HomeMy WebLinkAboutPW & U - 12/08/2015 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 thon "Retain until no Ionger 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
Date Method of
Description Minimum
Records Series Records Retention Minimum Retention Period (Box/Item numbers, Dates Covered Destruction(See
Records Series Title DAN Schedule Retention
volume,etc.) Met examples below*)
Authorizations/ G550-01-42 CORE Retain for 6 years after Hydraulic Project January&May 2002 6/1/2008 In-house Shredding
Certifications— Rev.1 Version 3.2 authorization superseded or Approval
Agency Management • terminated and conditions of
authorization satisfied and
violations(if any)corrected then
Destroy.
*Examples of inethods of destruction:electronic deletion,in-house OR outside contractor shredding,secure recyding,other(describeJ
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 f r inventorying t listed rec rds must sign below prior to the Record's Manager approval:
Employee Signature: Printed Name: l� � I (�'(u � ICn Y U 1� 1 ' vl� Division: l U��� C- V vU'`�S �' v I � I (��S
The Records Manager must sign t pproval of this request prior ro the destruction of the listed records:
Records Manager Signature: Printed Name:� LX/i 4� Date Approved: ��I�'`�
The person/people responsible for the destruction of records must sign upon destruction of the listed records:
Employee Signature: Printed Name: ��l I�.I��J �� l I �1' I Date Records Destroyed: Z �
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 OS/06/z014