HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Housing Services; 2019-09-05 (3)I
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RECORDS DESTRUCTION AUTHORIZATION FORM
DATE: Aug. 26, 2019
REQUESTING DEPARTMENT: CED/HNS REQUESTER: Marie Jones-Kirk -----------
DESTRUCTION APPROVALS:
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.
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DEPARTMENT HEAD: 'e/3,~/ t RECORDS MANAGEMENT: o.,,
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CITY ATTORNEY:' DATE
BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS TAB BARCODE
PERIOD (if applicable)
1 pack Volunteer applications 8/26/19 860-80 CL+3 (5L~ att?td.t.d) (Volunteer Programs)
*If more spaces are needed, click in the last box in right hand corner of table and hit "tab". This will create more fields in the table.
To be filled out once records have been destroyed.
RECORD DESTRUCTION COMPLETED BY: ~ &n d,,:;/;(__,;
CERTIFICATE OF DESTRUCTION? ES O NO
DATE:
SMEADSOFT BARCODES DELETED BY: DATE: -------------------
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program.
CCityor
Carlsbad Revised: 8/26/2019
Records Destruction Authorizaton: August 26, 2019
Last Name First Name VO Date Archive Date Purge Date
3/9/2019
3/7/2019
2/12/2019
3/10/2019
2/12/2019
2/12/2019
2/12/2019
3/7/2019
2/12/2019
3/7/2019
2/5/2019
2/12/2019
2/12/2019
2/12/2019
5/27/2019
3/7/2019
I •
3/2/2019
2/5/2019
2/5/2019
3/2/2019
3/2/2019
Page 2
CERTIFICATE OF DESTRUCTION & RECYCLING
This certificate is presented to: CITY OF CARLSBAD -RECORDS MANAGEMENT DIVISION
Per the express request of Client, Corodata has received the Material referred to below and has/will destroy and then
recycle said Material in accordance with its standard procedures. As the parties have agreed, Corodata will not
inventory, record or track any information contained within or related to the Material.
Account #(s)
Certificate #
Date Issued
Service Locations
Date Range of Service -
Work Ticket(s)
Quantity/Item
SD012455
110640
Monday, September 09, 2019
5815 EL CAMINO REAL
Sep-05-2019 thru Sep-05-2019
618871
60 -60 Boxes for Destruction (standard)
• Nothing in this certificate shall be deemed to modify the terms of the parties' SelVice Agreement(s) or Work Ticket(s).
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