HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Parks & Recreation; 2008-04-28RECORDS DESTRUCTION REQUEST
City Clerk/Records Management
Page 1 of 1
Department Requesting Destruction: Stagecoach Community Center
Approvals for Destruction
Gian Lauro
Department Head
I *,
.ecords Manager
January 29,2008
Date
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: P)
Becky Falk \~^~
No.
1
2
3
RECORDS DESCRIPTION
Class Registrations \f
Facility Use Applications/Light bills
Facility Use Applications/Openplay forms ' 0^ r\ (
DATED
8/04 -TX
12/04
1/05
1/043-
1/05
BOX
No.
1
2
3
RRS No.
1130-55,
V'
0900-40
0900-40
RRS
Period
CL+2
CL+2
CL+2
BARCODE APPROVED By
City Attorney
H=HOLD
RECORD DESTRUCTION COMPLETED BY ;
CERTIFICATE OF DESTRUCTION? Yes |^| No D
SMEADLINK BARCODES DELETED BY:
DATE :
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-COMMUNITY SWIM COMPLEX
Approvals for Destruction
CssT 3/s.VOB
DepaHment Head
./^-^Records Manager
Date
Date
_/? ^~O &
•*u»
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 Fj>rm: /^
Majka Penner ( £_QJ~\ \0&-Q,j ^->w
No.
1
2
3
4
5
6
7
8
9
10
11
RECORDS DESCRIPTION
Masters Swim Program Waivers
Lagoon Permit Applications
Swim Lesson Waivers
Water Safety Instructor Course Records
Facility Use Applications
Monthly User Group Billings
Masters Payment Requests
Aqua-X Program Waiver Sheets
Volunteer Permission Forms
Aquatics Registration Forms
Aquatics Registration Forms
GUVS 5
DATED
2005
2005
2005
2005
2002-
2005
2002-
2005
2004-
2005
1997-
1999
2004
2002
2000
BOX
No.
1002
1002
1002
1002
1001
1001
1001
1001
1001
1001
1001
RRS No.
1130-55 V
1130-60 .\s
1130-55 ^
1130-05
0900-04
1130-05
1130-05
1130-55
1130-05
1130-55 ,V
1130-55^
RRS
Period
CL+2
CL+2
CL+2
CU+2
CU+2
CU+2
CU+2
CL+2
Cl)*-2
CL+2
CL+2
BARCODE APPROVED By
City Attorney
H=HOLD
RECORD DESTRUCTION COMPLETED BY :_
CERTIFICATE OF DESTRUCTION? Yes B" No D
SMEADLINK BARCODES DELETED BY:A/a
DATE:
DATE:
7/j/s 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
pprovals 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: Christina Sebring
^No.
1
2
3
4
5
RECORDS DESCRIPTION
Winter/Spring Open Play & Registration Forms
Summer Open Play & Registration Forms
Fall Registration Forms
Facility Applications
Enrichment Reports/Payment Requests
DATED
2005
2005
2005
2002/
2005
19907
2004
BOX
No.
1
2
3
4
5
RRS No.
1130-55
1130-55
1130-55
0900-70
1130-80
RRS
Period
CL+2
CL+2
CL+2
CU+2
CU+2
BARCODE APPROVED By 1
City Attorney I
H=HOLD |
RECORD DESTRUCTION COMPLETED BY :_
CERTIFICATE OF DESTRUCTION? Yes E? No D
SMEADLINK BARCODES DELETED BY:
DATE :
DATE:
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 I of 2
Exhibit C - Onsite Records Destruction Form F005
ONSITE RECORDS DESTRUCTION LIST
Approved for Destruction
Department
,u*/C
Date
7-6-<?7
ity Records Manager Date
City Attorney
Total of records approved for destruction: (0
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.
This form documents the destruction of City records in accordance with the California Public Records Act.
Request by Originating Department:
Recreation Department
Requested Date:
5/1 5/07
Originating Department Manager Initials: L.S.
Person's Completing Form: Christina Sebring ^/b^
No.
1
2
3
4
5
6
1
8
9
RECORDS DESCRIPTION
Registration Forms
Registrations Forms
Registration Forms
Open Play/Registration Forms
Injury Reports/Incident Reports
Applications, Time sheets, Open Play
Shift notes
Registration Forms
General Information (surveys)
Facility Use Applications
DATED
2003-04
2002-03
2002-03
2004
2003-04
2004
2003-04
2004
2003-04
BOX
No.
1
2
3
4
5
5
6
5
5
RRS No.
1130-55
1130-55
1130-55
1130-55
1130-15
1130-05
1130-55
1130-05
0900-40
RRS
Period
CL+2
CL+2
CL+2
CL+2
CL+2
CU+2
CL+2
CU+2
CU+2
BARCODE PDF
TIP
APPROVED By
City Attorney
H=HOLD
RECORD DESTRUCTION COMPLETED BY ;
CERTIFICATE OF DESTRUCTION? Yes H" No D
DATE
CJNlAS
DOCUMENT MANAGEMENT
CITY OF CARLSBAD
2351 FARADAY AVE
CARLSBAD, CA 920087217
CERTIFICATE OF DESTRUCTION
CONTACT: Tanya Bjork - Phone: (760)602-2786
SERVICE PERFORMED SVC'D ADD'L
Pounds
Minutes .*
SERVICE TICKET #:
DATE:
CUSTOMER #:
SERVICE/TYPE:
NEXT SERVICE DATE:
NEXT SERVICE TYPE:
Lock(s) Present/Operable:
Clasp(s) Present/Operable:
i 3
\J o
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