HomeMy WebLinkAboutPOLICE - 02/10/2015 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 ( Dates Covered Minimum Destruction(See
Records Series Title DAN Schedule Minimum Retention Period Box/Item numbers, Retention volume,etc.) examples below')
Met
(,Ep(61�^ �Q�� u2- � �QrS G�'Grl 04- � "
1i0
eJ:zl,nL-�i riles rr hvflloC - 008-7q 22 ODDL( Q' 3 aqUnn
(�S(� 49� BO— Ilq�-I i3 GiSidE
�Vh rMd,t:vi,
*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: Printed Name: may-ie— &Vt 51f.VI Division:
2GD V-G1 S
The Records Manager must sign the approval of this request prior to the destruction of the listed records:
Records Manager Signature-c.. —IC Printed Name:_�S _L� Date Approved:
The person/people responsible for the destruction of records must sign upon destruction ofthe
Misted records:
Employee Signature: !/ Printed Name: oG 04:5r eSlz� 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
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 numbersDates Covered Minimum Destruction(See
DAN Schedule volume,etc.) Retention examples below*)t
G�,T/U-D � 5 1'$ Gtr 40t L7 04-009600 to 10/18/2004 to Outside
12 $- SOT 04-011822(end) 12/31/2004 )l)//(� Contractor
Shredding
ry
*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: p
Employee Signature: QkOT`-orIPrinted Name: �WL,n Division: 1 o
The Records Manager must sign
ntthe
Dapproval ofthisrequest prior to the destruction of the listed records:
Records Manager Signature:��-�"~�P/f�V� Printed Name: �!i/�5 / Date Approved:
The person/people responsible for the
ddeesstgtrruucctio1y'n of records must sign upon destruction of the listed records:
Employee Signature:� Printed Name: _.AX,"/'S Date Records Destroyed: a� ,O is
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 MoMob,,le CERTIFICATE OF DESTRUCTION
r C-�R �Nfp
�� �711 � , y 2910 Hogum Bay Rd
/� � /�� �G Olympia W a 98516 'o
��G �/�. //�/ �/// /�. %/G. E-Mail: Ims@wcnx.org c
////////////%//O//O////////i1'////O/%y//%/%/%/////////////////%�// Phone: 1-877-898-0112
Name: COOP 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: MS-LT OLAN Invoice Date: 2/10/2015 Invoice#: 1145052
On the date shown, Designated Confidential Data was Shredded and Destroyed as per Customers Instructions.
Notes: 2.10.15 SERVICE. MUST CALL 30 MIN BEFORE 360-473-5220
Service Description Qty Rate Amount
65SC 5.00 65 GAL SHRED CART
2.77
Driver Signature: Date:Z/v- Truck
Customer Signature: Date: Time Time
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