HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Fire Prevention; 2021-05-2004-14-2021 4/15/2021
Corodata 5/20/2021
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RECORDS DESTRUCTION AUTHORIZATION FORM
DATE: 3/31/2021
REQUESTING
DEPARTMENT: FIRE PREVENTION
DESTRUCTION APPROVALS:
REQUESTER:
MEGAN VANZANDT
We certify that the records listed below have been retained for the scheduled retention period, required audits have been
completed, and n in g or ongoing litigation or investigation involving these records is known to exist.
DATE RECORDS MANAGEMENT: DATE CITY ATTORNEY: DATE
BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS TAB BARCODE
PERIOD (if applicable)
FIRE PREVENTION TENT PERMITS 2002 TO FR-100 ✓ MINIMUM 2
~ 2018 YEARS , 2010 & MINIMUM 2
I WEED ABATEMENT DOCUMENTS 2016 FR-090 / YEARS
LIFE OF THE
STRUCTURE
FIRE INSPECTIONS RECORDS FOR OR ACTIVITY,
ARMENIAN CAFE AT 3126 CARLSBAD 2001 TO FR-110 ✓ OR MIN 5 2014
BLVD; BUILDING DEMOLISHED YEARS,
WHICHEVER
IS LONGER
HOOD &DUCT PERMIT FS100007 AND
PUBLIC ASSEMBLY PERMITS US130011 LIFE OF THE
& US140017 FOR ARMENIAN CAFE AT 2001 TO FR-125.I STRUCTURE 2014 OR ACTIVITY 3126 CARLSBAD BLVD; BUILDING
DEMOLISHED
*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: __________ _ DATE: _____ _
CERTIFICATE OF DESTRUCTION? 0 YES 0 NO
SMEADSOFT BARCODES DELETED BY: ___________ _ DATE: ------
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program.
C cityof ·
Carlsbad Revised: 3/30/2021
Account #(s)SD012455
Certificate #117346
Date Issued Monday, May 24, 2021
Service Locations 5815 EL CAMINO REAL
Date Range of Service May-20-2021 thru May-20-2021
Work Ticket(s)818289
Quantity/Item 60 -60 Boxes for Destruction (standard)
* Nothing in this certificate shall be deemed to modify the terms of the parties¶Service Agreement(s) or Work Ticket(s).
CERTIFICATE OF DESTRUCTION & RECYCLING
This Certificate is presented to: CITY OF CARLSBAD - R
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.
E•Jcoro data SSAE16
Type II Audit Completed • HIPA'A
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