HomeMy WebLinkAboutMUNI COURT - 10/28/2014 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 •Dam Method of
Records Series Records Retention Minimum
Records Series Title Minimum Retention Period .(Box/Item numbers, Dates Covered Destruction(See
DAN Schedule Retention
volume,etc.) Met examples below*),
Uniform Notice of DM52-06B- 3 years after 3 years Closed Jan-Sept 2011 10-1-2014 Outside
Infraction,Court 01 final disposition contractor
Docket,&Case File shredding
Uniform Citation, DM52-06A- 3 years after 3 years Closed Jan-Sept 2011 10-1-2014 Outside
Complaint,Court 01 final disposition contractor
Docket&Case File shredding
Domestic Violence DM52-06E-02 Permanent- 3 years after final disposition Closed 2004-2010 10-1-2014 Outside
&AntiHarassment Held by AS Closed Jan-Sept 2011 contractor
Case Files shredding
*Examples of methods of destruction:electronic deletion,in-house OR outside contractor shredding,secure recycling,other(describe)
Statement: The public record`s 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 responsiblefor inventorying the listed records must sign below prior to the Record's
,Manager approval:
Employee Signature: '?JC711 a�Y1 I L /l�;t'� Printed Name: ' ,�1 etY1 Division: m f�11 I C'�Q lv�f r4
The Records Manager must signilfkapproval of t ' request prio(to the destruction of the listed records:
Records Manager Signatur Printed Name: - l�-I�IUYt. �` �1\h Date Approved: LO
! y
The person/people responsible for the destruction
of records must sign upon destruction of thes ([�e lirsted1 records:
7 �l.�
Employee Signature: ,LAM OY% Printed Name:�Q�1 1 VWn Date Records Destroyed:
Vendor Business Name(if used): Lr-M Phone: /t9711- 98 j2
Vendor Signature /1 Printed Name:.AZ QO 52114f Date Records Destroyed:&O-23-N
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(CORED).
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 Dates Covered Minimum
DAN Schedule volume,etc. Retention Destruction(See
examples below*)
Met
Uniform Notice of GSSO-09-14 3 years Files scanned-electronic Closed 2013-2014 10-10- Outside
Infraction,Court copies to be maintained for 3 2014 contractor
Docket, &Case File years shredding
*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 prior to the Record's Manager approval:
Employee Signature: _i.( �I UYI I'? 5l 7Y1 Printed Name: _DaxA.3-n NeA n- nDivision: MUY7I�0' 5d ( ()()r4-
The Records Manager must sign approval of this r uest prior to the destruction of the listed records:
Records Manager Signature , &k �l
g g Printed Name: Date Approved:
The person/people responsible for the destruction of records must sign upon destruction of the listed records:
Employee Signature.-DOJAYn Printed Name: )Q A3h Nelson Date Records Destroyed:
Vendor Business Name(if used): LP Alrk.4 Phone:1`!�7~/— R CIr9 —Or/Z
Vendor Signature:Zzlu Printed Name:_IMOL:�W^ r r„� i Date Records Destroyed:�l�?.A^7i4
Form Revised 05/06/2014
f
LGA May Mobile CERTIFICATE OF DESTRUCTION
FOR UV
Shre4din
2910 Hogum Bay Rd
Olympia Wa 98516
E-Mail: lms@wcnx.org
Phone: 1-877-898-0112
Name: CO OP MUNICIPAL COURT-BREMERTON Fax: 1-360-486-2467
Address: 550. PARK AVEC ao
City: BREMERTON , 98337
Phone: 360-473-5242 Account : 2185-952778-705 Route Id: SN92
Request: RWAUTO Invoice Date: 10/28/2014 Invoice#: 1128656
On the date shown, Designated Confidential Data was Shredded and Destroyed as per Customers Instructions.
Notes: Acct: 952778-705
Service Description Qty Rate Amount
65SC 2.00 65 GAL SHRED CART 2.77
Date: 1U_�3_/c Truck
Driver Signature: /
Customer Signature: Date: Time