HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Public Works; 2021-01-21DocuSign Envelope ID: 013CF103-61C0-4F88-BA25-AF03E3DB3B83
RECORDS DESTRUCTION AUTHORIZATION FORM
DATE: 10/22/2020
REQUESTING
DEPARTMENT: PUBLIC WORKS REQUESTER: JEANETTE BROWN
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.
RECORDS MANAGEMENT: DATE CITY ATTORNEY: DATE
BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS PERIOD TAB BARCODE (if applicable)
12 boxes
CCTV Collection Line Inspection Tapes / Video Inspections / Video Tapes or Digital Recordings 1993-2012 PW-365
When No Longer Required - Minimum 5 years
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.
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program.
Revised: 10/22/2020
CERTIFICATE OF DESTRUCTION? YES NO
SMEADSOFT BARCODES DELETED BY: _ DATE:
DATE:
To be filled out once records have been destroyed.
RECORD DESTRUCTION COMPLETED BY:
10/28/2020
DEPARTMENT HEAD: DATE 11-02-2020 11/9/2020
Corodata 1/21/2021
x
- -