HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Transportation Engineering; 2016-03-14RECORDS DESTRUCTION AUTHORIZATION FORM
DATE: 6/29/2015
REQUESTING DEPARTMENT: PUBLIC WORKS - TRAN REQUESTER: JANEAN HAWNEY
DESTRUCTION APPROVALS:
We certify that the records listed below have been retained for the scheduled retention period, require
completed, and no pending or ongoing litigation or investigation involving these records is kno
DEPARTMT T HEAD:
RECORDS MANAGEMENT:
ve been
ORNEY:
/ BOX NO.
RECORDS DESCRIPTION
DATED
RRS NO.
RRS
PERIOD
TAB BARCODE
(if applicable)
/ 1-8
2003-2005 Traffic Request
2003-
2005
1040-07
Cis% 5
N/A
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: • )& C/ DATE: 3 ' / /- ` 6
CERTIFICATE OF DESTRUCTION? Or YES El NO
SMEADSOFT BARCODES DELETED BY: %I IOU
DATE:
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program.
CITY Or
Revised: 6/29/2015
CARLSBAD
Shred- it
3801 Ocean Ranch Blvd
Suite 101
Oceanside CA
92056
Phone: 760- 598- 5700
SERVICE RE( k ) 1, I) SUMMARY
CERTIFICATE OF DESTRUCTION
PLEASE KEEP THIS FO It YOUR RECORDS
IIISISNOTANIN�ci1C�?;
Customer: 00118ti'.2
CITY OF CARLSBAD- I;I.l u11)SMANAGEMENT
5815 El. CA !WINO REAL
CARLSBAD CA 92008- 8801
Order #: 8022396527
Order Date: 03.14.2016
Service Type: ON- SITE PURGE
Contact.
Time In: 10:17 AM
Y ? �bVvnr�
Material Collected
BANKERS/ARCHIVE BOX
Total:
Customer Signature; PAT
CSR Signature: DAVID SCHULTZ
157
157
Shred- it is committed to the secure destruction of its customers'
confidential information. This certification will affirm that
Shred- it destroys the customer confidential material, pursuant to
ow- customers request and instructions.
The following services are NAID certified:
Hard Drive Destruction
Mobile Destruction
Offsite Destruction
The following services are not NAID certified:
Non- Paper Destruction