HomeMy WebLinkAboutPOLICE - 12/22/2014 Cit of Bremerton Public Records Destruction Log
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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, Dates Covered Minimum Destruction(See
DAN Schedule Retention
volume,etc.) Met examples below*)
Connacitr
18.1 H
"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 belowprior tothe Record's Manager approval: p���,�
Employee Signature:U�ill.L,,y'lh�,(i 1 Printed Name: 1`_L 1.x.1/ j� R& se� I Division: l�c-l.\J, 6J
The Records Manager must sign the approval of this request prior to the destruction of the listed records:
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Records Manager SignaturPrinted Name: Date Approved:
—
The person/people responsible for the destruction of records must sign upon destruction of the listed records:
Employee Signature: Printed Name: ��> 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, Dates Covered Minimum Destruction(See
n
DAN Schedule volume,etc.) Retention examples below*)
11/14/14 to 05-003500 to Outside
11/19/14 L07-01-07 7 Years 05-006199 4/17/2005 to 6/28/2005 Contractor
Shredding
12/10/14 to 05-006200 to Outside
12/16/14 L07-01-07 7 Years 05-009399 6/28/2005 to 9/19/2005 Contractor
Shredding
04-008800 to Outside
12/17/14 L07-01-07 7&20 Years 04-009599 9/22/2004 to 10/18/2004 Contractor
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:Y "" �M.'t/✓�J Printed Name:60,-a wL" Division: 4�l�I �1✓
The Records Manager must sign the approval of this request prior to the destruction of the listed records:
Records Manager Signature: v Printed Name: d�,e�n ge�2� Date Approved: 1 c
The person/people responsible for the destruction of records must sign upon destruction of the listed record
Employee Signature: Printed Name: ��`�� �i/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 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 10/08/14 to 12/22/14 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:
Employee Signature: <_,,tL__41rinted Name: cly � Division:�7
The Records Manager must sign the approval of this request prior to the destruction of thelistedrecords:
Records Manager Signature l 1 n t e d Name: /1�y�/ `��L/ Date Approved:
The person/people responsible for the destruction of records must sign upon destruction of the listed records:
Employee Signature: C� Printed Name✓�.�''�J./_/��/ 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 G550-09-06.
Form Revised 05/06/2014
Le Mcg Mobile CERTIFICATE OF DESTRUCTION
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� 2910 Ho um Ba Rdi�°n eclolloolur
�/������� �� Olympia Wa 98516OG.GIG, �P � d/6.� E-Mail: lms@wcnx.org o
Phone: 1-877-898-0112
Name: CO OP POLICE-BREMERTON Fax: 1-360-486-2467
Address: 1025 BURWELL ST
City: BREMERTON , 98337
Phone: 360-473-5237 Account : 2185-952778-700 Route Id: SN92
Request: LT. OLAN-SARAH Invoice Date: 12/23/2014 Invoice #: 1137318
On the date shown, Designated Confidential Data was Shredded and Destroyed as per Customers Instructions.
Notes: 12/23 EMPTY BIN. CHECK IN WITH RECEPTION FOR BINS EMPTY ALL BIN CALL 30 MINS
BEFORE.
Service Description Qty Rate Amount
65SC 4.00 65 GAL SHRED CART — 2.77
Driver Signature: Date: /I- 2Z-4 Truck
Customer Signature: Date: Time