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HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Risk Management; 2007-06-04RECORDS DESTRUCTION REQUEST City Clerk/Records Management Page 1 of2 Department Requesting Destruction: Risk Management Approvals for Destruction Department Head Date Records Manager Attorney Date 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: Janet R. Gage-Jones No. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 RECORDS DESCRIPTION Incident Reports Incident Reports Incident Reports Incident Reports Incident Reports Incident Reports Incident Reports Incident Reports-City Vehicles Incident Reports-City Vehicles Incident Reports-City Vehicles Incident Reports-City Vehicles Incident Reports-City Vehicles Incident Reports-City Vehicles Incident Reports-City Vehicles DATED 2003-04 2002-03 2001-2 2000-01 1999-00 1998-99 1997-98 2003-04 2002-03 2001-02 2000-01 1999-00 1998-99 1997-98 BOX No. 28 28 28 28 28 28 28 28 28 28 28 28 28 28 RRS No. 0120-23 0120-23 0120-23 0120-23 0120-23 0120-23 0120-23 0120-23 0120-23 0120-23 0120-23 0120-23 0120-23 0120-23 RRS Period CL+2 CL+2 CL+2 CL+2 CL+2 CL+2 CL+2 CL+2 CL+2 CL+2 CL+2 CL+2 CL+2 CL+2 BARCODE APPROVED By City Attorney H=HOLD This form documents the destruction of City records in accordance with the California Public Records Act Revised 08/25/2005 City Clerk/Records Management Page 2 of2 Person(s) Completing Form: Janet R. Gage-Jones No. 15 16 17 18 19 20 21 22 23 24 25 26 27 RECORDS DESCRIPTION Incident Reports-City Vehicles - Police Special Event Insurance Special Event Insurance Insurance Review Requests Insurance Review Requests Insurance Review Requests Insurance Review Requests Request for Proposal - Insurance Coverage Certificates of Insurance (Misc. or Non-Applicable) Certificates of Insurance (Misc. or Non-Applicable) Certificates of Insurance (Misc. or Non-Applicable) Certificates of Insurance (Misc. or Non-Applicable) Certificates of Insurance and Miscellaneous Correspondence DATED 1998-02 2003-04 2002-03 2003-04 2002-03 2001-02 2000-01 & Prior Years 2/99 Expiration 12/99& Prior Expiration 12/01 & Prior Expiration 12/02 & Prior Expiration 12/03& Prior Expiration 1/79 & Prior BOX No. 28 28 28 28 28 28 28 28 29 29 29 29 29 RRS No. 0120-23 0120-13 0120-13 0120-18 0120-18 0120-18 0120-18 0120-35 0470-34 0470-34 0470-34 0470-34 0470-34 RRS Period CL+2 CL+2 CL+2 CL+2 CL+2 CL+2 CL+2 CU+5 CU+2 CU+2 CU+2 CU+2 CU+2 BARCODE APPROVED By City Attorney H=HOLD RECORD DESTRUCTION COMPLETED BY :. CERTIFICATE OF DESTRUCTION? Yes^ No ~ Cff-DATE: SMEADLINK BARCODES DELETED BY: A//A DATE: This form documents the destruction of City records in accordance with the California Public Records Act Revised 08/25/2005 RECORDS DESTRUCTION REQUEST City Clerk/Records Management Page 1 of2 Department Requesting Destruction: Risk Management^ Approvals for Destruction Department Head Date 0*7 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: Janet R. Gage-Jones 10/23/06 No. 1 2 3 4 5 6 7 8 9 10 11 12 13 RECORDS DESCRIPTION Faustino Camacho BAZAN; Marina Gloria Alejo; Porfirio, Jorge, Veronica, Gloria Camacho Alejo; Hipolito Camacho Gonzalez; and Lucina Bazan Ventura - Vehicle Accident CASTILLO, Sergio & Cesar - Vehicle Accident COASTLINE SERVICE CORP. - Indemnification Samantha DOURSON and Leslee STAUFFER - Trip and Fall SOUTH COAST ASPHALT - Indemnification CALIFORNIA PAVEMENT MAINTENANCE COMPANY, INC. - Indemnification Nicole ERNST - Vehicle Accident GARCIA, Salvador & Rayne - Vehicle Accident BIRTCHER PACIFIC - Indemnification CRUZ, Bonifacio & Mary - Vehicle Accident INDUSTRIAL INDEMNITY - Indemnification PALOMAR BUSINESS PARK & SIGNAL LANDMAR, INC. - Indemnification PILATO, Diane - Vehicle Accident DATED Closed 4/26/94 Closed 7/11/83 Closed 6/24/87 Closed 8/25/92 Closed 8/25/92 Closed 8/25/92 Closed 3/31/94 Closed 8/26/86 Closed 8/26/86 Closed 8/26/86 Closed 8/26/85 Closed 8/26/85 Closed 8/30/85 BOX No. 27 27 27 27 27 27 27 1099 1099 1099 1099 1099 1099 RRS No. 0745-50 0745-50 0745-20 0745-50 0745-20 0745-50 0745-50 0745-50 0745-20 0745-20 0745-50 0745-20 0745-20 RRS Period CL+7 CL+7 CL+5 CL+7 CL+5 CL+7 CL+7 CL+7 CL+5 CL+5 CL+7 CL+5 CL+5 BARCODE 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 APPROVED By City Attorney H=HOLD This form documents the destruction of City records in accordance with the California Public Records Act Revised 08/25/2005 City Clerk/Records Management Page 2 of 2 Person(s) Completing Form: Janet R. Gage-Jones 10/23/06 No. 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 RECORDS DESCRIPTION UNIVERSAL UNDERWRITERS - Vehicle Accident HENRY WORLEY & ASSOC. - Indemnification GRIFFIN, Taylor -Other METZGER, Elizabeth and Shirley - Other PATTERSON, Sarah - Vehicle Accident PATTERSON, Lorn & Janice - Vehicle Accident PERRY, IV, John; DEMERSON, Gwendolyn, Desiree and Edward, Jr. POWERS, James, Rebecca, Kelly, Mark and Alicia - Vehicle Accident SETMIRE, James and Susan - Indemnification WATTLES, Jason - Vehicle Accident BOSS, Kathryn - Vehicle Accident BECKMAN INSTRUMENTS - Indemnification CLEARY, Alan - Excessive Force LAU, Laura - Bicycle Accident PEARCE, Steve - Personnel Action PEARCE, Steve - Personnel Action SPENCER, David - Other Vehicle Damage WARREN, William - Personnel Action DATED Closed 8/26/85 Closed 8/26/85 Closed 12/28/93 Closed 6/11/87 Closed 1/9/95 Closed 1/9/95 Closed 6/29/94 Closed 11/26/96 Closed 10/1/92 Closed 1/25/96 Closed 1/27/95 Closed 1/31/97 Closed 7/19/86 Closed 10/7/91 Closed 4/29/97 Closed 6/28/98 Closed 6/29/92 Closed 1/8/92 BOX No. 1099 1099 1099 1099 1099 1099 1099 1100 & 1109 1109 1109 30 30 30 30 30 30 30 30 RRS No. 0745-20 0745-20 0745-50 0745-50 0745-50 0745-50 0745-50 0745-50 0745-50 0745-50 0745-50 0745-20 0745-50 0745-20 0745-50 0745-50 0745-50 0745-50 RRS Period CL+5 CL+5 CL+7 CL+7 CL+7 CL+7 CL+7 CL+7 CL+7 CL+7 CL+7 CL+5 CL+7 CL+5 CL+7 CL+7 CL+7 CL+7 BARCODE 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 APPROVED By City Attorney H=HOLD RECORD DESTRUCTION COMPLETED BY :. CERTIFICATE OF DESTRUCTION? Yes^Qr7 No Fl — 1 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 Exhibit C - Onsite Records Destruction Form F005 City Clerk/Records Management Page 1 of 19 ONSITE RECORDS DESTRUCTION LIST Approved for Destruction 12/26/06 Department Head Date ity Records Manager City Attorney Total of records approved for destruction: Date -1- 0*1- 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. Tft/s form documents the destruction of City records in accordance with the California Public Records Act. Request by Originating Department: RISK MANAGEMENT Requested Date: 4/25/06 Originating Department Manager Initials: Erin Letsch Person's Completing Form: Erin Letsch - Risk Manager No. 1 2 3 4 5 6 7 8 g 10 RECORDS DESCRIPTION 2^' CENTURY (Benton) - Hit City Vehicle Loss Recovery COLE, Debra - Hit street sign COX, Gary - Hit vegetation DAUGHERTY, Freeman - Hit sign EATON, Jennifer- Hit sign ELLIOTT, Patsy - Hit sign FALVEY, Sharilyn - Hit vegetation HILL, Robert - Hit sign HOEFFS, James - Hit street light LAWRENCE, Cameron - Hit fire hydrant DATE Closed 2/17/00 Closed 9/21/99 Closed 6/24/99 Closed 4/10/00 Closed 4/10/00 Closed 10/19/99 Closed 9/27/99 Closed 5/26/00 Closed 4/26/00 Closed 6/6/00 BOX No. 1 1 1 1 1 1 1 1 1 1 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 -3-3 APPROVED By City Attorney H=HOLD City Clerk/Records Management Page 2 of 19 This form documents the destruction of City records in accordance with the California Public Records Act. Request by Originating Department: RISK MANAGEMENT Requested Date: 4/25/06 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 26 27 28 29 RECORDS DESCRIPTION LIAGA, Sandra - Hit fire hydrant NICHOLS, Robert - Hit street sign O'DONNELL, Donna - Hit traffic signal PERALTA, Maria - Hit sign PONTE, Derek - Hit City vehicle RODIGHIERO, Brie - Hit street light RUFO, Ramon - Light pole VENTURA, Alberto - Hit street light WATTS, Susan - Street light WAWANESA (Shepard) - Hit guardrail and fence ADCOCK, Michael - Vehicle Collision ALEGRE, Alexis - Law Enforcement ALEGRE, Irene - Law Enforcement ALEGRE, Margaret - Law Enforcement ALEGRE, Mary -Law Enforcement ALEGRE, Natalie - Law Enforcement ALVAREZ-NUNO, Estela - Law Enforcement ARGUMEDO, Alexander - Vehicle Collision AUTO CLUB Insured Zumbrunen - Vehicle Collision DATE Closed 5/17/00 Closed 11/15/99 Closed 4/28/00 Closed 5/16/00 Closed 3/10/00 Closed 10/19/99 Closed 3/23/99 Closed 5/23/00 Closed 4/17/00 Closed 8/23/99 Received 4/13/99 Closed 10/31/99 Received 11/12/99 Closed 5/31/00 Received 11/12/99 Closed 5/31/00 Received 11/12/99 Closed 5/31/00 Received 11/12/99 Closed 5/31/00 Received 11/12/99 Closed 5/31/00 Received 4/13/00 Closed 4/28/00 Received 3/18/99 Closed 10/31/99 Received 7/12/99 Closed 8/10/99 BOX No. 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 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 19 This form documents the destruction of City records in accordance with the California Public Records Act. Request by Originating Department: RISK MANAGEMENT Requested Date: 4/25/06 Originating Department Manager Initials: Erin Letsch Person's Completing Form: Erin Letsch - Risk Manager No. 30 31 32 33 34 35 36 37 38 39 40 41 42 43 RECORDS DESCRIPTION BABER, Charles - Vehicle Collision BARRENS, Tami - Vehicle Collision BERGESON, Theodore - Vehicle Comprehensive BISBEE, Robert - Law Enforcement BODO, Matthew -Vehicle Collision BRINKS, Christopher - Other BRUTAS, Carmelita - Vehicle Collision BUFFINGTON, Linne - Vehicle Comprehensive CLARKE, Gloria & Michael - Sewer/Water CLINE, Sandra - Vehicle Collision CONNOLLY, John - Vehicle Comprehensive COSTANTINO, Ben -Tree DUDAS, Julia Russell - Law Enforcement FARMERS INSURANCE Insured Gorman - Vehicle Collision DATE Received 10/25/99 Closed 11/10/99 Received 1/14/99 Closed 7/27/99 Received 4/15/99 Closed 10/31/99 Received 7/20/99 Closed 1/31/00 Received 4/19/99 Closed 10/31/99 Received 5/4/99 Closed 11/30/99 Received 2/3/98 Closed 12/3/99 Received 8/30/99 Closed 4/28/00 Received 11/15/99 Closed 5/31/00 Received 12/2/99 Closed 6/30/00 Received 6/18/99 Closed 9/29/99 Received 2/2/99 Closed 10/31/99 Received 1/29/99 Closed 8/20/99 Received 9/21/99 Closed 4/28/00 BOX No. 1 1 1 1 1 1 1 1 1 1 1 1 1 1 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 of 19 This form documents the destruction of City records in accordance with the California Public Records Act. Request by Originating Department: RISK MANAGEMENT Requested Date: 4/25/06 Originating Department Manager Initials: Erin Letsch Person's Completing Form: Erin Letsch - Risk Manager No. 44 45 46 47 48 49 50 51 52 53 54 55 56 57 RECORDS DESCRIPTION FARR, Claire - Vehicle Collision FLINT, George - Vehicle Comprehensive FOX, Tina - Vehicle Collision FRAZIER, Gertrude - Vehicle Collision GILBERT, Jocelyn - Trip & Fall GIOVINAZZO, Nick -Vehicle Comprehensive GOEDERT, Samantha - Vehicle Collision GONZALEZ, Simon Contredas - Tree GRAZIANO, Ettore and INMAN, Susan- Law Enforcement GREASLEY, Martin - Vehicle Collision HENDERSON-LEWIS, Alfreda - Vehicle Comprehensive HEYDEN, Lawrence - Vehicle Collision JELINEK, Robert - Vehicle Collision JOHNSON, Donald - Sewer/Water DATE Received 8/16/99 Closed 4/28/00 Received 12/2/99 Closed 6/30/00 Received 3/29/99 Closed 10/31/99 Received 12/14/98 Closed 7/27/99 Received 4/21/99 Closed 10/31/99 Received 1/14/99 Closed 7/27/99 Received 12/10/99 Closed 5/9/00 Received 8/5/99 Closed 2/29/00 Received 3/17/99 Closed 10/31/99 Received 10/21/99 Closed 4/28/00 Received 5/3/99 Closed 11/30/99 Received 12/1/99 Closed 6/30/00 Received 11/1/99 Closed 6/30/00 Received 2/25/99 Closed 7/27/99 BOX No. 1 1 1 1 1 1 1 1 1 1 1 1 1 1 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 19 This form documents the destruction of City records in accordance with the California Public Records Act Request by Originating Department: RISK MANAGEMENT Requested Date: 4/25/06 Originating Department Manager Initials: Erin Letsch Person's Completing Form: Erin Letsch - Risk Manager No. 58 59 60 61 62 63 64 65 66 67 68 69 70 71 RECORDS DESCRIPTION JOHNSON, Elaine - Vehicle Comprehensive JOHNSON, Eleanor -Vehicle Comprehensive JOHNSON, Karen - Trip and Fall JOHNSON, Sierra - Trip and Fall JONES-THEIS, Bret - Vehicle Collision KAEBISCH, Tyler -Law Enforcement LARSEN, Katherine - Trip and Fall LATIANO, Karen - Vehicle Comprehensive LITVIN, Alia - Sewer/Water LYONS, Ralph - Tree MACKAY, Virginia -Vehicle Collision MARTINEZ, Freddy - Vehicle Collision MCLAUGHLIN, Ann - Vehicle Collision MINESINGER, Ellen - Trip and Fall DATE Received 1/20/99 Closed 7/27/99 Received 11/1/99 Closed 5/31/00 Received 5/21/99 Closed 11/30/99 Received 5/21/99 Closed 5/31/00 Received 3/17/99 Closed 10/31/99 Received 7/21/99 Closed 2/29/00 Received 12/9/98 Closed 7/7/99 Received 5/27/99 Closed 12/15/99 Received 6/28/99 Closed 7/13/99 Received 5/27/99 Closed 9/7/99 Received 8/9/99 Closed 9/7/99 Received 2/3/98 Closed 12/3/99 Received 11/2/99 Closed 5/31/00 Received 3/18/99 Closed 10/31/99 BOX No. 1 1 1 1 1 2 2 2 2 2 2 2 2 2 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 19 This form documents the destruction of City records in accordance with the California Public Records Act. Request by Originating Department: RISK MANAGEMENT Requested Date: 4/25/06 Originating Department Manager Initials: Erin Letsch Person's Completing Form: Erin Letsch - Risk Manager No. 72 73 74 75 76 77 78 79 80 81 82 83 84 85 RECORDS DESCRIPTION MONTALVO, Leslie - Law Enforcement MOULTON, William & Lois - Sewer/Water PACIFIC BELL - Sewer/Water PALOMAR & CO. - Vehicle Collision PASINI, Bart -Vehicle Comprehensive PERMANENT GENERAL - Vehicle Collision PERRUCCIO, Mary - Vehicle Collision PETERSON, William - City Vehicle Collision PHUONG, HuuLe- Vehicle Collision PIERSON, Gary -Vehicle Collision PILMER, William - Vehicle Collision PORTER, Bill and Mary - Sewer/Water PRESTON, Patrick - Personnel Action REPUBLIC WESTERN INS. Co. Insured La Costa 15 - Sewer/Water DATE Received 2/9/99 Closed 8/10/99 Received 4/8/98 Closed 5/31/00 Received 12/2/99 Closed 2/1/00 Received 3/29/00 Closed 5/5/00 Received 10/28/99 Closed 5/31/00 Received 11/15/99 Closed 1/7/00 Received 5/1/99 Closed 12/15/99 Received 5/29/98 Closed 7/15/98 Received 9/21/99 Closed 10/8/99 Received 12/8/99 Closed 2/1/00 Received 4/30/99 Closed 11/30/99 Received 6/28/99 Closed 7/27/99 Received 3/7/00 Closed 5/31/00 Received 3/3/99 Closed 9/29/99 BOX No. 2 2 2 2 2 2 2 2 2 2 2 2 2 2 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 19 This form documents the destruction of City records in accordance with the California Public Records Act. Request by Originating Department: RISK MANAGEMENT Requested Date: 4/25/06 Originating Department Manager Initials: Erin Letsch Person's Completing Form: Erin Letsch - Risk Manager No. 86 87 88 89 90 91 92 93 94 95 96 97 98 99 RECORDS DESCRIPTION REXROADE, John - Vehicle Collision RUIZ, Haddy- Vehicle Collision SEMPRA ENERGY - Sewer/Water SHEPP, Jr., Richard - Vehicle Collision SHULLO, David - Vehicle Collision SIGURDSON, James - Vehicle Comprehensive SIMMONS, Erik -Vehicle Collision SNYDER, Shari - Vehicle Collision STANZIONE, Vincent - Vehicle Collision SULLI, Paul -Tree TAYLOR BALL OF CALIFORNIA - Other TOLLACK, Marilyn - Trip and Fall VALDIBIESO, Alex - Tree VILLA LOMA APTS. - Sewer/Water DATE Received 3/2/99 Closed 10/31/99 Received 7/28/99 Closed 2/29/00 Received 10/15/99 Closed 11/10/99 Received 12/15/99 Closed 6/30/00 Received 2/4/00 Closed 3/10/00 Received 10/1/99 Closed 12/3/99 Received 9/13/99 Closed 4/28/00 Received 3/25/99 Closed 10/31/99 Received 1/25/99 Clsoed 7/27/99 Received 10/18/99 Closed 5/9/00 Received 12/3/99 Closed 2/29/00 Received 10/12/99 Closed 6/1/00 Received 7/19/99 Closed 10/4/99 Received 6/28/99 Closed 7/13/99 BOX No. 2 2 2 2 2 2 2 2 2 2 2 2 2 2 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 19 This form documents the destruction of City records in accordance with the California Public Records Act. Request by Originating Department: RISK MANAGEMENT Requested Date: 4/25/06 Originating Department Manager Initials: Erin Letsch Person's Completing Form: Erin Letsch - Risk Manager No. 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 RECORDS DESCRIPTION WAWANESA Ins Ley - Vehicle Collision WELLMAN, Molly -Vehicle collision with City vehicle WESTERN UNITED (Cordova) - Vehicle Collision WOODLAND, Louise - Law Enforcement ZEIDLER, Pete - Vehicle Collision AGUAYO, Atanacio - Hit sign AMOS, Clint Jordan - Damaged City vehicle BAKER, Alice - Hit guard rail BAKER, Erik - Hit fire hydrant BORLA, Amy Jo - Hit City vehicle BROWN, Linn Darnell - Damage vegetation BRUNNER, Dennis - Hit City vehicle CAREY, John - Vandalized toilets at Stagecoach park CASTRELLON, Javier- Hit sign CEH ENTERPRISES - Hit signs CENDEJAS, Valerie - Hit light pole CHAMPAGNE, Joffre - Hit traffic signal CHRIST, Charles - Hit City vehicle COAST WASTE - Hit street sign COAST WASTE - Hit street light COLBERT, Gary - Hit traffic signal CALHOUN, Kristina - Hit street light DATE Received 8/6/99 Closed 4/6/00 Received 6/23/98 Closed 7/14/98 Received 5/12/99 Closed 7/20/99 Received 6/4/99 Closed 12/15/99 Received 12/3/99 Closed 1/7/99 Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 Closed 7/1/01 Closed 8/1/01 Closed 8/1/01 Closed 5/3/01 Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 BOX No. 2 2 2 2 2 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 RRS No. 0745-20 0745-20 0745-20 0745-20 0745-20 0120-20 0120-20 0120-20 0120-20 0120-20 0120-20 012020 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 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 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 19 This form documents the destruction of City records in accordance with the California Public Records Act. Request by Originating Department: RISK MANAGEMENT Requested Date: 4/25/06 Originating Department Manager Initials: Erin Letsch Person's Completing Form: Erin Letsch - Risk Manager No. 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 RECORDS DESCRIPTION COLWELL, Christopher- Hit fence CONKLIN, Mark - Hit City tree COTTAM, Kimberly - Hit street light CRONK, Wendell - Hit sign DANIELSON, Kevin - Hit street light DISNEY, Benjamin - Damaged City vehicles DOVE, James T. - Hit street light EMSWILER, Robert - Hit sign ENTERPRISE LEASING - Hit sign ENTERPRISE RENTAL - Hit sign ERICKSON-HALL CONST. CO. - Hit street light FARMERS - Hit City vehicle FERGUSON, David - Damage due to pursuit FUKUDA, San Juana - Damaged vegetation GARLAND, Dwight - Hit street light GILES, Jose Gonzalez - Hit fire hydrant GOMES, RAMOS, MORALES, IBANEZ, LANG, & MONTOYA - Vandalized Holiday Park GRAVES, James - Hit light pole GUTTIEREZ, Elmer - Hit City vehicle HARRIS, Gordon - Hit street sign HANNEY, Lorraine - Hit street sign HERCZECH, Phillip - Burglary at City Hall HERNANDEZ, Genaro- Damaged landscape HOWARD, Darryl - Hit City vehicle HOYT TRANSPORTATION - Oil spill clean-up JORGE, Pablo - Hit street light KAISER, Sara - Hit City vehicle DATE Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 Closed 3/14/01 Closed 2/28/01 Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 Closed 7/5/00 Closed 8/1/01 Closed 2/26/01 BOX No. 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 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 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 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 Risk Mgmt Risk Mgmt PDF APPROVED By City Attorney H=HOLD City Clerk/Records Management Page 10 of 19 This form documents the destruction of City records in accordance with the California Public Records Act. Request by Originating Department: RISK MANAGEMENT Requested Date: 4/25/06 Originating Department Manager Initials: Erin Letsch Person's Completing Form: Erin Letsch - Risk Manager No. 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 RECORDS DESCRIPTION KIM, March/AMADRO - Hit street light KISSEL, Joseph - Damaged irrigation lines and landscaping KOERPER, Kevin - Hit guard rail LARICCIA, Michael LICKETY-SPLIT TRUCKING - Hit traffic signal LISENBY, William - Damaged stucco wall LOOS, David - Damaged City vehicle LOWMAN, Michael - Hit street light LOZANO, Rosalio Trujillo - Hit street light LUCIANO, Jay - Hit fire hydrant MacNabb, Valeria - Hit guard rail MELTON, Justine - Hit stop sign MERCURY INS. (Cowley) - Hit sign MERINO, Alfonso - Hit City vehicle MICHALOWSKI, Laurie - Hit sign MODERN BUILDING SUPPLY - Fuel spill clean-up NANCY, Michelle - Hit barricade and stanchion N. G. TRUCKING - Hit City vehicle OLSEN & FIELDING - Hit Street sign OSUNA, Manuel - Hit street light OSUNA, Selsa - Hit sign POUMELE, Angel - Hit street light Progressive Ins. (Drementea) - Hit fire hydrant RECENDEZ, Robert - Hit windshield REYNAGA, Ray - Hit street light ROBERTSON, Monigue - Hit traffic signs SANGER, Kent - Hit landscaping DATE Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 Closed 8/6/01 Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 Closed 1/10/01 Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 BOX No. 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 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 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 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 Risk Mgmt Risk Mgmt PDF APPROVED By City Attorney H=HOLD City Clerk/Records Management Page 11 of 19 This form documents the destruction of City records in accordance with the California Public Records Act. Request by Originating Department: RISK MANAGEMENT Requested Date: 4/25/06 Originating Department Manager Initials: Erin Letsch Person's Completing Form: Erin Letsch - Risk Manager No. 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 RECORDS DESCRIPTION SENIOR CENTER - Water pipe break, recovery from City's property coverage SOUTHLAND SOD FARM - Hit fire hydrant STAYTON, Michael - Hit traffic signal STEUCK, Bridgette - Hit City vehicle TALBERT, John - Hit street light TAYLOR, Alan - Hit City vehicle THOMPSON, Bryan - Hit landscaping TIGHE, John - Hit sign TURNER, Craig - Hit street light UNDERDAHL, Jeff -Hit landscaping VANDERWEIT, Marilyn - Hit City vehicle WASTE MANAGEMENT - Hit street light WAVE, Ruth - Hit landscaping WESTERN EXPRESS - Hit traffic signal WHEELS, INC. - Hit street light WHITE, Lee - Hit guard rail WINDHAM, Scott - Hit street light ZIEGLER, Betty - Hit street light ALDEA @ AVIARA HO ASSOC - Sewer/Water ALLEN, Rachael - Vehicle Collision ANDERSEN, Richard - Vehicle Collision ANDERSON, Marlys J. DATE Closed 4/3/01 Closed 2/14/01 Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 Closed 4/26/02 Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 Closed 12/6/01 Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 Closed 8/1/01 Received 11/15/00 Closed 3/22/01 Received 7/12/00 Closed 9/19/00 Received 3/27/01 Closed 5/15/01 Received 8/3/00 Closed 9/18/00 BOX No. 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 4 4 4 4 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 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 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CU+2 CL+5 CL+5 CU+5 CU+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 Risk Mgmt Risk Mgmt Risk Mgmt PDF APPROVED By City Attorney H=HOLD City Clerk/Records Management Page 12 of 19 This form documents the destruction of City records in accordance with the California Public Records Act. Request by Originating Department: RISK MANAGEMENT Requested Date: 4/25/06 Originating Department Manager Initials: Erin Letsch Person's Completing Form: Erin Letsch - Risk Manager No. 198 199 200 201 202 203 204 205 206 207 208 209 210 211 RECORDS DESCRIPTION ARNOLD, Sheila - Vehicle Collision ASSA, Julie -Trip and Fall BEAUCHAMP, Maud - Trip and Fall BEISWENGER, Robin - Sewer/Water BORNSTEIN, Steven - Vehicle Collision BRAY, David - Other BRENNAN, Susan - Vehicle Collision BRUNN, Scott -Vehicle Comprehensive BURNETTE, Ralph - Trip and Fall CADE, Steven - Sewer/Water CARUSO, Daniel - Vehicle Collision CCS COMPANIES - Vehicle Collision CHANCELLOR-MADDISON, John COLEMAN, Teresa - Vehicle Collision DATE Received 3/9/00 Closed 9/28/00 Received 7/5/00 Closed 2/28/01 Received 1/11/00 Closed 9/28/00 Received 3/3/00 Closed 8/31/00 Received 9/26/00 Closed 4/27/01 Received 7/13/00 Closed 1/26/01 Received 9/13/00 Closed 3/30/01 Received 1/22/01 Closed 3/28/01 Received 4/13/00 Closed 9/28/00 Received 12/30/99 Closed 7/31/00 Received 9/29/00 Closed 4/27/01 Received 2/9/00 Closed 7/31/00 Received 12/20/99 Closed 7/31/00 Received 9/13/00 Closed 11/13/00 BOX No. 4 4 4 4 4 4 4 4 4 4 4 4 4 4 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 19 This form documents the destruction of City records in accordance with the California Public Records Act. Request by Originating Department: RISK MANAGEMENT Requested Date: 4/25/06 Originating Department Manager Initials: Erin Letsch Person's Completing Form: Erin Letsch - Risk Manager No. 212 213 214 215 216 217 218 219 220 221 222 223 224 225 RECORDS DESCRIPTION CONRAD, Paul - Law Enforcement COSTA, Dorothy - Other CRABTREE, Robert - Sewer/Water DE MARCO, Jane - Vehicle Collision DERRICKSON, Adam - Vehicle Collision ENGELMAN, Jessica - Vehicle Collision ENTEZARI, Pat -Vehicle Comprehensive EUBANKS, Debbie - Other FARMERS Ins Norman - Vehicle Collision FISCHER, Ruth - Law Enforcement FISHEL COMPANY - Other FORD, John - Sewer/Water FURNISS, Corey - Vehicle Collision GALINDO, Sheila - Vehicle Collision DATE Received 5/7/01 Closed 6/8/01 Received 11/2/00 Closed 3/1/01 Received 12/29/00 Closed 3/1/01 Received 1/19/01 Closed 3/28/01 Received 7/25/00 Closed 9/18/00 Received 4/5/00 Closed 10/30/00 Received 8/10/00 Closed 2/28/01 Received 4/12/00 Closed 10/30/00 Received 2/5/01 Closed 2/8/01 Received 3/28/00 Closed 10/30/00 Received 10/5/00 Closed 4/24/01 Received 5/17/01 Closed 6/8/01 Received 2/28/00 Closed 10/30/00 Received 11/28/00 Closed 3/1/01 BOX No. 4 4 4 4 4 4 4 4 4 4 4 4 4 4 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 19 This form documents the destruction of City records in accordance with the California Public Records Act. Request by Originating Department: RISK MANAGEMENT Requested Date: 4/25/06 Originating Department Manager Initials: Erin Letsch Person's Completing Form: Erin Letsch - Risk Manager No. 226 227 228 229 230 231 232 233 234 235 236 237 238 239 RECORDS DESCRIPTION GEICO Ins Bentley - Vehicle Collision GROSS, Virginia - Vehicle Collision HARRIS, Tommy - Trip and Fall HUGHES, Jean - Trip and Fall INGLES, Karen -Vehicle Comprehensive JENKINS, Raymond - Trip and Fall KOSCHEI, Kate - Sewer/Water LA PLANTE, Susan - Vehicle Collision LARSEN, John -Tree LASSEN, Jessica - Vehicle Collision LINEHAN, John and Donna - Tree MAC MILLAN, Timothy - Vehicle Collision MARVEL, Archie - Vehicle Comprehensive MIGAIOLO, Tony - Vehicle Collision DATE Received 9/5/00 Closed 11/13/00 Received 12/8/00 Closed 3/1/01 Received 12/26/00 Closed 3/1/01 Received 9/25/00 Closed 2/28/01 Received 6/21/00 Closed 12/28/00 Received 12/13/00 Closed 3/1/01 Received 7/11/00 Closed 1/26/01 Received 7/21/00 Closed 1/26/01 Received 3/27/01 Closed 5/25/01 Received 5/3/00 Closed 12/28/00 Received 12/27/00 Closed 3/1/01 Received 3/17/00 Closed 10/30/00 Received 2/18/00 Closed 8/31/00 Received 6/20/01 Closed 1/31/01 BOX No. 4 4 4 4 4 4 4 4 4 4 4 4 4 4 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 19 This form documents the destruction of City records in accordance with the California Public Records Act. Request by Originating Department: RISK MANAGEMENT Requested Date: 4/25/06 Originating Department Manager Initials: Erin Letsch Person's Completing Form: Erin Letsch - Risk Manager No. 240 241 242 243 244 245 246 247 248 249 250 251 252 253 RECORDS DESCRIPTION MILLS, Suzie- Vehicle Comprehensive MITCHELL, Wil - Vehicle Collision MOWRY, Alex - Vehicle Comprehensive NICOL, Bonnie - Tree' NIEVES, Richard - Trip and Fall NORMAN, Terry and Marilyn - Vehicle Collision NOVAK, John C. - Other ORDAZ, Carlos -Vehicle Comprehensive PALOMAR GRADING & PAVING, INC. -Trip and Fall PARKER, Michael -Vehicle Comprehensive PETERSEN, Ann - Vehicle Comprehensive PIRO, Justin - Other PORTER, George - Vehicle Collision QUARTARO, Arturo - Vehicle Collision DATE Received 8/23/00 Closed 4/27/01 Received 11/15/00 Closed 3/1/01 Received 3/23/99 Closed _ 12/7/00 Received 8/1/00 Closed 11/30/00 Received 11/27/00 Closed 3/1/01 Received 12/15/00 Closed 3/1/01 Received 11/3/00 Closed 5/31/01 Received 6/28/00 Closed 1/26/01 Received 11/4/00 Closed 3/30/01 Received 6/26/00 Closed 1/26/01 Received 11/7/00 Closed 6/29/01 Received 4/10/00 Closed 10/30/00 Received 5/5/00 Closed 11/30/00 Received 5/11/00 Closed 11/30/00 BOX No. 4 4 4 5 5 5 5 5 5 5 5 5 5 5 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 19 This form documents the destruction of City records in accordance with the California Public Records Act. Request by Originating Department: RISK MANAGEMENT Requested Date: 4/25/06 Originating Department Manager Initials: Erin Letsch Person's Completing Form: Erin Letsch - Risk Manager No. 254 255 256 257 258 259 260 261 262 263 264 265 266 267 RECORDS DESCRIPTION ROSE, Dan - Vehicle Collision SCAFFIDI, Peter -Law Enforcement SCOLLARD, Charlie - Vehicle Comprehensive SEPULVEDA, Connie - Sewer/Water SHARIAT, Seyed - Other SHEFFIELD, James - Other SHIMERDA, Marge - Sewer/Water SHIRLEY, Kathleen - Sewer/Water STAMPER, Sandra - Vehicle Collision STATE FARM INS. Co. Ins. Mitchell - Vehicle Collision STATE FARM Ins. Ory- Vehicle Collision STATE FARM Ins. Stanley - Vehicle Collision STEELE, Amy - Vehicle Collision STEELE, Sandra - Vehicle Collision DATE Received 2/15/00 Closed 8/31/00 Received 6/22/00 Closed 1/26/01 Received 8/21/00 Closed 2/28/01 Received 3/7/01 Closed 5/8/01 Received 8/18/00 Closed 2/28/01 Received 8/14/00 Closed 2/28/01 Received 11/27/00 Closed 4r/27/01 Received 11/9/00 Closed 3/1/01 Received 5/4/00 Closed 7/5/00 Received 12/7/00 Closed 3/1/01 Received 11/14/00 Closed 3/1/01 Received 12/15/99 Closed 9/28/00 Received 6/30/00 Closed 10/18/00 Received 6/6/00 Closed 12/28/00 BOX No. 5 5 5 5 5 5 5 5 5 5 5 5 5 5 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 19 This form documents the destruction of City records in accordance with the California Public Records Act. Request by Originating Department: RISK MANAGEMENT Requested Date: 4/25/06 Originating Department Manager Initials: Erin Letsch Person's Completing Form: Erin Letsch - Risk Manager No. 268 269 270 271 272 273 274 275 276 277 278 279 280 281 RECORDS DESCRIPTION US POSTAL SERVICE - Vehicle Collision WALSH, Michael - Trip and Fall WARD, Marty - Trip and Fall WASHINGTON MUTUAL BANK- Sewer/Water WAWANESA Ins. Steele - Vehicle Collision WILLIAMS, Helen and Roger - Sewer/Water WILLIAMS, Theresa - Sewer/Water WILSON, Ken - Vehicle Comprehensive ZAWACKI-HOYT, Carolyn - Vehicle Collision ALCAZAR, Ricardo - Law Enforcement AKHAVAN, Joseph & Mary - Trip and Fall-Minor BLYTH, Peter - Vehicle Collision BROOKS, Mr. & Mrs. Sheldon - Weed Abatement CALL, Eleanor - Sewer/Water DATE Received 2/28/01 Closed 4/27/01 Received 11/15/00 Closed 6/29/01 Received 4/12/00 Closed 11/30/00 Received 5/1/00 Closed 7/7/00 Received 7/12/00 Closed 11/20/00 Received 5/19/00 Closed 7/5/00 Received 5/1/00 Closed 7/5/00 Received 2/10/00 Closed 8/31/00 Received 6/15/00 Closed 12/28/00 Received 3/30/95 Closed 2/18/98 Received 5/26/95 Closed 10/1/97 Received 5/13/96 Closed 12/30/97 Received 421/97 Closed 12/9/97 Received 5/14/96 Closed 3/27/98 BOX No. 5 5 5 5 5 5 5 5 5 25 25 25 25 25 RRS No. 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-20 0745-50 0745-50 0745-50 0745-50 0745-50 RRS Period CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+5 CL+7 CL+7 CL+7 CL+7 CL+7 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 18 of 19 This form documents the destruction of City records in accordance with the California Public Records Act. Request by Originating Department: RISK MANAGEMENT Requested Date: 4/25/06 Originating Department Manager Initials: Erin Letsch Person's Completing Form: Erin Letsch - Risk Manager No. 282 283 284 285 286 287 288 289 290 291 292 293 294 295 RECORDS DESCRIPTION CLARK-RYLL, Catherine - Personnel Action DAVIES, Donald - Property Drainage (Small Claims) FLORES, Jose - Law Enforcement (Small Claims) LA COSTA HOTEL & SPA - Sewer/Water LOUIS, Leo - Vehicle Collision (Small Claims) C. W. McGRATH, INC. - Contractual MOORADIAN, Harry & Lawana - Weed Abatement ROSENFELD, Marjorie - Construction BERNARDO, James Ray - Trip and Fall BUTLER, Terry - Law Enforcement CARPENTER, Shande - Personnel Action COOLEY, James - Vehicle Collision (Small Claims) DIVINCENZO, Jerrica - Bicycle Accident MOORE, Guy - Sewer/Water (Small Claims) DATE Received 10/12/93 Closed 12/1/97 Received 3/3/97 Closed 10/1/97 Received 8/4/97 Closed 3/3/98 Received 10/22/96 Closed 3/3/98 Received 4/1/98 Closed 6/26/98 Received 7/1/96 Closed 12/17/97 Received 4/18/97 Closed 3/27/98 Received 6/17/97 Closed 8/12/97 Received 2/24/97 Closed 8/17/98 Received 8/1/98 Closed 4/27/99 Received 8/11/98 Closed 12/30/98 Received 3/2/98 Closed 12/7/98 Received 5/29/98 Closed 4/23/99 Received 6/12/98 Closed 12/14/98 BOX No. 25 25 25 25 25 25 25 25 26 26 26 26 26 26 RRS No. 0745-50 0745-50 0745-50 0745-50 0745-50 0745-50 0745-50 0745-50 0745-50 0745-50 0745-50 0745-50 0745-50 0745-50 RRS Period CL+7 CL+7 CL+7 CL+7 CL+7 CL+7 CL+7 CL+7 CL+7 CL+7 CL+7 CL+7 CL+7 CL+7 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 19 of 19 This form documents the destruction of City records in accordance with the California Public Records Act. Request by Originating Department: RISK MANAGEMENT Requested Date: 4/25/06 Originating Department Manager Initials: Erin Letsch Person's Completing Form: Erin Letsch - Risk Manager No. 296 297 298 299 RECORDS DESCRIPTION SANCHEZ, Mark - Personnel Action SCHMIDT, Verda - Trip and Fall SCHONFELD, Bernard -ADA Compliance STOFFEY, Roberta Eleanor - Vehicle Collision DATE Received 6/13/97 Closed 4/6/99 Received 6/11/97 Closed 3/16/99 Received 6/13/96 Closed 6/29/99 Received 5/27/97 Closed 3/16/99 BOX No. 26 26 26 26 RRS No. 0745-50 0745-50 0745-50 0745-50 RRS Period CL_7 CL+7 CL+7 CL+7 BARCOD E Risk Mgmt Risk Mgmt Risk Mgmt Risk Mgmt PDF APPROVED By City Attorney H=HOLD End of List DOCUMENT DESTRUCTION WILL BE PROVIDED BY SifttEBElT COMPANY, mobile paper shredding and recycling. 0130-25/F005 SECURE DOCUMENT DESTRUCTION Client materials are to be destroyed off-site. Client will receive official Certificate of Destruction upon completion of service. "his 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:^ '" Lf~ti? Billing Address Service Address Contact:Phone Number: { X. SHREDFORCE ID#:. Balance Due: $. Amount Paid: $_ / Oo^ SHRED FORCE Signature: Please Invoice Client Check Number: Authorized Representative: Comments: TB: Hours:Other: Type Quantity Service Rate Total File Boxes f6Afc ^$^aO X2- Bankers Boxes ShredForce Executive 100 Shred Force 250 /%J&CL I /^^ &<*> Other Other SHREDFORCE PO Box 891 San Marcos, CA 92079 • (800) 444-6209 09/05