HomeMy WebLinkAboutPOLICE - 02/24/2015 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 Title Records Series Records Retention Minimum
DAN Schedule Minimum Retention Period (Box/Item numbers, Dates Covered Destruction(See
volume,etc.) Retention examples below*)
�1*1) &JI tQ� 5 2�ks &,,(, j). 92-00012 to 1/1/1992 to 12/31/1992 1 Outside
4ie,F/{,r l �9-lear592-13010(end) )��i?� � ���P��L� � �, r'_ l 1� Contractor
l�lluLoQ Shredding
k�f;j 05-009400 to 9/19/2005 to 12/31/2005 TI/11
Outside
2774115' ��� DYG��e�i� �. �", 05-013099(end) Contractor
Q a t` &4 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: T
Employee Signature: �f,1/le, Printed Name: Dec)CC W"n Division: P�[7(�� UIVIS)0•�1
The Records Manager must sign the approval of this request prior to the destruction of the listed records:
Records Manager Signature: �'�rhited Name: �y�i� +kJ ��`�4"�'✓ Date Approved: y� .
The person/people responsible for the destruction of recor s must sign upon destruction of the listed records:
Employee Signature: Printed Name: Z4_r%3 O of< Date Records Destroyed: '�vY
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 Minimum
DAN Schedule (Box/Item numbers, Dates Covered Retention Destruction(See
volume,etc.) Met examples below*)
1��U'L� �a^— Cj c./2�er� DIS
86-005000 to 7/16/1986 to 12/31/1991 Outside
&e �A�-9� 7^ /' / 91-13000 //il�� Contractor
Shredding
59� afl-'fyrsGy 93-000001 to 01/01/1993 to 12/31/1994 Outside
_tF/►�� /' c_' y 94-015510 /1///� Contractor
(�►� r'/�S ;1 �1�� �j�� Shredding
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: I`���,1fam,1,, _ Printed Name: Marie Hansen Division: Records
The Records Manager must sign the approval of this request prior to the destruction of the listed records: 'J ,�/
Records Manager Signatur.�� Printed Name: Luis Olan Date Approved: �o�%��
The person/people responsible for the destruction of rec rds must sign upon destruction of the listed records:
records:
Employee Signaturea�'� rinted Name: �vi� D�+/�`1/ Date Records Destroyed: 15 �V_4/E
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 May Mobile CERTIFICATE OF DESTRUCTION
/ 2910 Hogum Bay Rd"S hr , " ' � , Olympia Wa 98516 Z
ew t";
////� �
E-Mail: lms@wcnx.org
Name: COOP POLICE-BREMERTON Phone: 1-877-898-0112
Address: 1025 BURWELL ST Fax: 1-360-486-2467 °%�� ao•
City: BREMERTON , 98337 ,
Phone: 360-473-5237 Account#: 2185-952778-700 Route Id: SN92
Request: LT OLAN/TD Invoice Date: 2/24/2015 Invoice#: 1147156
On the date shown, Designated Confidential Data was Shredded and Destroyed as per Customers Instructions.
Notes: 2/24/15 - SERVICE 5-65GL BINS TODAY, CALL LT OLAN 360-473-5221 BEFORE SERVICE SO
HE CAN ASSIST YOU.
Service Description Qty Rate Amount
SHPP 1.00 SHRED PER POUND _C� 1.04
65SC 5.00 65 GAL SHRED CART 2.77
Driver Signature: Date:2-21/,r Truck
Customer Signature: Date Time
Le MaV Molle CERTIFICATE OF DESTRUCTION
SOA iNfp
2910 Hogum Bay Rd � ��°z
G FE / / Olympia Wa 98516
E-Mail: Ims@wcnx.org
Name: CO OP POLICE-BREMERTON Phone: 1-877-898-0112
Address: 1025 BURWELL ST Fax: 1-360-486-2467
City. BREMERTON , 98337
Phone: 360-473-5237 Account#: 2185-952778-700 Route Id: SN71
Request: RR-MS-LT OLAN Invoice Date: 2/23/2015 Invoice#: 1145542
On the date shown, Designated Confidential Data was Shredded and Destroyed as per Customers Instructions.
Notes: 2/23/15 PURGE 400 POUNDS OF NON PAPER. $1.04 PER POUND. PLEASE CALL 15 MIN
BEFORE. OK TO BILL. HOURS 9AM-1 PM
Service Description Cgty Rate Amount
SHPP 1.00 SHRED PER POUND 1.04
65SC 5.00 65 GAL SHRED CART 2.77
Driver Signature: f l� i�/ Date s Truck
Customer Signature./,, ` Date; ./ ����Time