HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Community Development; 2023-10-25RECORDS DESTRUCTION AUTHORIZATION FORM
DATE: 1/17/2024
REQUESTING DEPARTMENT: COMMUNITY DEVELOPMENT REQUESTER: LAUREEN RYAN
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.
RECORDS MANAGEMENT DATE CllV ATTORNEY DATE
BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS
PERIOD
VIATRON BACK-FILE SCANNING OF CD DOCUMENTS (BUILDING PLANS/PERMITS SEE ATTACHED) 45 BOXES PJ6770 (BLDG PLANS -13 BOXES; PJ8015 (BLDG PLANS -26 BOXES; PJ8012 (BLDG PERMITS - 5 BOXES; PJ6768 (BLDG PERMITS - 1 BOX
TAB BARCODE
(if applicable)
**ORIGINAL SCANNED
DOCUMENTS UPLOADED
INTO LASERFICHE AND HARD
COPIES DESTROYED PER
RECORDS MANAGEMENT
PROCEDURES
*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: PAPER RECYCLING SHREDDING SPECIALISTS DATE: 10/25/2023
CERTIFICATE OF DESTRUCTION? [!) YES O 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
01-25-2024 1/31/24
I
II I II
Certificate of Destruction
Paper Recycling .Shredding Specialists, Inc.
1391 E. MusionBlvd, Pomona, CA 91766
Receipt of this Certificate guarantees that all records documents received from:
CITY OF CARLSBAD - BLDG MAPS
located at:
18233 S. Hoover St
Gardena, CA 90248
by Paper Recycling ..Shredding Specialists, Inc. was shredded at the address noted on this certificate. In addition, the Customer acknowledges that they were given the opporttmity to witness the destruction of their paper, by the on-site shredding process.
Authorized Signature
Customer Acknowledgement ________ Date ____ _
Customer Printed Name
Arrival time: ______ Departure time:. ____ _
Date
Item description of products shredded
______ Security Containers
13 Boxes Project NO. # PJ6770 (113-125)------
______ Executive Security Consoles
_ _____ Weight (when applicable)
P�r R«ydlllg Shrtddlng �cJaluu, /M. ls NAID t:ttnlj/alfor both on-site and off..slte datrua/on of paper and prlnlffl material£ We arrt nOI NAID catiflalforanyothu type ofmtdla datnu:tlon.
Certificate of Destruction
Paper Recycling .Shredding Specialists, Inc.
1391 E. Mission Blvd. Pomona, CA 91766
Receipt of this Certificate guarantees that all records documents received from:
CITY OF CARLSBAD - BLDG MAPS
located at:
18233 S. Hoover St
Gardena, CA 90248
by Paper Recycling .Shredding Specialists, Inc. was shredded at the address noted on this certificate. In addition, the Customer acknowledges that they were given the opportunity to witness the destruction of their paper, by the on-site shredding process.
Authorized Signature
Castomer Acknowledgement ________ Date ____ _
Customer Printed Name
Arrival time: ______ Departure time:. ____ _
Date
Item description of products shredded
______ Security Containers
26 Boxes Project NO.# PJ8015 (1-26)------
______ Executive Security Consoles
______ Weight (when applicable)
PapuR«ydlng ShreddlngSp«iol1$U.lnc.isNA/DcutlfledforbathOII-Slt•ond"-'4ttedatrvctlono/paperandprlnledmatulols. WeatenatNAJD«rtljled/oranyothutypeofmt.dladauvalon.
Certificate of Destruction
Paper Recycling .Shredding Specialists, Inc.
1391 E. Mission Blvd, Pomona, CA 91766
Receipt of this Certificate guarantees that all records documents received from:
CITY OF CARLSBAD -BLDG PERMITS
located at:
18233 S. Hoover SL
Gardena, CA 90248
by Paper Recycling .Shredding Specialists, Inc. was shredded at the address noted on this certificate. In addition, the Customer aclazowledges that they were given the opportunity to witness the destruction of their paper, by the on-site shredding process.
Authorized Signature
Customer Acknowledgement ________ Date ____ _
Customer Printed Name
Arrival time: ______ Departure time: ___ _
Date
Item description or products shredded
_ _____ Security Containers
5 Boxes Project NO.# PJ8012 (1-5)------
______ Executive Security Consoles
______ Weight (when applicable)
Papu R«ydlng Shraldlng Sp«iollm, Inc. u NAID artljltd/or boll, on-site and oj/"-,slte datn1t:tlon o/papuand prlnled mot•rfab. We ant not NAID artljl«l/orany odtu type oftMdla datnalon.
Certificate of Destruction
Paper Recycling .Shredding Specialists, Inc. • 1391 E. Mission Blvd, Pomona, CA 91766
Receipt of this Certificate guarantees that all records documents received.from:
CITY OF CARLSBAD -BLDG PERMITS
located at:
18233 S. Hoover St.
Gardena, CA 90248
by Paper Recycling .Shredding Specialists, Inc. was shredded at the address noted on this certificate. In addition, the Customer acknowledges that they were given the opportunity to witness the destruction of their paper, by the on-site shredding process.
Authorized Signature
Customer Acknowledgement ________ Date ____ _
Customer Printed Name
Arrival time:. ______ Departure time: ____ _
Date
Item description of products shredded
______ Securi� Containers
1
Boxes Project NO.# PJ6768 (199)------
______ Executive Security Consoles
______ Weight (when applicable)
Papu Rec:ydlng Shretldlng �daltsu. Inc. & HAID «rtifralfor both on-.rlle and ojf-ffle datnu:tlan of paper and prlnu.d materials. We are not HAID «nlfiedfar any other type of med/a datrualan.