HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Building; 2023-11-02This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program.
Revised: 2021
Page | 1
DATE: 8/29/2023
REQUESTING DEPARTMENT: RM/BUILDING REQUESTER: Maria Emery/Spencer Waldron
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)
3 BOXES
Requests & Permissions to Receive Copies of Plans (to and from Architects) 1/1/2018-
4/8/2021 CD-065 2 YEARS N/A
RECORDS DESTRUCTION AUTHORIZATION FORM
08-20-2023 9/7/2023 8/30/2023
CORODATA 11/2/2023
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Carlsbad
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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.
Account #(s)SD012455
Certificate #102896
Date Issued Friday, November 3, 2023
Service Locations 5815 EL CAMINO REAL
Date Range of Service Nov-02-2023 thru Nov-02-2023
Work Ticket(s)1221789
Quantity/Item 86 -86 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).
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