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HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Housing Services; 2021-12-30This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program. Revised: 2021 P a g e | 1 DATE: 10/18/2021 REQUESTING DEPARTMENT: HOUSING SERVICES REQUESTER: PATTI CRESCENTI 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 *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? YES NO TAB BARCODES DELETED BY: _____ _______________________________ DATE: ______________ BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS PERIOD TAB BARCODE (if applicable) 471 AFFORDABLE HOUSING FILES: JOHNSON, DAWN 2003; BROWN, LEONARD & SARAH 2003; WILSON, RAQUEL 2003; PRINCIPE, JEANNE 2003; JOHNSON, JOANNE 2003; KIRSCH, KATHERINE 2002; NORMAN, RICHARD & SHEILA 2003; MARTINEZ, FRANK & ROSEMARIE 2002; GREEN, IVAN 2001; GOODWIN, RICHARD & FRANCES 1999; MENG, DOROTHY 1999; VERA CHEGDIAN 1990; GURULE, DENISE 2003 HS-035 LOAN PAYOFF + 5 YRS 376 AFFORDABLE HOUSING FILES: HADDAD, RICHARD 2008; BARBARA PETZ 2005; MILLIMAN, RYAN 2011; SANGIS, LAWRENCE & MELISSA 2012; KUWABARA, SHIHO 2008; CHASE, PARNELL; GOMEZ, DARIIO & IRIS; SPEER, CHRISTI; STRANG, ADAM * BRIANA; OROZCO, FRANCIS; MILLIMAN, RYAN 2012 HS-035 LOAN PAYOFF + 5 YRS INACTIVE PARTIIPANT: CASTANEDA, LEONARD 2009 HS-060 CLOSE OF FILE + 7 YEARS RECORDS DESTRUCTION AUTHORIZATION FORM Mandy Mills 10/25/21 10-26-2021 10/28/2021 Corodata 12/30/2021 x - - CCityar Carlsbad □ □ Affordable Housing Destruction 10/18/2021 Name Address Program BROWN, LEONARD & SARAH 6167 PASEO ENSILLAR AFFORDABLE HOUSING CASTANEDA, LEONARD HOUSING DIVISION - Section 8, HCV CHASE, PARNELL 2564 NAVARRA DRIVE #215 AFFORDABLE HOUSING CHEGDIAN, VERA 6504 OCEANVIEW AFFORDABLE HOUSING GOMEZ, DARIIO & IRIS 7301 ESFERA STREET AFFORDABLE HOUSING GOODWIN, RICHARD & FRANCES 6516 OCEANVIEW AFFORDABLE HOUSING GREEN, IVAN 6535 EASY STREET AFFORDABLE HOUSING GURULE, DENISE 6166 PASEO GRANITO AFFORDABLE HOUSING HADDAD, RICHARD D.2088 AVENUE OF THE TREES AFFORDABLE HOUSING JOHNSON, DAWN 6163 PASEO ENSILLAR AFFORDABLE HOUSING JOHNSON, JOANNE 3330 DON PABLO DR AFFORDABLE HOUSING KIRSCH, KATHERINE 6500 EASY STREET AFFORDABLE HOUSING KUWABARA, SHIHO 2675 LEIGHTON CIRCLE AFFORDABLE HOUSING MARTINEZ, FRANK C. & ROSE MARIE 3575 MADISON STREET AFFORDABLE HOUSING MENG, DOROTHY 6610 EASY STREET AFFORDABLE HOUSING MILLIMAN, RYAN 6012 PASEO SALINERO AFFORDABLE HOUSING NORMAN, RICHARD & SHEILA 893 CAMELLIA PLACE AFFORDABLE HOUSING OROZCO, FRANCIS 6133 PASEO GRANITO AFFORDABLE HOUSING PETZ, BARBARA J 6550 93 PONTO DR AFFORDABLE HOUSING PRINCIPE, JEANNE 1330 STATICE COURT AFFORDABLE HOUSING SANGIS, LAWRENCE & MELISSA 6168 PASEO PICADOR AFFORDABLE HOUSING SPEER, CHRISTI 6046 PASEO SALINERO AFFORDABLE HOUSING STRAND, ADAM & BRIANA 6159 PASEO ENSILLAR AFFORDABLE HOUSING WILSON, RAQUEL 3441 DON CARLOS AFFORDABLE HOUSING Account #(s)SD012455 Certificate #101376 Date Issued Monday, January 03, 2022 Service Locations 5815 EL CAMINO REAL Date Range of Service Dec-30-2021 thru Dec-30-2021 Work Ticket(s)912008 Quantity/Item 1 -CALL 20 MINUTES RPIOR TO ARRIVAL - 760-271-6841 50 -50 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 GIJIJlll!affl