HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Housing Services; 2021-10-07RECORDS DESTRUCTION AUTHORIZATION FORM
DATE: 8/24/2021
REQUESTING DEPARTMENT: HOUSING SERVICES REQUESTER: PATTI CRESCENT1I
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.
DEPT. HEAD/DIVISION MANAGER DATE RECORDS MANAGEMENT DATE CITY ATTORNEY DATE
BOX NO. DATED RRS NO. RRS TAB BARCODE
PERIOD (if applicable)
LOAN
354 2013 HS-035 PAYOFF
+ 5 YRS
LOAN
356 2014 HS-035 PAYOFF
+ 5 YRS
LOAN
357 2014 HS-035 PAYOFF
+ 5 YRS
LOAN
352 2015 HS-035 PAYOFF
+ 5 YRS
RECORDS DESCRIPTION
AFFORDABLE HOUSING FILES:
HAUSE 2011; HA 2007;
LANGHAM 2011; WYCKOFF
2006; CHIA, LEE 2013; LEDESMA
2012; LAVER 2003; LEHRMANN
2008; HERNANDEZ 2007
AFFORDABLE HOUSING FILES:
RISKO 2004; ROMERO 2004;
GRAF 2007; WEATHERFORD
2014; WHITE 2004; PHAM 2009;
PARENT 2012; PERALTA 2008;
PORTILLA 2005; OSTERHOUT
2003; PFANKUCH 2009
AFFORDABLE HOUSING FILES:
MARISTELA 2004; MCLEOD
2005; BLACK 2014; CHUNG
2014; YEE 2012; YANG/PADILLA
2013; FRETWELL2012; EVERS
2011; MARTIN 2009;
MANGIAPANE 2013
AFFORDABLE HOUSING FILES:
HUMPHREY KATHERINE 2014;
LEVEILLE 2015; COLVIN/CARR
2014; HARRIS/GRANDE 2010;
WHITEHEAD 2013; LI/TRAN
2013; HUMPHREY JULIE 2015;
WHITMAN 2015
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program.
(°City of Carlsbad Revised: 2021
Page /1
See attached
08-30-2021 08/31/2021
*If more spaces ore 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 hove been destroyed.
RECORD DESTRUCTION COMPLETED BY: __________ _ DATE: _____ _
CERTIFICATE OF DESTRUCTION? 0 YES 0 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 ofCarlsbad Revised: 2021
Page /2
Corodata 10/07/2021
x
Maria Emery 10/06/2021
Affordable Housing Destruction 8/30/2021
Name Address Program
YUNG/PADILLA, YANNA & JAVIER 2673 LIBERTY PLACE AFFORDABLE HOUSING
YEE, JOHNNY 6214 LIBERTY PLACE AFFORDABLE HOUSING
WYCKOFF, MESHANDA 6130 PASEO ENSILLAR AFFORDABLE HOUSING
WITMAN, JOAN 2983 PASEO ALLMIAR AFFORDABLE HOUSING
WHITEHEAD, TREVOR JAY 7022 FORSTERS TERN DRIVE AFFORDABLE HOUSING
WHITE, RONALD & JENNIFER 6179 PASEO CAMAS AFFORDABLE HOUSING
WEATHERFORD, KATHERINE E.6053 PASEO SALINERO AFFORDABLE HOUSING
ROMERO, SAMUEL & CINDY 6171 PASEO CAMAS AFFORDABLE HOUSING
RISKO, BERNICE J.1307 PHLOX COURT AFFORDABLE HOUSING
PORTILLA, LEE & CATHERINE 1310 STATICE COURT AFFORDABLE HOUSING
PHAM, LONG Q 2683 ALAMEDA CIRCLE AFFORDABLE HOUSING
PFANKUCH, ADAM M.4030 SAND COVE WAY AFFORDABLE HOUSING
PERALTA, GREGG & DENISE 1338 STATICE COURT AFFORDABLE HOUSING
PARENT, SHAWN & PHILIP 6060 PASEO ACAMPO AFFORDABLE HOUSING
OSTERHOUT, TIFFANY 2912 RANCHO POSTA AFFORDABLE HOUSING
MCLEOD, FRANK & MARY 3462 DON LORENZO AFFORDABLE HOUSING
MARTIN, SCHUYLER J & MELISSA 6203 LIBERTY PLACE AFFORDABLE HOUSING
MARISTELA, ANDREW & MARIA 2987 PASEO ALIMAR AFFORDABLE HOUSING
MANGIAPANE, LEONARDO 2685 ALAMEDA CIRCLE AFFORDABLE HOUSING
LI/ TRAN & LUI LYDIA & BOAN 7003 FORSTERS TERN DRIVE AFFORDABLE HOUSING
LEVEILLE, JOYCE M.7011 FORSTERS TERN DRIVE AFFORDABLE HOUSING
LEHRMANN, PATRICK 1306 STATICE CT AFFORDABLE HOUSING
LEDESMA, ROBERT D & VANESSA N.6219 LIBERTY PLACE AFFORDABLE HOUSING
LAVER, CAROL M.1337 VERBENA CT AFFORDABLE HOUSING
LANGHAM, NORMA 1309 VERBENA CT AFFORDABLE HOUSING
HUMPHREY, KATHERINE A.4032 SAND COVE WAY AFFORDABLE HOUSING
HUMPHREY, JULIE 4032 SAND COVE WAY AFFORDABLE HOUSING
HERNANDEZ, LUIS & EVELIA 6024 PASEO SALINERO AFFORDABLE HOUSING
HAUSE, BRENDAN S.6213 SHAMROCK PLACE AFFORDABLE HOUSING
HARRIS, GRANDE/ JAMES & DENISE 2675 ALAMEDA CIRCLE AFFORDABLE HOUSING
HA, SANDY 2679 LEIGHTON CIRCLE AFFORDABLE HOUSING
GRAF, CHELSEA 7018 FORSTERS TERN DRIVE AFFORDABLE HOUSING
FRETWELL, ALISON & JOSHUA 7016 FORSTERS TERN DRIVE AFFORDABLE HOUSING
EVERS, ALLYSON O.579 LAGUNA DRIVE AFFORDABLE HOUSING
COLVIN/CARR, AUTUMN AND CHRISTIAN 4030 SANDCOVE WAY AFFORDABLE HOUSING
CHUNG, JOON W 6217 LIBERTY PLACE AFFORDABLE HOUSING
CHIA, HENRY Y.T. & LEE, LYE-SIM 6064 PASEO ACAMPO AFFORDABLE HOUSING
AGNOS, JOHN & KIMBERLY 6056 PASEO ACAMPO AFFORDABLE HOUSING
Account #(s)SD012455
Certificate #101273
Date Issued Friday, October 08, 2021
Service Locations 5815 EL CAMINO REAL
Date Range of Service Oct-07-2021 thru Oct-07-2021
Work Ticket(s)873043
Quantity/Item
1 -CALL 20 MINUTES RPIOR TO
ARRIVAL - 760-271-6841
67 -67 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 - 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.
E•Jcoro data SSAE16
Type II Audit Completed • HIPA'A
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