HomeMy WebLinkAboutPolice - 08/09/2011 FOR USE BY THE CITY OF BREMERTON
Public Records Destruction Log
Request for In -House Destruction
To comply with RCW 40 14 060, WAC 434 - 610 -070, and WAC 434 -640 -010, 020, and 030, it is vital
that public records be destroyed according to their approved retention periods Therefore, the
purpose of this form is to verify compliance and reasonable accoun provin spec public
records have clearl met a retention periods for dis posal J Please fill out this form for pub icl
reco disposal in -house with an a retention per iod g reater than 1 y ear r THE RETENTION
PERIOD FOR THIS FORM IS PERMANENT AS STATED IN THE LOCAL GOVERNMENT
GENERAL RECORDS RETENTION SCHEDULE (GS5- 09 -06).
DATE DIVISIOWSECTION RECORDS OFFICER
August 09, 2011 1 Police Lt. Luis D. Olan
BOX NUMBERS RECORDS SERIES DAN INCLUSIVE DATES RETENTION PERIOD DATE DESTROYED
Secondary L07 -01 -03 02 -28 -11 08 -09 -11
copies no Appendix A 08 -09 -11
retention value
All public records listed have been Identified to be at the end of their designated retention period,
have no need to be retained for audits, lawsuits, public records request or program requirements and
shall be destroyed
The Individual who is responsible for destroying the listed records must sign below prior to the Records Officer signature
approval
i
Employee Signature Date 0 0
Employee Name (Please print clearly) Lt Luis D Olan
The Records Officer must sign the ap oval of this request prior to the destruction of the listed records
Records Officer Signature Date
t
2910 Hogum Bay Rd Phone 1 -877- 898 -0112
Olympia, WA 98516 Fax 1- 360- 486 -2467
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•% CERTIFICATE ICA'II'IE _ ®F DIES�'I[$ T T'JION
; or If" " V '16e,1W /�f / Invoice #
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l: l I - Y OF B RC: SCI~' i�1 �'C)L 7 f E � a - � �
1025 IILJRWCl_L 1 ,51 ? r :l _! °Y OF BREIriE p rON - -POL ICE. DE1 , i
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P Ir)M E ur, i y 1 ; 9 r 98
On the date shown, Designated Confidential Data was Shredded - and destroyed as per Customer's Instructions
Date of D tryction , , Drivers Initials , ,r','" Truck No
Time In i a
r �� Time Total Tfine
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Notes P , f3 j 3g Pa I i � , � c 4C : 30 td T hi R L
Container Description — ___ 11 Ouantity Amount
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Requested by Total Amount Due
Printed Name Authorized Signature �'�/'``� r