HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Parks & Recreation; 2007-06-04City Clerk/Records Management
Page 1 of 1
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OFFSITE/ONSITE RECORDS DESTRUCTION REQUEST
/O /T'""?'-^ // / /
>ved for Destruction \J^A ^^JLJ^ \l^/OT~
Department Head
tuj)
LosCity Records Manager
fLr^
City Attorney
Total of records approved for destruction: -10m-
Date
£^/"07
Date
Date
S BoMon — J nww
NOTE : City records on "Hold" cannot be destroyed.
77)/s form documents the destruction of City records in accordance with the California Public Records Act
We certify that the records listed below have been retained for the scheduled retention period, required audits
have been completed, and no pending or ongoing litigation or investigation involving these records is known to
exist.
This form documents the destruction of City records in accordance with the California Public Records Act.
Request by Originating Department:
Recreation / Community Swim Complex
Person(s) Completing Form: Hugh Barker
No.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
RECORDS DESCRIPTION
Lagoon Permit Applications / Files
Lagoon Permit Applications / Files
Swim Lesson Course Records
Swim Lesson Course Records
Swim Lesson Course Records
Swim Lesson Course Records
Staff Training Guides
Facility Use Applications
Masters Swim Program Waivers
Lifeguard Accounting Sheets
Lifeguard Accounting Sheets
Requested Date:
3/21/07
DATED
2004
2003
2004
2001
2000
2003
2003
1992-99
2004
2003-04
2004
BOX
No.
1
1
1
1
1
2
3
3
3
4
5
OriainatioaJDepartment Manager Initials:
(jH^&l ; g^/fj^J
^RRS No.
1130-60
1130-60
1130-05
1130-05
1130-05
1130-05
1130-55
0900-40
1130-55
0900-40
0900-40
I DOCUMENT DESTRUCTION PROVIDED BY : ^^/L^-T^CC
0130-25/F002
RRS
Period
CL+2
CL+2
CU+2
CU+2
CU+2
CU+2
CL+2
CU+2
CL+2
CU+2
CU+2
BARCODE STORAGE APPRO'VED
By City
Attorney
H=HOLD
DATE: W^/8~?
CERTIFICATE OF DESTRUCTION? Yes (27 No'D*
RECORDS DESTRUCTION REQUEST
City Clerk/Records Management
Page 1 of 1
Department Requesting Destruction: Stagecoach Community Center
Approvals for Destruction
Department Head Date
Records Manager Date
Attorney Date
We certify that the records listed below have been retained for the scheduled retention period, required audits have
been completed, and no pending or ongoing litigation or investigation involving these records is known to exist.
Person(s) Completing Form:
Becky Falk STV&GCoffCA
No.
1
2
3
4
5
6
7
RECORDS DESCRIPTION
Class Registrations
Class Registrations
Class Registrations
Class Registrations
Facility Use Applications
Facility Use Applications
upen nay Forms
Facility Use Applications
DATED
1/03
6/03
11/03
1/04
4/04
5/03
•2662-
$001-0 a
2003
2003
<"ir*r\rt«4CLULfU
<Vto-£«o
BOX
No.
N/1
2
3
4.
5-
6
<o
7
RRS No.
1130-55
1130-55
1130-55
1130-55
0900-40
0900-40
I \3O-SS~
0900-40
RRS
Period
CL+2
CL+2
CL+2
CL+2
CL + 2
CL + 2
c.L-*a
CL + 2
^BARCODE APPROVED By
City Attorney
H=HOLD
RECORD DESTRUCTION COMPLETED BY ;
CERTIFICATE OF DESTRUCTION? Yes\[3? No D
SMEADLINK BARCODES DELETED BY:
DATE:
4 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 of 1
Department Requesting Destruction: Recreation /Senior Center
Approvals for Destruction
i
Department Head~f/v -Date 5/02/07
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.
Kris Westland/Senior Center
Person(s) Completing Form:
VC^vfis, t>^<a,2rVVand
1 No'
1
2
3
4
5
6
7
8
RECORDS DESCRIPTION
Senior Activities
Senior Programs
Senior Programs
Senior Programs
Senior Programs
Calendars
Facility Use Applications
General Information
DATED
2002-
2003
1998-
2004
1999-
2002
2000-
2004
2003-
2004
1991-
2002
2003-
2004
1993-
2002
BOX
No.
1
2 -
3
4
5
6
7
8
RRS No.
0690-10
0690-10
0690-10
0690-10
0690-10
0100-50
0900-40
0690-05
RRS
Period
CU+2
CU+2
CU+2
CU+2
CU+2
2
CU+2
CU+2
BARCODE APPROVED By
City Attorney
H=HOLD
RECORD DESTRUCTION COMPLETED BY :
CERTIFICATE OF DESTRUCTION? Yes^f^ No H
SMEADLBVK BARCODES DELETED BY:
DATE:
DATE:
7/j/s form documents the destruction of City records in accordance with the California Public Records Act
Revised 08/25/2005
SECURE DOCUMENT DESTRUCTION
Client materials are to be destroyed off-site. Client will
receive official Certificate of Destruction upon completion
of service.
This CERTIFICATE OF DESTRUCTION certifies the complete
destruction of all material contained as described below on the
date and at the time recorded herewith.
Date / Time of Pick up:__AM PM Date / Time of Destruction:ion:^ " ^-
Billing Address Service Address
. f/^ A-L
J, C/
Contact:Phone Number: ( )
Type
Quantity
Service
Rate
Total
File Boxes
few
^i
~£)
.? *^~
aO
Bankers
Boxes
ShredForce
Executive
100
ShredForce
250
Other.^
/c%£>^a£fcX
\
<yO
/£*
/^
Other Other
•
SHREDFOflCEID#:_
Balance Due: $.
Amount Paid:$.
Please Invoice Client
Check Number:
Credit Card:
'
VISA
. >t,,_
->'' '•
-*~^'''. I*".:¥_JL; f A,?s3),-»" "L '-
Authorized ' '••* f,
Authorized Representative:
Comments:
Authorized Signatun
Hours:Other:
SHREDFORCE • PO Box 891 • San Marcos, CA 92079 • (800) 444-6209
09/05