HomeMy WebLinkAboutPOLICE - 10/08/2014 City of Bremerton Public Records Destruction Log
The purpose of this form is to document compliance and reasonable accountability by verifying that specific public records have met current, approved minimum retention
periods before being destroyed pursuant to RCW 40.14.070, WAC 434-610.070, and WAC 434.640.010, -020, and -030. Please fill out this form when destroying public records
whose minimum retention is other than "Retain until no longer needed for agency business then destroy" (such as records covered in the "Records with Minimal Retention
Value"section of the Local Government Records Retention Schedule(CORE)).
Legal Disposition Authority(taken from Records Retention Schedule) Agency Records
Description Date Method of
Records Series Records Retention Minimum
Records Series title DAN Schedule Minimum Retention Period (Box/Item numbers, Dates Covered Destruction(See
volume,etc.) Retention examples below*)
-aa--lq_40cotskde
L��-o►-01 - i �
R-15-11LA +0
0-3-tL, _1-01'0 �"l c� �� �4—I�-o� Cb
*Examples of methods of destruction:electronic deletion,in-house OR outside contractor shredding,secure recycling,other(describe)
Statement: The public records listed above have met their minimum retention period(s), are not subject to ongoing or reasonably anticipated litigation or
public records requests, are not needed for audit or other agency business, and shall be destroyed.
The individual responsible for inventorying the listed records must sign below prion to the
Record's Manager approval:
Employee Signature:�� `�""� Printed Name:• Wun Division:r[ )I ykC"�13
The Records Manager must sign the approval of this request prior to the destruction of the listed records:
Records Manager Signatur Z _ _ _ inted Name: /�� � � rt/ Date Approved:
The person/people responsible for the destruction of records must sign upon destruction of the listed records: /
Employee Signature 40" anted Name: 4�w ' Date Records Destroyed:
Vendor Business Name(if used): Phone:
Vendor Signature: Printed Name: Date Records Destroyed:
The retention and disposition action for this Public Records Destruction Log is'Retain for the life of the agency'pursuant to CORE series GS50-09-06.
Form Revised 05/06/2014
City of Bremerton Public Records Destruction log
The purpose of this form is to document compliance and reasonable accountability by verifying that specific public records have met current, approved minimum retention
periods before being destroyed pursuant to RCW 40.14.070, WAC 434-610.070, and WAC 434.640.010, -020, and -030. Please fill out this form when destroying public records
whose minimum retention is other than "Retain until no longer needed for agency business then destroy" (such as records covered in the "Records with Minimal Retention
Value"section of the Local Government Records Retention Schedule(CORE)).
Legal Disposition Authority(taken from Records Retention Schedule) Agency Records
Description Date Method of
Records Series Title Records Series Records Retention Minimum Retention Period (Box/Item numbers, Minimum
DAN Schedule Dates Covered Retention Destruction(See
volume,etc.) Met examples below*)
gl'Zooy- 000ceo+l JCUq ( 2.004 0a5lde,
fU�7�i� r
Z�� ` Ve �:tU
e 111
*Examples of methods of destruction:electronic deletion,in-house OR outside contractor shredding,secure recycling,other(describe)
Statement: The public records listed above have met their minimum retention period(s), are not subject to ongoing or reasonably anticipated litigation or
public records requests, are not needed for audit or other agency business, and shall be destroyed.
The individual responsible for invvyen�t�opryiinpg�the listed records must sign below prior
oto the Record's Manager approval:
Employee Signature:.�.l"VOLA.— Printed Name: �Jko_ e_ P I.A,`se_n Division:
The Records Manager must sign the approval of this request-pr' to the destruction of the listed records:
Records Manager Signature rinted Name: `�--s � Date Approved: `
The person/people responsible for the destruction of re ords must sign upon destruction of the listed records:
Employee Signature. anted Name: �3 `�'s� Date Records Destroyed: X� �7
Vendor Business Name(if used): Phone:
Vendor Signature: Printed Name: Date Records Destroyed:
The retention and disposition action for this Public Records Destruction Log is'Retain for the fife of the agency"pursuant to CORE series GS50-09-06.
Form Revised 05/06/2014
City of Bremerton Public Records Destruction log -
The purpose of this form is to document compliance and reasonable accountability by verifying that specific public records have met current, approved minimum retentio
periods before being destroyed pursuant to RCW 40.14.070, WAC 434-610.070, and WAC 434.640.010, -020, and -030. Please fill out this form when destroying public recorc
whose minimum retention is other than "Retain until no longer needed for agency business then destroy" (such as records covered in the "Records with Minimal Retentio
Value"section of the Local Government Records Retention Schedule(CORE)).
Legal Disposition Authority(taken from Records Retention Schedule) Agency Records
DAN Schedule
Description Retention Date Method of
Records Series Title Records Series Records Retention Minimum Retention Period (Box/item numbers, Dates Covered Minimum Destruction(See
volume,etc.) Met examples below*)!
Secondary Copies L07--01-03 N/A N/A N/A 08/120/14 to 10/08/14 2014 Le May Certified
No retention value Appendix A Shredding
Company
*Examples of methods of destruction:electronic deletion,in-house OR outside contractor shredding,secure recycling,other(describe)
Statement: The public records listed above have met their minimum retention period(s), are not subject to ongoing or reasonably anticipated litigation c
public records requests, are not needed for audit or other agency business, and shall be destroyed.
The individual responsible for inventorying the listed records must sign below prior to the Record's Manager approval: t )`)
Employee Signature:Q �� Printed Name:_1!!; �"� �� Division: �0.�✓ c7erC�"Y'� �✓
The Records Manager must sign the approval of this request prior to the destruction of the listed records: O-
Records Manager Signatur�O inted Name: ^��'� ' iDate Approved: �v
The person/people responsible for the destruction of records must sign upon destruction of the listed records: �XY Employee Signatur {�t/'-Printed Name: i -<Y Date Records Destroyed: o
Vendor Business Name(if used): Phone:
Vendor Signature: Printed Name: Date Records Destroyed:
The retention and disposition action for this Public Records Destruction Log is"Retain for the life of the agency"pursuant to CORE series GS50-09-06.
Form Revised 05/06/2014
LG MoVMobile CERTIFICATE OF DESTRUCTION
a FOR IN
O
Cw' 2910 Hogum Bay Rd
A/0'.
r1_100,131.
���� / Olympia Wa 98516
� C/1
� /, �,, 11111 E-Mail: ims@wcnx.org
i0,E"//%//%/%////%%//////1.4=11111,071,01/•x1=111110 V Phone: 1-877-898-0112
Name: CO OP POLICE-BREMERTON Fax: 1-360-486-2467
25 BURW ELL ST
Address: 10 , .
City: BREMERTON , 98337 Route Id: SN92
Phone: 360-473-5237 Account : 2185-952778-700
Request: LT OLAN-SARAH Invoice Date: 10/7/2014 Invoice#: 1124958
On the date shown, Designated Confidential Data was Shredded and Destroyed as per Customers Instructions.
Notes: 10/7 EMPTY ALL BIN CALL 30 MINS BEFORE.
Service Description ?Qty Rate Amount
65SC 4.00 65 GAL SHRED CART 2.65
�. Date:&)_8/Z., Truck
Driver Signature:
Customer Signature: Date: �® �� Time