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HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Housing & Homeless Services; 2022-12-29This 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:OCTOBER 18,2022 REQUESTING DEPARTMENT: HOUSING &HOMELESS SERVICES REQUESTER: LEAH SORENSEN 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. BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS PERIOD TAB BARCODE (if applicable) 339 INACTIVE PARTICIPANTS: DONAN, MAYRA; NASH, MONICA; SALVATIERRA, FRANK; SMITH, MARVA; VANRUN, GUSBERDINA; YDIGORAS, MICHAEL 2015 HS-060 Close of File + 7 years See attached 340 INACTIVE PARTICIPANTS: DE FRANCISCO, SHERRY; KATZ, STUART; MARTINEZ, JULIE (1,2,3,4,5)2015 HS-060 Close of File + 7 years “ 343 INACTIVE PARTICIPANTS: ANASTASIA, SANDRA (1,2,3,4,5,6,7)2015 HS-060 Close of File + 7 years “ 344 INACTIVE PARTICIPANTS: CARRILLO, PAULA; PADILLA, CARMEN; PHILLIPS, TANYA; RAYMAN, SCOTT; SAMANIEGO, GABRIELA; STANDLEY, JANE 2015 HS-060 Close of File + 7 years “ 346 INACTIVE PARTICIPANTS: GERMER, DOROTHY (1,2); CORE, GRACE (1,2,3,4); HORSTKOETTER, SALLY (1,2,3) 2015 HS-060 Close of File + 7 years “ 347 INACTIVE PARTICIPANTS: BRADSHAW, MARK (1,2); GALARZA, CHRISTINA; O'NEIL, BEVERLY (1,2); WYATT, MURIEL (1,2) 2015 HS-060 Close of File + 7 years “ 348 INACTIVE PARTICIPANTS: HOWARTH, FLORENCE (1,2,3); LOPEZ, EVA (1,2); MARINACCIO, ANTHONY (1,2) 2015 HS-060 Close of File + 7 years “ 349 INACTIVE PARTICIPANTS: ASTRAHAN, DANIEL (1,2,3); CRANER, CAROLE; CONTRERAS, MARLENE (1,2) 2015 HS-060 Close of File + 7 years “ 350 INACTIVE PARTICIPANTS: LEONCAVALLO, JOSEPH (1,2); MAZURKIEWICZ, CHRISTINE (1,2,3)2015 HS-060 Close of File + 7 years “ RECORDS DESTRUCTION AUTHORIZATION FORM Mandy Mills 12/2/22 DocuSign Envelope ID: B6495309-597F-40C8-8C48-CCE1 D0089D34 DATE: REQUESTING DEPARTMENT: DESTRUCTION APPROVALS: OCTOBER 18, 2022 HOUSING & HOMELESS SERVICES REQUESTER: LEAH SORENSEN 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 {'cityof Carlsbad DATE RECORDS MANAGEMENT 12/21/2022 12/21/2022 DATE CITY ATTORNEY DATE This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program. Revised: 2021 P a g e | 2 To be filled out once records have been destroyed. RECORD DESTRUCTION COMPLETED BY:___________________________DATE:______________ CERTIFICATE OF DESTRUCTION?YES NO TAB BARCODES DELETED BY:_____ _______________________________ DATE:______________ CORODATA 12/29/2022 X 12/29/2022 DocuSign Envelope ID: B6495309-597F-40C8-8C48-CCE1 D0089D34 {'cityof Carlsbad □ Maria fmery □ RECORDS DESTRUCTION REPORT Maria Emery DATE: 10/18/2022 TEMPLATE NAME: Physical Folder TOTAL RECORD COUNT: 59 COMMENTS: SECTION 8 TENANT FILES WITHOUT UNPAID BALANCES (2015) - 59 RECORDS ENTRY ID REVIEW DATE NAME FILE NUMBER 4347799 10/18/2022 ANASTASIA, SANDRA; ; HOUSING 055020 4347800 10/18/2022 ANASTASIA, SANDRA; ; HOUSING (2) 055020 4347796 10/18/2022 ANASTASIA, SANDRA; ; HOUSING (3)055020 4347802 10/18/2022 ANASTASIA, SANDRA; ; HOUSING (4) 055020 4347806 10/18/2022 ANASTASIA, SANDRA; ; HOUSING DIVISION - Section 8, HCV 055020 4347804 10/18/2022 ANASTASIA, SANDRA; ; HOUSING DIVISION - Section 8, HCV (2) 055020 4347809 10/18/2022 ANASTASIA, SANDRA; ; HOUSING DIVISION - Section 8, HCV (3) 055020 4348052 10/18/2022 ASTRAHAN, DANIEL F; ; HOUSING 055020 4348056 10/18/2022 ASTRAHAN, DANIEL F; ; HOUSING (2)055020 4348055 10/18/2022 ASTRAHAN, DANIEL F; ; HOUSING DIVISION - Section 8, HCV 055020 4347803 10/18/2022 BRADSHAW, MARK D; ; HOUSING 055020 4347807 10/18/2022 BRADSHAW, MARK D; ; HOUSING DIVISION - Section 8, HCV 055020 4347789 10/18/2022 CARRILLO, PAULA; ; HOUSING 055020 4347782 10/18/2022 CONTRERAS, MARLENA G; ; HOUSING 055020 4347784 10/18/2022 CONTRERAS, MARLENA G; ; HOUSING DIVISION - Section 8, HCV 055020 4347762 10/18/2022 CORE, GRACE M; ; HOUSING 055020 4347761 10/18/2022 CORE, GRACE M; ; HOUSING DIVISION - Section 8, HCV 055020 4347771 10/18/2022 CORE, GRACE M; ; HOUSING DIVISION - Section 8, HCV (2) 055020 4347769 10/18/2022 CORE, GRACE M; ; HOUSING DIVISION - Section 8, HCV (3) 055020 4347787 10/18/2022 CRANER, CAROLE; ; HOUSING DIVISION - Section 8, HCV 055020 4347845 10/18/2022 DE FRANCISCO, SHERRY; ; HOUSING 055020 DocuSign Envelope ID: B6495309-597F-40C8-8C48-CCE1 D0089D34 DIVISION - Section 8, HCV 4347854 10/18/2022 DONAN, MAYRA; ; HOUSING 055020 4347805 10/18/2022 GALARZA, CHRISTINA; ; HOUSING 055020 4347765 10/18/2022 GERMER, DOROTHY M; ; HOUSING 055020 4347755 10/18/2022 GERMER, DOROTHY M; ; HOUSING DIVISION - Section 8, HCV 055020 4347757 10/18/2022 HORSTKOETTER, SALLY A; ; HOUSING 055020 4347766 10/18/2022 HORSTKOETTER, SALLY A; ; HOUSING (2)055020 4347753 10/18/2022 HORSTKOETTER, SALLY A; ; HOUSING DIVISION - Section 8, HCV 055020 4347797 10/18/2022 HOWARTH, FLORENCE; ; HOUSING 055020 4347798 10/18/2022 HOWARTH, FLORENCE; ; HOUSING (2) 055020 4347788 10/18/2022 HOWARTH, FLORENCE; ; HOUSING DIVISION - Section 8, HCV 055020 4347851 10/18/2022 KATZ, STUART; ; HOUSING DIVISION - Section 8, HCV 055020 4347776 10/18/2022 LEONCAVALLO, JOSEPH; ; HOUSING DIVISION - Section 8, HCV 055020 4347772 10/18/2022 LEONCAVALLO, JOSEPH; ; HOUSING DIVISION - Section 8, HCV (2) 055020 4347794 10/18/2022 LOPEZ, EVA; ; HOUSING 055020 4347790 10/18/2022 LOPEZ, EVA; ; HOUSING DIVISION - Section 8, HCV 055020 4347792 10/18/2022 MARINACCIO, ANTHONY; ; HOUSING 055020 4355702 10/18/2022 MARINACCIO, ANTHONY; ; HOUSING DIVISION - Section 8, HCV 055020 4347843 10/18/2022 MARTINEZ, JULIE A; ; HOUSING 055020 4347852 10/18/2022 MARTINEZ, JULIE A; ; HOUSING DIVISION - Section 8, HCV 055020 4347849 10/18/2022 MARTINEZ, JULIE A; ; HOUSING DIVISION - Section 8, HCV (2) 055020 4347840 10/18/2022 MARTINEZ, JULIE A; ; HOUSING DIVISION - Section 8, HCV (3) 055020 4347847 10/18/2022 MARTINEZ, JULIE A; ; HOUSING DIVISION - Section 8, HCV (4) 055020 4347780 10/18/2022 MAZURKIEWICA, CHRISTINE L; ; HOUSING DIVISION - Section 8, HCV 055020 4347778 10/18/2022 MAZURKIEWICZ, CHRISTINE L; ; HOUSING DIVISION - Section 8, HCV 055020 4347774 10/18/2022 MAZURKIEWICZ, CHRISTINE L; ; HOUSING DIVISION - Section 8, HCV (2) 055020 4347858 10/18/2022 NASH, MONICA; ; HOUSING 055020 4347801 10/18/2022 O'NEILL, BEVERLY; ; HOUSING DIVISION - Section 8, HCV 055020 DocuSign Envelope ID: B6495309-597F-40C8-8C48-CCE1 D0089D34 4347749 10/18/2022 O'NEILL, BEVERLY; ; HOUSING DIVISION - Section 8, HCV (2) 055020 4347795 10/18/2022 PADILLA, CARMEN; ; HOUSING DIVISION - Section 8, HCV 055020 4347791 10/18/2022 PHILLIPS, TANYA; ; HOUSING DIVISION - Section 8, HCV 055020 4347793 10/18/2022 RAYMAN, SCOTT; ; HOUSING DIVISION - Section 8, HCV 055020 4347860 10/18/2022 SALVATIERRA, FRANK; ; HOUSING DIVISION - Section 8, HCV 055020 4347786 10/18/2022 SAMANIEGO, GABRIELA; ; HOUSING DIVISION - Section 8, HCV 055020 4347856 10/18/2022 SMITH, MARVA; ; HOUSING DIVISION - Section 8, HCV 055020 4347862 10/18/2022 VANRIJN, GIJSBERDINA; ; HOUSING DIVISION - Section 8, HCV 055020 4347747 10/18/2022 WYATT, MURIEL; ; HOUSING DIVISION - Section 8, HCV 055020 4347750 10/18/2022 WYATT, MURIEL; ; HOUSING DIVISION - Section 8, HCV (2) 055020 4347864 10/18/2022 YDIGORAS, MICHAEL; ; HOUSING DIVISION - Section 8, HCV 055020 DocuSign Envelope ID: B6495309-597F-40C8-8C48-CCE1 D0089D34 Account #(s)SD012455 Certificate #102136 Date Issued Wednesday, January 04, 2023 Service Locations 5815 EL CAMINO REAL Date Range of Service Dec-29-2022 thru Dec-29-2022 Work Ticket(s)1067282 Quantity/Item 69 -69 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