HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Planning; 2019-10-31RECORDS DESTRUCTION AUTHORIZATION FORM
DATE: 10/15/2019 ---~-------
REQUESTING DEPARTMENT: PLANNING REQUESTER: PAM DREW -----------
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
I
DATE RECORDS MANAGEMENT DATE w (21?,,1 , , f 10/k, 1/"1
CllY ATTORNEY ~ATE I
BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS TAB BARCODE
PERIOD (if applicable)
1 AGRICULTURAL CONVERSION MITIGATION 2006-2013 0565-10 TE+5 FEE COMMITTEE GRANTS
*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: &rodr:tl-v DATE:
CERTIFICATE OF DESTRUCTION? J[l YES O NO
TAB BARCODES DELETED BY: ___________ _ DATE: _____ _
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program.
{'city of
Carlsbad Revised: 2019
Page /1
N/A
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
110789
Monday, November 04, 2019
5815 EL CAMINO REAL
Oct-31-2019 thru Oct-31-2019
637183
37 -37 Boxes for Destruction (standard)
• Nothing in this cerlificate shat/ be deemed to modify the terms of the pa,ties' Se/Vice Agreement(s) or Work Ticket(s).
1:-Jcorodata itSSAE16
Type II Audil Completed HIPAA