HomeMy WebLinkAboutPOLICE - 06/28/2013 (4) 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 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(', 5, IDIVISIONlSECTION ' " ' F '4 "'' " 7 �
RECORDS =OFFICER
ors tzkv >, ty
POI(cckciords m aoseA_.-
BOXiNUMBER& , ' "RECORDS'SERIES,DAN, r � � INCL'USIVE,DATES, ..,,,,,' v ,RETENTION'PERIOD. _ -- E DESTROYEDi4" a
11 JUN 2 8 2013
7 a1�0
q�- X500
q
7 map LOT Of - 0"7 21 �� 97 �' �IZ�q `7 G rs JUN 2 8 2013
q7 tt>� 5' 1 J I 5v x.0"7 01 •0 7 �7 - 5 21 I JUN 2 0 2013
97 - 52
LOT 01 07 712 - �1�11�7 JUN 2 8 2013
Q7 % ' ' +'S
9 6 - 750
%_ v LOT 01, 6 7 f r Z119� - 311(0 `7� r JUN 2 0 2013
as s
y�45 - 5)7]98 JUN 2 8 2013
R y� X0 0 0-7 -7 jr.5
7 -U LUT 0� 0 514%- JUN 2 8 2013 8 fog
9 � � Ir5
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) i Qxle, kyi ye n
The Records Officer must sign the approval of this request prior to the destruction of the listed records
e ! � '; Records Officer Signature Date
THIS FORM IS MAINTAINED BY THE CITY CLERK'S OFFICE AND CANNOT BE ALTERED IN ANYWAY