HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Construction Management & Inspection; 2008-04-28RECORDS DESTRUCTION REQUEST
City Clerk/Records Management
Page 1 of 1
Department Requesting Destruction: PW Construction Mgmt & Inspections
Approvals for Destruction
Date
Attorney
Date
1-7.2.. o*
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.
Xt/ i—^
Person(s) Completing Form: / J
No.
1
RECORDS DESCRIPTION
Haul Route Permits 2005
eQ
DATED
2005
BOX
No.
aoK-
ti&
RRS No.
(000-75
RRS
Period
dtH*
BARCODE
•^r 4. 1 1 ^^JU I j\
APPROVED By
City Attorney
H=HOLD
RECORD DESTRUCTION COMPLETED BY :_
CERTIFICATE OF DESTRUCTION? Yes H No [j
SMEADLINK BARCODES DELETED BY:
\r\-4-cVS DATE :
DATE: A/a
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: Construction Mgmt & Inspections
^ Approvals for Destruction
£~
Date
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: C3 -— ,
Kim Stankavich / Construction Management & Inspections £^'^~^ 1 fif^Hf)*
No.RECORDS DESCRIPTION
Expired Certificates of Insurance
DATED
2004-
2005
BOX
No.
EtiCr/
CMI
2008
#1
RRS No.
0470-30
J*
RRS
Period
EX-2
BARCODE
N/A
APPROVED By
City Attorney
H=HOLD
RECORD DESTRUCTION COMPLETED BY :_
CERTIFICATE OF DESTRUCTION? Yes H" No FJ
SMEADLINK BARCODES DELETED BY:
DATE :
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 of 1
Department Requesting Destruction: Construction Mgmt & Inspections,
jprovals for Destruction
Date
Records Manager Date
- 3-
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.
Kim Stankavich
^A
Person(s) Complet^y Form:
No.RECORDS DESCRIPTION
Expired Certificates of Insurance
towers
\v v\ \*t\derS
xv ^v \^*L
DATED
ZooJ-
Zm3
2£e< -
Zoe>S
zoo's
zooH
BOX
No.
2
Z
1.
RRS No.
OM^o-SS
oM^o-75
c<-\lo-33
RRS
Period
ewa
EA3
•ey^-a
BARCODE
—
—
—
P
APPROVED By
City Attorney
H=HOLD
RECORD DESTRUCTION COMPLETED BY :_
CERTIFICATE OF DESTRUCTION? Yes C3 No [j
SMEADLINK BARCODES DELETED BY:
DATE :
A/a DATE;
7/7/s form documents the destruction of City records in accordance with the California Public Records Act
Revised 08/25/2005
CERTIFICATE OF DESTRUCTION
DOCUMENT MANAGEMENT
CITY OF CARLSBAD
2351 FARADAY AVE
CARLSBAD, CA 920087217
CONTACT: Tanya Bjork - Phone: (760)602-2786
SERVICE PERFORMED
Pounds
Minutes ^,
m(cro
•** 3
SVC'D ADD'L
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 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:ariMO
DATE:
DATE:
9455 WAPLES ST • STE. 110 • SAN DIEGO, CA 921213924 • Phone: (858)678-0460 • Fax: (858)678-0894