Traffic Signal Box Loss Recovery JANUZZI, Barbara - Hit Light Pole Loss Recovery LANE, Sharon - Hit City Vehicle Loss Recovery LATCHFORD, Peggy - Hit Traffic Signs Loss Recovery MIRAMAR BOBCAT INC - Hit Plant Material Loss Recovery PHILLIPS, Sarah - Hit City Vehicle Loss Recovery POOLE, Alan - Hit Plant Material Loss Recovery RAGIN, Veron - Hit Light Pole Loss Recovery ST. JOHN, Marley - Hit Light Pole Loss Recovery DATE Closed Date 11/4/97 Closed Date 9/25/97 Closed Date 12/19/97 Closed Date 2/11/98 Closed Date 6/1/98 Closed Date 4/14/98 Closed Date 9/3/97 Closed Date 1/28/98 Closed Date 12/19/97 Closed Date 1/6/98 BOX No. 1110 1110 1110 1110 1110 1110 1110 1110 1110 1110 RRS No. 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 RRS Period CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 BARCOD E Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt PDF APPROVED By City Attorney H=HOLD City Clerk/Records Management Page 2 of 17 This form documents the destruction of City records in accordance with the California Public Records Act. Request by Originating Department: RISK MANAGEMENT Requested Date: 3/3/06 Originating Department Manager Initials: Erin Letsch Person's Completing Form: Erin Letsch - Risk Manager No. 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 RECORDS DESCRIPTION SAMBI SEASIDE HEIGHTS - Hit Construction Meter Loss Recovery STEEN, Randall - Hit City Vehicle Loss Recovery UNITED VAN LINES/Sorensen Moving - Hit Light Pole Loss Recovery USAA (Laurent) - Hit City Vehicle Loss Recovery ALLEN, Richard - Other Electrical Surge at Work Damaged Personal Property Claim ALVAREZ, Louise - Vehicle Comprehensive Claim AUTO CLUB, Boss - Vehicle Collision Subrogation Claim AUTO CLUB, Dion - Other Wrong Jurisdiction Sheriff Claim BAIRD, William - Property Damage Claim BALDWIN, Wayne - Sewer/Water Back-Up Claim BALTIERRA, Andree - Vehicle Collision w/City Vehicle Claim BEAINY, Stanley -Vehicle Collision Claim BENHARROSH, Michel - Trip/Fall Claim BRACKEN, Stuart- Vehicle Comprehensive Claim BURNETT, Brian -Vehicle Collision Claim DATE Closed Date 1/16/98 Closed Date 8/8/97 Closed Date 1/26/98 Closed Date 1/26/98 Received 3/9/98 Closed Date 6/8/98 Received 8/29/97 Closed Date 3/27/98 Received 10/15/92 Closed Date 8/25/97 Received 2/1/97 Closed Date 2/17/97 Received 8/13/97 Closed Date 10/1/97 Received 2/5/98 Closed Date 3/27/98 Received 1/10/97 Closed Date 2/9/97 Received 1/15/97 Closed Date 8/26/97 Received 3/10/97 Closed Date 10/28/97 Received 2/4/97 Closed Date 7/29/97 Received 6/11/97 Closed Date 12/19/97 BOX No. 1110 1110 1110 1110 1110 1110 1110 1110 1110 1110 1110 1110 1110 1110 1110 RRS No. 0120-20 0120-20 0120-20 0120-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 RRS Period CU+2 CU+2 CU+2 CU+2 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 BARCOD E Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt PDF APPROVED By City Attorney H=HOLD City Clerk/Records Management Page 3 of 17 This form documents the destruction of City records in accordance with the California Public Records Act. Request by Originating Department: RISK MANAGEMENT Requested Date: 3/3/06 Originating Department Manager Initials: Erin Letsch Person's Completing Form: Erin Letsch - Risk Manager No. 26 27 28 29 30 31 32 33 34 35 36 37 38 39 RECORDS DESCRIPTION BURTSON, Jr., William - Law Enforcement Claim CAMINO HILLS H/O ASSOCIATION - Sewer/Water Claim CAPEATCALAVERA- Sewer/Water Claim CARPENTER, Shande - Vehicle Collision Claim CHAFFEE, Katharine - Vehicle Comprehensive Claim CHRIST, Thomas - Other Damage due to Fire Fighters Battling Blaze Claim DENNIS, Deborah -Vehicle Collision Claim DIAZ, Joanne - Vehicle Collision Claim DOBBS, Clayton - Other Personal Vehicle Damaged during Working Hours Claim DYNES, Sean - Vehicle Comprehensive Claim ERBSEN, Loretta - Trip/Fall Claim EXPLORER INSURANCE CO. (Lopez) - Vehicle Collision with City Vehicle Claim FAIRWAY SOUTH HOA - Sewer/Water Claim FOSTER, Cory - Vehicle Collision Claim DATE Received 9/8/97 Closed Date 3/27/98 Received 2/23/98 Closed Date 4/1/98 Received 10/31/97 Closed Date 12/30/97 Received 8/20/97 Closed Date 3/27/98 Received 9/29/97 Closed Date 4/27/98 Received 4/21/97 Closed Date 12/19/97 Received 1/30/97 Closed Date 7/29/97 Received 3/19/08 Closed Date 6/26/98 Received 2/13/96 Closed Date 1/30/98 Received 2/4/97 Closed Date 6/26/98 Received 4/11/97 Closed Date 12/19/97 Received 3/9/98 Closed Date 6/8/98 Received 6/11/97 Closed Date 7/17/97 Received 9/10/97 Closed Date 12/30/97 BOX No. 1110 1110 1110 1110 1110 1110 1110 1110 1110 1110 1110 1110 1110 1110 RRS No. 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 RRS Period CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 BARCOD E Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt PDF APPROVED By City Attorney H-HOLO City Clerk/Records Management Page 4 of 17 This form documents the destruction of City records in accordance with the California Public Records Act. Request by Originating Department: RISK MANAGEMENT Requested Date: 3/3/06 Originating Department Manager Initials: Erin Letsch Person's Completing Form: Erin Letsch - Risk Manager No. 40 41 42 43 44 45 46 47 48 49 50 51 52 53 RECORDS DESCRIPTION FREDRICKS, Gloria - Vehicle Comprehensive Claim FULLMER, Orvis - Other Real Property Damaged by Contractor Claim GAITAUD, Renee- Vehicle Collision Claim GOMBAR, John - Vehicle Collision w/City Vehicle Claim GONZALEZ, Federico - Vehicle Comprehensive Claim HALLSTROM, Ralph - Trip/Fall Claim HARLOFF, Jennifer- Vehicle Comprehensive Claim HERMAN, Tammy - Vehicle Comprehensive Claim HERNANDEZ, Paul - Vehicle Collision with City Vehicle Claim HIGGINS, E. Denise- Vehicle Collision with City Vehicle Claim HOWARD, Jennifer- Vehicle Collision with City Vehicle Claim HUNTINGTON, Sandra - Vehicle Collision with City Vehicle Claim JANICKI, Ed - Sewer/Water Claim JENKINS, Andrew - Vehicle Collision with City Vehicle Claim DATE Received 10/22/97 Closed Date 5/29/98 Received 5/8/97 Closed Date 12/19/97 Received 10/25/97 Closed Date 12/9/97 Received 3/16/98 Closed Date 6/8/98 Received 8/8/97 Closed Date 3/3/98 Received 1/24/97 Closed Date 12/30/97 Received 10/10/97 Closed Date 4/28/98 Received 4/29/97 Closed Date 12/19/97 Received 2/16/97 Closed Date 3/3/98 Received 9/15/97 Closed Date 5/29/98 Received 10/3/97 Closed Date 11/3/97 Received 8/8/97 Closed Date 10/2/97 Received 1/15/98 Closed Date 2/13/98 Received 8/5/97 Closed Date 10/2/97 BOX No. 1110 1110 1110 1110 1110 1110 1110 1110 1110 1110 1110 1110 1110 1110 RRS No. 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 RRS Period CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 BARCOD E Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt PDF APPROVED By City Attorney H=HOLD City Clerk/Records Management Page 5 of 17 This form documents the destruction of City records in accordance with the California Public Records Act Request by Originating Department: RISK MANAGEMENT Requested Date: 3/3/06 Originating Department Manager Initials: Erin Letsch Person's Completing Form: Erin Letsch - Risk Manager No. 54 55 56 57 58 59 60 61 62 63 64 65 66 67 RECORDS DESCRIPTION JONES, William - Vehicle Collision Claim KAIZA POINSETTIA - Other Claim KEHLER, Paul -Vehicle Comprehensive Claim KENT, John - Sewer/Water Claim KOHN, David - Law Enforcement Claim LAMA, Bumtso - Vehicle Collision with City Vehicle Claim LEGLER, Wilma - Sewer/Water Claim LOPEZ, Jesus - Vehicle Collision Claim LOPEZ, Victoria - Vehicle Collision Claim MACDOUGALL, Joseph - Other Claim MALINSKI, Edward - Vehicle Comprehensive Claim MANTOR, Sheridan - Vehicle Comprehensive Claim MARINEZ, John - Tree Claim MARTINEZ, Elias - Other Personal Property Damaged Claim DATE Received 7/17/97 Closed Date 3/3/98 Received 2/19/97 Closed Date 6/26/98 Received 9/30/97 Closed Date 4/28/98 Received 9/18/97 Closed Date 3/3/98 Received 8/12/97 Closed Date 3/27/98 Received 7/1/97 Closed Date 8/19/97 Received 1/30/98 Closed Date 3/3/98 Received 10/29/97 Closed Date 6/19/98 Received 10/29/97 Closed Date 6/19/98 Received 2/16/97 Closed Date 3/3/98 Received 7/14/97 Closed Date 3/3/98 Received 1/27/97 Closed Date 7/29/97 Received 5/12/97 Closed Date 9/19/97 Received 9/18/97 Closed Date 12/1/97 BOX No. 1110 1110 1110 1111 1111 1111 1111 1111 1111 1111 1111 1111 1111 1111 RRS No. 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 RRS Period CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 BARCOD E Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt PDF APPROVED By City Attorney H=HOLD City Clerk/Records Management Page 6 of 17 This form documents the destruction of City records in accordance with the California Public Records Act. Request by Originating Department: RISK MANAGEMENT Requested Date: 3/3/06 Originating Department Manager Initials: Erin Letsch Person's Completing Form: Erin Letsch - Risk Manager No. 68 69 70 71 72 73 74 75 76 77 78 79 80 81 RECORDS DESCRIPTION MC COMAS, Audrey - Tree Claim MCINTOSH, Ron - Sewer/Water Claim MERCURY INSURANCE GROUP (Richman - Vehicle Collision Claim MERCURY INSURANCE (Estefani) - Vehicle Collision Claim MORGAN, Roy - Tree Claim MULLEN, John -Law Enforcement Claim NOVELLA, April - Other Power Surge Damaged Personal Property Claim NUZZI, Janet - Vehicle Collision Claim PACIFIC BELL - Other Cable Damaged Claim PERNELL, Jan - Sewer/Water Claim PHILLIPS, Nancy -Law Enforcement Claim POOLE, Geoffrey - Sewer/Water Claim PRICE, Robert - Vehicle Damage Claim QUITT, Walter- Vehicle Collision Claim DATE Received 8/21/97 Closed Date 10/7/97 Received 2/11/97 Closed Date 2/13/98 Received 2/23/96 Closed Date 7/19/97 Received 9/15/97 Closed Date 5/11/98 Received 2/27/97 Closed Date 10/1/97 Received 4/21/97 Closed Date 12/19/97 Received 2/1 1/97 Closed Date 5/28/98 Received 2/15/97 Closed Date 5/28/98 Received 8/8/97 Closed Date 3/3/98 Received 2/5/98 Closed Date 3/27/98 Received 2/14/96 Closed Date 8/26/97 Received 7/15/97 Closed Date 3/3/98 Received 1/7/97 Closed Date 5/28/98 Received 2/19/97 Closed Date 3/3/98 BOX No. 1111 1111 1111 1111 1111 1111 1111 1111 1111 1111 1111 1111 1111 1111 RRS No. 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 RRS Period CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 BARCOD E Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt PDF APPROVED By City Attorney H=HOLD City Clerk/Records Management Page 7 of 17 This form documents the destruction of City records in accordance with the California Public Records Act. Request by Originating Department: RISK MANAGEMENT Requested Date: 3/3/06 Originating Department Manager Initials: Erin Letsch Person's Completing Form: Erin Letsch - Risk Manager No. 82 83 84 85 86 87 88 89 90 91 92 93 94 95 RECORDS DESCRIPTION RATCLIFFE, Martyn - Vehicle Comprehensive Claim ROSSALL, Barbara - Trip/Fall Claim SAAD, John - Vehicle Collision Claim SANBORN, Laurie - Vehicle Collision Claim SANDOR, Judith - Law Enforcement Claim SOUTHERN INSURANCE (Burnett) - Vehicle Collision Claim STRAUCH, Ken - Vehicle Comprehensive Claim TANNER, Carolyn - Other Pushed by Patrons at Pool Claim TITA, Heather -Vehicle Comprehensive Claim TOMPKINS, Karin - Law Enforcement Claim TRIPP, Chris - Vehicle Comprehensive Claim TUBBS, Evelyn - Trip/Fall Claim VALENCIA, Erica - Vehicle Collision Claim VALLELY, Dwight - Vehicle Comprehensive Claim DATE Received 3/19/98 Closed Date 6/2/98 Received 2/6/96 Closed Date 7/29/97 Received 2/22/97 Closed Date 6/23/98 Received 1/22/97 Closed Date 7/29/97 Received 9/19/97 Closed Date 4/28/98 Received 9/8/97 Closed Date 3/3/98 Received 10/23/97 Closed Date 4/28/98 Received 10/29/97 Closed Date 5/28/98 Received 10/7/97 Closed Date 4/28/98 Received 9/15/97 Closed Date 3/27/98 Received 1/28/97 Closed Date 8/26/97 Received 1/7/95 Closed Date 2/1/97 Received 6/24/97 Closed Date 7/17/97 Received 10/28/97 Closed Date 4/28/98 BOX No. 1111 1111 1111 1111 1111 1111 1111 1111 1111 1111 1111 1111 1111 1111 RRS No. 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 RRS Period CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 BARCOD E Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt PDF APPROVED By City Attorney H=HOLD City Clerk/Records Management Page 8 of 17 This form documents the destruction of City records in accordance with the California Public Records Act. Request by Originating Department: RISK MANAGEMENT Requested Date: 3/3/06 Originating Department Manager Initials: Erin Letsch Person's Completing Form: Erin Letsch - Risk Manager No. 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 RECORDS DESCRIPTION VAN LEUVEN, Audrey - Trip/Fall Claim WALLIEN, Ernest - Vehicle Collision Claim WISENER, Gail - Tree Claim WORTH, Vicki - Vehicle Comprehensive Claim AHLES, Steven - Hit Plant Material and Irrigation Equipment Loss Recovery ALCARAS, Armond - Hit Signs Loss Recovery ARIAS, Duran - Hit Street Light Loss Recovery BOLLINGER, Douglas - Hit Street Sign and Pole Loss Recovery BRUNNER, Kimberly - Hit Street Sign Loss Recovery BUFFINGTON, Doric - Hit Street Light Pole Loss Recovery BUNDY, Carol - Hit Street Sign Loss Recovery CABLE GRAFTERS CONST. - Hit Fire Hydrant Loss Recovery CARPENTER, David - Hit Fire Hydrant Loss Recovery CENTEX Golden Const. - Hit Construction Meter Loss Recovery CITY OF CARLSBAD - Stolen Vehicle Loss Recovery from City's Insurance Carrier COBRA GOLF - Hit Fire Hydrant Loss Recovery CONTINENTAL EXPRESS - Hit Street Signs Loss Recovery COSTA, Raphael - Hit Signal Control Box Loss Recovery CUMMINGS, Katherine - Hit Street Signs DALEY CORP. - Hit Line Loss Recovery Loss Recovery EARTHBUSTERS & MTLS. - Hit Fire Hydrant Loss Recovery EDGE, Ulrike - Hit Signal Pole Loss Recovery DATE Received 6/2/97 Closed Date, 7/17/97 Received 7/29/97 Closed Date 3/3/98 Received 2/16/97 Closed Date 1/27/98 Received 10/30/97 Closed Date 5/28/98 Closed Date 10/11/98 Closed Date 3/17/00 Closed Date 7/7/97 Closed Date 9/4/98 Closed Date 4/21/99 Closed Date 11/25/98 Closed Date 2/25/01 Closed Date 4/24/00 Closed Date 4/23/98 Closed Date 1/31/98 Closed Date 11/22/94 Closed Date 7/22/98 Closed Date 4/24/00 Closed Date 4/3/98 Closed Date 4/21/99 Closed Date 1/17/98 Closed Date 3/17/99 Closed Date 8/31/00 BOX No. 1111 1111 1111 1111 986 986 986 986 986 986 986 986 986 986 986 986 986 986 986 986 986 986 RRS No. 0745-20 0745-20 0745-20 0745-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 RRS Period CL+5 CL+5 CL+5 CL+5 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 BARCOD E Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt PDF APPROVED By City Attorney H=HOLD City Clerk/Records Management Page 9 of 17 This form documents the destruction of City records in accordance with the California Public Records Act Request by Originating Department: RISK MANAGEMENT Requested Date: 3/3/06 Originating Department Manager Initials: Erin Letsch Person's Completing Form: Erin Letsch - Risk Manager No. 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 RECORDS DESCRIPTION ELECTRIC CA WESTERN INC. - Hit Overhead Signal Loss Recovery EVANS, Joe & ACME PALLET - Hit Fire Hydrant Loss Recovery FARR, Eric - Hit Fire Hydrant Loss Recovery FELICES, Raymundo - Hit Light Pole Loss Recovery GANAN, Kean - Hit Fire Hydrant Loss Recovery GENERAL INS. (Lalonde) - Hit Street Light Pole Loss Recovery GRIFFIN, Kenneth - Hit Fire Hydrant Loss Recovery HAMANN CONSTRUCTION - Hit Construction Meter Loss Recovery HANEY, Cherice - Hit Sign Loss Recovery HARPER, Mark - Hit Sign and Pole Loss Recovery HARRISON TRKG. (Robertson) - Hit Signal Pole Loss Recovery HAWTHORNE RENTAL - Diesel Fuel Spill Loss Recovery HESKETT, Virginia - Hit Sign Loss Recovery HIGANONNA, Alanna - Hit Light Pole Loss Recovery JERNBERG, Deborah - Hit Signs Loss Recovery JOHNSON, Celester- Hit Fire Hydrant Loss Recovery JONES, Heather- Hit Chain Link Fence Loss Recovery KOLL CONSTRUCTION - Damaged Construction Meter Loss Recovery LAPORTE, Shirlee - Hit Plant Material Loss Recovery LESINSKI, Anthony - Hit Light Pole Loss Recovery LUCAS & MERGER DEV. - Damaged Construction Meter Loss Recovery LUSARDI CONST. - Hit Fire Hydrant Loss Recovery M. L. BASHAW, INC. - Hit Water Line Loss Recovery MARIO, Badillo - Hit Fire Hydrant Loss Recovery MARKLEY, Ryan - Hit Plant Material and Irrigation Line Loss Recovery DATE Closed Date 11/13/00 Closed Date 6/23/97 Closed Date 1/31/98 Closed Date 5/11/97 Closed Date 8/13/98 Closed Date 9/16/98 Closed Date 4/24/00 Closed Date 12/22/99 Closed Date 10/8/99 Closed Date 12/13/98 Closed Date 4/10/00 Closed Date 19/9/98 Closed Date 3/17/00 Closed Date 8/31/00 Closed Date 5/21/99 Closed Date 1/21/98 Closed Date 11/7/94 Closed Date 3/6/00 Closed Date 11/23/00 Closed Date 11/21/97 Closed Date 1/31/98 Closed Date 2/28/99 Closed Date 9/24/98 Closed Date 4/24/00 Closed Date 10/29/98 BOX No. 986 986 986 986 986 986 986 986 986 986 986 986 986 986 986 986 986 986 986 986 986 986 986 986 986 RRS No. 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 RRS Period CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 BARCOD E Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt PDF APPROVED By City Attorney H=HOLD City Clerk/Records Management Page 10 of 17 This form documents the destruction of City records in accordance with the California Public Records Act Request by Originating Department: RISK MANAGEMENT Requested Date: 3/3/06 Originating Department Manager Initials: Erin Letsch Person's Completing Form: Erin Letsch - Risk Manager No. 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 RECORDS DESCRIPTION MARSH, Dale - Hit Signs Loss Recovery MARSHALL, Steven - Hit Light Pole Loss Recovery McCALL, Sarah - Hit Fire Hydrant Loss Recovery McNulty, Sheila - Hit Electrical Sprinkler Boxes Loss Recovery MERCURY INS. (Mercado) - Hit Street Light Loss Recovery MORENO, Daniel - Hit Plant Material Loss Recovery MORTIMER, Sandra - Hit City Vehicle Loss Recovery O. C. I. - Damaged Construction Meter Loss Recovery ORTEGA, Julio - Hit Street Signs Loss Recovery Possible 1/4/95 Storm Damage Recovery from City's Insurance Carrier PACIFIC TREND PROPERTIES - Damaged Water Service Line Loss Recovery PAREDES, Raul - Hit Irrigation System Loss Recovery PINEDA, Jesus - Hit City Vehicle Loss Recovery POHLMANN, Carl - Hit Street Light Pole Loss Recovery RADCLIFFE, Kevin - Hit Fire Hydrant Loss Recovery RAMIREZ, Juan - Hit Fire Hydrant Loss Recovery RICHER, John - Hit Fire Hydrant Loss Recovery RICHMOND AMERICAN - Damaged Construction Meter Loss Recovery RANCHO SANTA FE SECURITY - Hit Controller Cabinet Loss Recovery RODRIGUEZ, Luis - Hit Signs Loss Recovery SAFECO (Mulholland) - Hit Fire Hydrant Loss Recovery SALAMESSY, Aaron - Hit Light Pole Loss Recovery SHEA HOMES - Damaged Construction Meter Loss Recovery SHEA HOMES - Damaged Construction Meter Loss Recovery SIERRA CASCADE CONCRETE - Damaged Water Service Line Loss Recovery DATE Closed Date 3/17/00 Closed Date 3/17/00 Closed Date 4/23/98 Closed Date 11/5/00 Closed Date 1/17/98 Closed Date 12/1/96 Closed Date 3/15/96 Closed Date 12/22/99 Closed Date 4/24/00 Closed Date 11/6/95 Closed Date 3/26/99 Closed Date 12/21/00 Closed Date 11/1/01 Closed Date 8/31/00 Closed Date 1/16/99 Closed Date 11/15/96 Closed Date 12/22/99 Closed Date 12/22/99 Closed Date 11/13/00 Closed Date 4/9/99 Closed Date 4/24/00 Closed Date 2/25/00 Closed Date 1/31/98 Closed Date 12/22/99 Closed Date 5/9/99 BOX No. 986 986 986 986 986 986 986 986 986 986 986 986 986 986 986 986 986 986 986 986 986 986 986 986 986 RRS No. 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 RRS Period CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 BARCOD E Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt PDF APPROVED By City Attorney H=HOLD City Clerk/Records Management Page 11 of 17 This form documents the destruction of City records in accordance with the California Public Records Act Request by Originating Department: RISK MANAGEMENT Requested Date: 3/3/06 Originating Department Manager Initials: Erin Letsch Person's Completing Form: Erin Letsch - Risk Manager No. 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 RECORDS DESCRIPTION SMITH, Victoria L. - Hit City Vehicle Loss Recovery SNYDER, Ken - Hit Fire Hydrant Loss Recovery STAGECOACH PARK - Snack Bar Fire Loss Recovery from City's Carrier 20 r" CENTURY (Gordon) - Hit City Vehicle Loss Recovery TALLEY, Richard - Hit Street Sign Loss Recovery UDC HOMES INC. - Hit Construction Meter Loss Recovery VALENTINE, Thomas -Hit Control Box Loss Recovery VARDY, Katherine - Hit Light Pole Loss Recovery WESTERN PACIFIC HOMES - Damaged Construction Meter Loss Recovery WHITMER, Rex - Hit Sign Loss Recovery ANGELINI, John -Vehicle Collision Pothole Claim AUTO CLUB (Ins. Ibbetson) - Vehicle Collision w/ City Vehicle Claim AUTO CLUB (Ins. Paulin) - Vehicle Collision Pothole Claim BANTZ, Thomas - Vehicle Comprehensive Substance Claim BERGMANN, Rene and Anita - Sewer/Water Back-up Claim BLACKBURN, Dawn -Vehicle Comprehensive Substance Claim BRENNEISE, Dennis - Sewer/Water Back-Up Claim BROCK, Ronald -Vehicle Comprehensive Vandalism Claim DATE Closed Date 2/9/95 Closed Date 6/25/00 Closed Date 12/12/97 Closed Date 1/29/00 Closed Date 4/16/99 Closed Date 12/22/98 Closed Date 2/25/00 Closed Date 4/21/00 Closed Date 12/22/99 Closed Date 2/25/01 Received 10/5/98 Closed date 04/26/99 Received 8/3/98 Closed date 12/23/98 Received 5/4/98 Closed date 10/30/98 Received 4/13/98 Closed date 10/30/98 Received 2/10/98 Closed date 04/09/99 Received 8/24/98 Closed date 10/27/98 Received 8/5/98 Closed date 06/07/99 Received 3/2/98 Closed date 10/30/98 BOX No. 986 986 986 986 986 986 986 986 986 986 986 986 986 986 986 986 986 986 RRS No. 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 RRS Period CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 BARCOD E Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt PDF APPROVED By City Attorney H=HOLD City Clerk/Records Management Page 12 of 17 This form documents the destruction of City records in accordance with the California Public Records Act. Request by Originating Department: RISK MANAGEMENT Requested Date: 3/3/06 Originating Department Manager Initials: Erin Letsch Person's Completing Form: Erin Letsch - Risk Manager No. 186 187 188 189 190 191 192 193 194 195 196 197 198 199 RECORDS DESCRIPTION CARLSBAD LODGE - Law Enforcement Search/Entry Property Damaged Claim CARLSBAD RACEWAY - Sewer/Water Shut Off Claim CHAFEY, Kim - Law Enforcement Claim CHAFEY, Michael - Law Enforcement Use of Extreme Procedures Claim CHAFEY, Sterling - Law Enforcement Use of Extreme Procedures Claim CHILES, Olan and Carlene - Trip/Fall Sidewalk Claim DEGOUR, John & Lisa - Vehicle Collision with City Vehicle Claim DELONG, Larry -Vehicle Collision with City Vehicle Claim DEWHURST, Donald - Tree Damaged Curb Claim DONCO, Denise - Law Enforcement Property Damaged during Search Claim DUNN, Daniel - Vehicle Collision Pothole Claim ESTEFANI, Ramon - Vehicle Collision with City Vehicle Claim FARIA, Sherie - Trip/Fall Sidewalk Claim FREEDMAN, Vanessa - Law Enforcement Vehicle Tow Claim DATE Received 7/8/98 Closed date 02/01/99 Received 3/12/99 Closed date 05/11/99 Received 3/1/99 Closed date 05/28/99 Received 3/1/99 Closed date 05/28/99 Received 3/1/99 Closed date 05/28/99 Received 7/9/98 Closed date 02/01/99 Received 5/4/99 Closed date 06/30/99 Received 6/29/98 Closed date 07/29/98 Received 5/26/98 Closed date 02/01/99 Received 6/15/98 Closed date 01/06/99 Received 7/31/98 Closed date 02/01/99 Received 12/11/97 Closed date 10/14/98 Received 3/26/98 Closed date 09/29/98 Received 10/30/98 Closed date 05/28/99 BOX No. 986 986 986 986 986 986 986 986 986 986 986 986 986 986 RRS No. 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 RRS Period CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 BARCOD E Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt PDF APPROVED By City Attorney H=HOLD City Clerk/Records Management Page 13 of 17 This form documents the destruction of City records in accordance with the California Public Records Act. Request by Originating Department: RISK MANAGEMENT Requested Date: 3/3/06 Originating Department Manager Initials: Erin Letsch Person's Completing Form: Erin Letsch - Risk Manager No. 200 201 202 203 204 205 206 207 208 209 210 211 212 213 RECORDS DESCRIPTION GLOGER, Richard - Other Damaged Sprinkles during Replacement of Sidewalk Claim GRACIANO, Rudy - Vehicle Comprehensive Substance Claim GRAY, Patrick & Vickie - Tree Driveway Damage Claim HUSTON, Chad - Vehicle Collision With Hydrant Guard Claim IOZZIA, Jason - Vehicle Collision Claim IRVIN, William and Daurine - Sewer/Water Double Payment of Water Bills Claim JIMENO, Frank - Other Electrical Surge Claim JINJA, Tamamitsu - Other Rental Fence Damaged Claim JOHNSON, Geneva -Trip/Fall Sidewalk Claim JOHNSON, Larry -Vehicle Comprehensive Claim JONES, Brande - Vehicle Collision Claim JUSTICE, Kathleen - Trip/Fall Walking Claim KAITANGIAN, Christine - Vehicle Comprehensive Claim KAKADELAS, Dana - Vehicle Comprehensive Claim DATE Received 4/19/99 Closed date 05/11/99 Received 12/18/98 Closed date 05/28/99 Received 3/30/99 Closed date 06/29/99 Received 3/16/98 Closed date 09/28/98 Received 7/7/98 Closed date 02/01/99 Received 9/10/98 Closed date 01/25/99 Received 12/1/98 Closed date 01/26/99 Received 9/16/98 Closed date 11/23/98 Received 4/9/98 Closed date 12/14/98 Received 4/2/98 Closed date 10/21/98 Received 3/24/99 Closed date 05/07/99 Received 8/25/98 Closed date 03/25/99 Received 4/28/98 Closed date 12/14/98 Received 7/28/98 Closed date 02/22/99 BOX No. 1113 1113 1113 1113 1113 1113 1113 1113 1113 1113 1113 1113 1113 1113 RRS No. 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 RRS Period CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 BARCOD E Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt PDF APPROVED By City Attorney H=HOLD City Clerk/Records Management Page 14 of 17 This form documents the destruction of City records in accordance with the California Public Records Act. Request by Originating Department: RISK MANAGEMENT Requested Date: 3/3/06 Originating Department Manager Initials: Erin Letsch Person's Completing Form: Erin Letsch - Risk Manager No. 214 215 216 217 218 219 220 221 222 223 224 225 226 227 RECORDS DESCRIPTION KAKADELAS, Kevin - Vehicle Comprehensive Claim KRISTIANSEN, Trygve - Vehicle Collision with City Vehicle Claim LA COSTA 15, Jeanie S. Gott - Law Enforcement Claim LAKE, Donald - Law Enforcement Claim LARSON, Joseph - Vehicle Collision Claim LAS PLAYAS H.O. Association - Trip/Fall Claim LECHTMAN, Miles - Tree Claim Walkway Damage LEIGH, Laurie -Vehicle Comprehensive Claim LIEN, Richard - Law Enforcement Claim LUTHER, Ed - Vehicle Collision Claim w/City Vehicle MACMILLAN, John - Trip/Fall Claim over manhole MAFFETT, Erma - Vehicle Comprehensive Claim MAJORCA West HOA- Sewer/Water Claim MCLAUGHLAN, Brand! - Law Enforcement Claim Personal Property Missing DATE Received 7/23/98 Closed date 02/22/99 Received 5/17/99 Closed date 06/30/99 Received 11/20/98 Closed date 06/28/99 Received 3/2/98 Closed date 09/28/98 Received 6/29/98 Closed date 02/01/99 Received 8/24/98 Closed Date 04/26/99 Received 8/4/98 Closed Date 03/25/99 Received 10/28/98 Closed Date 05/28/99 Received 5/28/98 Closed Date 08/17/98 Received 9/21/98 Closed Date 03/09/99 Received 8/3/98 Closed Date 02/22/99 Received 1/20/98 Closed Date 08/31/98 Received 3/11/99 Closed Date 05/07/99 Received 9/14/98 Closed Date 03/25/99 BOX No. 1113 1113 1113 1113 1113 1113 1113 1113 1113 1113 1113 1113 1113 1113 RRS No. 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 RRS Period CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 BARCOD E Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt PDF APPROVED By City Attorney H=HOLD City Clerk/Records Management Page 15 of 17 This form documents the destruction of City records in accordance with the California Public Records Act. Request by Originating Department: RISK MANAGEMENT Requested Date: 3/3/06 Originating Department Manager Initials: Erin Letsch Person's Completing Form: Erin Letsch - Risk Manager No. 228 229 230 231 232 233 234 235 236 237 238 239 240 241 RECORDS DESCRIPTION MILLER, Tracy & Rick - Vehicle Collision Claim w/City Vehicle MONTOYA, Chris - Vehicle Collision Claim NARDELL, James Michael - Vehicle Collision w/City vehicle NOSSE, Stormy - Trip/Fall Claim on Manhole Cover NUGENT, Barbara -Trip/Fall Claim Walking ORTEGA, Henry- Vehicle Collision Claim w/City vehicle OWENS, Lynette - Vehicle Collision Claim PACIFIC BELL - Sewer/Water Claim Cut Cable PACIFIC BELL - Sewer/Water Claim Cut Cable PATT, Larry - Vehicle Collision Claim w/City Vehicle PEREZ AKA Angeles - Vehicle Collision Claim w/Pedestrian PRITTEN, Lew & Joan - Tree Claim Walkway RAKICH, Ron - Other Claim Contractual REMAS, Mark - Sewer/Water Claim Back-Up DATE Received 12/2/98 Closed Date 01/26/99 Received Closed Date 02/01/99 Received 7/10/98 Closed Date 08/27/98 Received 8/12/98 Closed Date 05/28/99 Received 4/1/98 Closed Date 10/30/98 Received 9/4/98 Closed Date 09/28/98 Received 9/17/98 Closed Date 03/25/99 Received 8/11/98 Closed Date 01/11/99 Received 10/23/98 Closed Date 09/11/98 Received 11/3/98 Closed Date 12/04/98 Received 2/20/98 Closed Date 08/31/98 Received 3/1/96 Closed Date 07/30/98 Received 1/5/98 Closed Date 08/31/98 Received 12/7/98 Closed Date 03/01/99 BOX No. 1113 1113 1113 1113 1113 1113 1113 1113 1113 1113 1113 1113 1154 1154 RRS No. 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 RRS Period CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 BARCOD E Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt PDF APPROVED By City Attorney H=HOLD City Clerk/Records Management Page 16 of 17 This form documents the destruction of City records in accordance with the California Public Records Act. Request by Originating Department: RISK MANAGEMENT Requested Date: 3/3/06 Originating Department Manager Initials: Erin Letsch Person's Completing Form: Erin Letsch - Risk Manager No. 242 243 244 245 246 247 248 249 250 251 252 253 254 255 RECORDS DESCRIPTION RIDER, Damian - Law Enforcement Claim Brutality RIDER, Marsha - Law Enforcement Claim Brutality RIDER, William - Law Enforcement Claim Brutality RIELA, Thomas - Vehicle Collision Claim w/City Vehicle ROGERS, Jennifer - Vehicle Collision Claim w/Lid ROLLER, Adolf- Other Claim Personal Property Damaged RUBENSTEIN, L. - Other Claim Flowers Damaged SEASHORE ON THE SEA - Sewer/Water Claim Back-Up SIGAFOOSE, NORINE - Sewer/Water Claim Back-Up SULLIVAN, Brian - Trip/Fall Claim Bicycling on Street TAHAJIAN, Roy -Vehicle Collision Claim THE PLAZA - Sewer/Water Claim Leak TOYOTA CARLSBAD - Vehicle Comprehensive Claim TRYGSTAD, Jean - Tree Claim Damaged Driveway DATE Received 12/17/97 Closed Date 05/31/99 Received 12/17/97 Closed Date 05/31/99 Received 12/17/97 Closed Date 05/31/99 Received 10/21/98 Closed Date 12/04/98 Received 2/25/98 Closed Date 09/28/98 Received 6/6/99 Closed Date 06/30/99 Received 1/6/98 Closed Date 07/30/98 Received 3/9/99 Closed Date 05/11/99 Received 8/6/98 Closed Date 10/14/98 Received 12/1/87 Closed Date 07/30/98 Received 8/15/98 Closed Date 02/01/99 Received 1/21/98 Closed Date 07/30/98 Received 4/10/98 Closed Date 10/30/98 Received 11/25/98 Closed Date 05/28/99 BOX No. 1154 1154 1154 1154 1154 1154 1154 1154 1154 1154 1154 1154 1154 1154 RRS No. 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 RRS Period CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 BARCOD E Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt PDF APPROVED By City Attorney H=HOLD City Clerk/Records Management Page 17 of 17 This form documents the destruction of City records in accordance with the California Public Records Act. Request by Originating Department: RISK MANAGEMENT Requested Date: 3/3/06 Originating Department Manager Initials: Erin Letsch Person's Completing Form: Erin Letsch - Risk Manager No. 256 257 258 259 260 RECORDS DESCRIPTION VILLA LOMA APARTMENTS - Sewer/Water Claim Back-Up WRIGHT, Deborah - Vehicle Collision Claim YEATES, Lorraine - Personnel Action YOUNGKIN, Constance - Law Enforcement Claim False Arrest ZOOLAKIS, Kaye & Andrew - Vehicle Collision Claim DATE Received 3/9/99 Closed Date 05/07/99 Received 2/5/98 Closed Date 08/31/98 Received 9/30/98 Closed Date 04/26/99 Received 3/5/98 Closed Date 10/30/98 Received 4/29/98 Closed Date 09/28/98 BOX No. 1154 1154 1154 1154 1154 RRS No. 0745-20 0745-20 0745-20 0745-20 0745-20 RRS Period CL+5 CL+5 CL+5 CL+5 CL+5 BARCOD E Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt PDF APPROVED By City Attorney H=HOLD DOCUMENT DESTRUCTION WILL BE PROVIDED BY SHREB-fTtTOMPANY. 0130-25/F005 11 fa I O , mobile pape/shreddipapershredding and recyclr jm^ \mm I ^^_ \" IMPSmxb FORCE 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 Date / Time of Destruction •//- 2'? -AM Billing Address Service Address Contact:Phone Number: r7<jS# )/ Type Quantity Service Rate Total File Boxes (Llo •2^ ?&^ Bankers Boxes ShredForce Executive 100 ShredForce 250 Other 7r^ sCft^" / ^ •« wv L^r\^r Other Other SHREDFORCE ID#: Balance Due: $ Amount Paid: $ 'T SHREDFORCE Signature: Please Invoice Client Authorized Representative: Comments: TB:Hours:Other: 09/05 SHREDFORCE D PO Box 891 D San Marcos, CA 92079 D (800) 444-6209