HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Housing & Homeless Services; 2022-04-21RECORDS DESTRUCTION AUTHORIZATION FORM
DATE:
REQUESTING DEPARTMENT:
DESTRUCTION APPROVALS:
FEBRUARY 24, 2022
HOUSING & HOMELESS
SERVICES REQUESTER: PATTI CRESCENTI
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/DIVISIDN MANAGER DATE RECORDS MANAGEMENT DATE CITY ATTORNEY DATE
BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS TAB BARCODE
PERIOD (if applicable)
AFFORDABLE HOUSING FILES:
ALAMI-RAD, MAHVASH &
DIANATI 2004; CISNEROS, ELVA
2005; NETTLES, WENDY 2004; LOAN WALTERS, AMELIE & PAYOFF 55 ANGELIQUE 2004; GRAHAM, 2013 HS-035
THEODORE F & MAYA 2003; +5
LARSON, BETTY 2002; LITVIN, YEARS
ALLA 2005; WING, VIVIAN 1999;
TURNER, MARY 2002; KOPLOFF,
ANNETTE 2013
AFFORDABLE HOUSING FILES: LOAN DOOSE, CAROL 1992; HOWARD, PAYOFF 375 EILEEN 1993; NAVARRO, 2004 HS-035
RICHARD 2004; AMJADI, +5
ALI REZA 2003 YEARS
To be filled out once records hove been destroyed.
RECORD DESTRUCTION COMPLETED BY: DATE:
CERTIFICATE OF DESTRUCTION? 0 YES □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 � + � fd Pl. 6 ,
Revised: 2021
Page /1
03-07-2022 3/7/2022
(See attached)
"
CORODATA 4/21/2022
X
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I
I
RECORDS DESTRUCTION REPORT
Maria Emery
DATE: 3/3/2022
TEMPLATE NAME: Physical Folder
TOTAL RECORD COUNT: 15
COMMENTS:
ENTRY ID REVIEW DATE NAME FILE NUMBER
4354785 03/03/2022 ALAMI-RAD, MAHVASH & ROBERT R.
DIANATI; 6054 PASEO SALINERO;
AFFORDABLE HOUSING
056050
4348507 03/03/2022 AMJADI, ALIREZA; 6107 PASEO ACAMPO;
AFFORDABLE HOUSING
056050
4354761 03/03/2022 CISNEROS, ELVA; 2911 RANCHO POSTA;
AFFORDABLE HOUSING
056050
4356541 03/03/2022 DOOSE, CAROL; 3940 HOLLY BRAE LANE;
AFFORDABLE HOUSING
056050
4356539 03/03/2022 DOOSE, CAROL; 3940 HOLLY BRAE LANE;
AFFORDABLE HOUSING (3)
056050
4347709 03/03/2022 GRAHAM, THEODORE F. & MAYA; 2904
RANCHO POSTA; AFFORDABLE HOUSING
056050
4356537 03/03/2022 HOWARD, EILEEN; 1011 HOME AVENUE;
AFFORDABLE HOUSING
056050
4354685 03/03/2022 KOPLOFF, ANNETTE; 3457 DON JOSE DR;
AFFORDABLE HOUSING
056050
4348232 03/03/2022 LARSON, BETTY; 2903 RANCHO POSTA;
AFFORDABLE HOUSING
056050
4348242 03/03/2022 LITVIN, ALLA; 1314 STATICE COURT;
AFFORDABLE HOUSING
056050
4347695 03/03/2022 NAVARRO, RICHARD; 6141 PASEO
GRANITO; AFFORDABLE HOUSING
056050
4347693 03/03/2022 NETTLES, WENDY C.; 6154 PASEO PICADOR;
AFFORDABLE HOUSING
056050
4356759 03/03/2022 TURNER, MARY; 6606 EASY STREET;
AFFORDABLE HOUSING
056050
4347712 03/03/2022 WALTERS, AMELIE & ANGELIQUE; 6061
PASEO SALINERO; AFFORDABLE HOUSING
056050
4356757 03/03/2022 WING, VIVIAN; 6513 EASY STREET;
AFFORDABLE HOUSING
056050
·tyof
lsbad
Ca li fornia
Account #(s)SD012455
Certificate #101558
Date Issued Friday, April 22, 2022
Service Locations 5815 EL CAMINO REAL
Date Range of Service Apr-21-2022 thru Apr-21-2022
Work Ticket(s)958844
Quantity/Item
1 -CALL 20 MINUTES RPIOR TO
ARRIVAL - 760-271-6841
46 -46 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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