HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Construction Management & Inspection; 2024-03-21DocuSign Envelope ID: BB0FC584-7553-4E19-AAC8-CDBFB2F189A9
RECORDS DESTRUCTION AUTHORIZATION FORM
DATE: 1/26/2024 -------------
REQUESTING DEPARTMENT: CM&I REQUESTER: KARI KOZLOWSKI -------------
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.
t'.-i7: 1:/~e••Ult•••
DEPT. HEAD/DIVISION MANAGER
2/29/2024 Pl't4-t.awV\).__ 2/29/2024
DATE RECORDS MANAGEMENT DATE
{_,ilA,tiL k., fvtt./ll.J,1>~( 2 9 / 2 o 2 4
CITY ATTORNEY DATE
BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS PERIOD TAB BARCODE
(if applicable)
Capital Improvement Projects +10 years (CIP) Land Development Projects or after
(LDE)-Where Construction PW-000 funding
13095203 Management & Inspection is the 2010 PW-005 agency N/A
Lead audit, if
PW-010 require MS 05-32, CT 03-01, MS 04-01, whichever
PD 06-15, MS 05-12, CUP 05-28 is longer
Capital Improvement Projects
(CIP) Land Development Projects +10 years
or after (LDE)-Where Construction PW-000 funding
13095206 Management & Inspection is the 2013 PW-005 agency N/A Lead audit, if
PW-010 require MS 04-10, CT 09-01, CDP 10-12, whichever PD 11-01, PD 07-08 is longer
*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.
('Cityof
Carlsbad
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program.
Revised: 2021
Page /1
DocuSign Envelope ID: BB0FC584-7553-4E19-AAC8-CDBFB2F189A9
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 /2
CORODATA 3/21/2024
X
3/21/2024
RECORDS DESTRUCTION REPORT
Maria Emery
DATE: 2/22/2024
TOTAL RECORD COUNT: 11
COMMENTS: CM&I PROJECT FILES
ENTRY ID REVIEW DATE Template NAME
4362773 2024/01/30 Physical Folder CDP 10-12; SMERUD RESIDENCE; GR 11-07
4363031 2024/01/30 Physical Folder CT 09-01; ROBERTSON RANCH PA 22; GR 09-26
DWG466-8A
4364783 2024/01/30 Physical Folder CT030001; 2101 COSTA DEL MAR ROAD; FILE TWO
4364114 2024/01/30 Physical Folder CT030001; LA COSTA RESORT CLUBHOUSE WATERLINE;
DWG 422-6H
4363738 2024/01/30 Physical Folder CUP050028; BRESSI RANCH SELF STORAGE; LOT 14
4363242 2024/01/30 Physical Folder MS 04-01; BUSBY MINOR SUB. DIV; OAK AVE
4363426 2024/01/30 Physical Folder MS040010; JENNINGS RESIDENCE; 3725 WESTHAVEN
DR
4363527 2024/01/30 Physical Folder MS050012; PACIFIC SUNSET CONDOS; 3770 CARLSBAD
BLVD
4364131 2024/01/30 Physical Folder MS050032; TAMARACK BEACH LOFTS;
4363311 2024/01/30 Physical Folder PD 06-15; SOLAMAR SLOPE REPAIR;
4363378 2024/01/30 Physical Folder PD 07-08; Marbella Slope Stabilization;
0
d
Ca li fornia
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 #104371
Date Issued Tuesday, March 26, 2024
Service Locations 5815 EL CAMINO REAL
Date Range of Service Mar-21-2024 thru Mar-21-2024
Work Ticket(s)1287533
Quantity/Item 53 -53 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).