HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Fire; 2022-08-11CORODATA 8/11/2022
X
-- --
RECORDS DESTRUCTION AUTHORIZATION FORM
DATE: 05/05/2022
REQUESTING DEPARTMENT: FIRE ADMINISTRATION REQUESTER: VANESSA MARTINEZ
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.
~ ~!:o<JXL ~tiflils:
j . RRS TAB BARCODE BOX NO. RECORDS DESCRIPTION DATED RRS NO. PERIOD (if applicable)
FA,031 Controlled Drug Inventory Rec. Jan 2015-FR-050 3 years Dec 2016
FQ031 Controlled Drug Inventory Rec. May 2017-FR-050 3 Years Dec 2018
FA031 Ambulance Medication Logs Nov 2018-Dec FR-050 3 years 2018
*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
TAB BARCODES DELETED BY: DATE: ------------------------
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program.
('Cityof
Carlsbad Revised: 2021
Page /1
Account #(s)SD012455Certificate #101838Date IssuedMonday, August 15, 2022Service Locations5815 EL CAMINO REALDate Range of ServiceAug-11-2022 thru Aug-11-2022Work Ticket(s)1004451Quantity/Item74 - 74 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 & RECYCLINGThis Certificate is presented to: CITY OF CARLSBAD - RECORDS MANAGEMENT DIVISIONPer 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.tJcorodata m ~,~ SSAE16 Type II Audit Completed HIP.NA