HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Library & Cultural Arts; 2008-04-28 (2)RECORDS DESTRUCTION REQUEST
City Clerk/Records Management
Page 1 of 1
Department Requesting Destruction: LIBRARY
Approvals for Destruction
Department Head Date
U/iRecords Manager\r 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: •jt'2^"1 P^3-
Cissie Sexton , Administrative Secretary to the Library Director V
No.RECORDS DESCRIPTION
Applications for part time employment
Applications for part time employment
Duplicate personnel requisition forms from Adult
Learning Office files
Library Board of trustees agenda
Historic Preservation Commission agenda
DATED
2003
2004
various
2002
2002
BOX
No.
RRS No.
NotJ- K
033540
032540
RRS
Period
cf3
qy+s
u
EC* «*-£
CU+5
Cu+5
BARCODE
none
none
i
LD000003
LD000007
APPROVED By
City Attorney
H=HOLD
RECORD DESTRUCTION COMPLETED BY :_
CERTIFICATE OF DESTRUCTION? Yes S No D
SMEADLINK BARCODES DELETED BY:
\ A-Ve> "DATE :
DATE:
77i/s form documents the destruction of City records in accordance with the California Public Records Act
Revised 08/25/2005
CINlAS
DOCUMENT MANAGEMENT
CITY OF CARLSBAD
2351 FARADAY AVE
CARLSBAD, CA 920087217
CONTACT: Tanya Bjork - Phone: (760)602-2786
SERVICE PERFORMED
Pounds
Minutes -
SVC'D ADD'L
*3
CERTIFICATE OF DESTRUCTION
SERVICE TICKET #:
DATE:
CUSTOMER #:
SERVICE/TYPE:
NEXT SERVICE DATE:
NEXT SERVICE TYPE:
Lock(s) Present/Operable:
Clasp(s) Present/Operable:
OOG36 - 42136
04/28/2008
10284
Purge/Onsite
Not scheduled.
Not scheduled.
Yes
Yes
No
No
COMMENTS: I ^ I
This certificate is to certify that Cintas Document Management will shred confidential data per customer's instructions and according to HIPAA & GLBA
regulations for the above-mentioned company. Mobile destruction services are NAID certified. Non-paper destruction services are not NAID certified.
CUSTOMER SIGNATURE:
SERVICE REP SIGNATURE:
9455 WAPLES ST • STE. 110- SAN DIEGO, CA 921213924 • Phone: (858)678-0460 • Fax: (858)678-0894