HomeMy WebLinkAboutCity Council - 01/13/2012 FOR USE BY THE CITY OF BREMERTON
Public Records Destruction Log
Request f o r In -House Destruction
To comply with RCW 4014 060, WAC 434-010 -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 accountability proving specific
public records have clearly met approved retention periods for disposal Please fill out this form
for public records disposal in -house with an approved retention period greater than 1 year THE
RETENTION PERIOD FOR THIS FORM IS SIX YEARS (GS 11005).
DATE I DIVISK)NISECTION RECORDS OFFICER
l 1 I el'ly �N h
BOX NUMBERS RECORDS SERIES DAN INCLUSIVE DATES RETENTION PERIOD DATE DESTROYED
NA G7 -0 5_A -03 a.00 9 des-L - w l A3//a
c btu e
A)A 6 jS5D - oSA - 01, a.o0 13 ��-
11
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
Employee Signature Date
Employee Name (Please print clearly) L'i IYt�he ren 2 k'
The Records Officer must sign the a val of this requ nor to the destruction of the listed records
Records Officer Signature Date / Y/�