HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Community Development; 2007-06-04RECORDS DESTRUCTION REQUEST
City Clerk/Records Management
Page 1 of 1
Department Requesting Destruction: COMMUNITY DEVELOPMENT
Approvals for Destruction
Department Head Date
^'Records Manager Dat
City 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.
i):'90 f-
Person(s) Completing Form:
Ronna Stickrod, Records Management
No. I RECORDS DESCRIPTION
I
1
2
Marty Orenyak calendar ( 1 996)
Barbara Nedros Chrono File (1 995)
Don Rideout Chrono File (1996)
(may include correspondence records)
Pat Kelley Chrono File (1996)
Esgil Invoices (copies) (1991-1995)
(may include correspondence records)
DATED
1995-1996
1991-1996
BOX
No.
270959
270959
RRS No.
0540-05
0570-05
RRS
Period
CU+2
CU+2
BARCODE
N/A
N/A
APPROVED By
City Attorney
H=HOLD
RECORD DESTRUCTION COMPLETED BY :
CERTIFICATE OF DESTRUCTION? Yes No
-~TTI DATE :
SMEADLINK BARCODES DELETED BY: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.
jhis 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: ' V-
Billing Address Service Address
. c./
Contact:.Phone Number: ( )
SHREDFOf?CEID#:.
Balance Due: $.
Amount Paid: $.
/ Oe^ SHRED FORCE Signature:
Please Invoice Client
Check Number:
Authorized Representative:
Comments:
TB: Hours:Other:
Type
Quantity
Service
Rate
Total
File Boxes
/?gA6
^
^aO
X2-
Bankers
Boxes
Shred Force
Executive
100
Shred Force
250
JPther.^
£&*a!%*L
I
*&-
&<*>
Other
-
Other
Authorized Signature^
SHREDFORCE PO Box 891 San Marcos, CA 92079 (800) 444-6209
09/05