HomeMy WebLinkAboutPW & U - 12/04/2015 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 Re[entjon Schedule(COREJ).
Legal Disposition Authority(taken from Records Retention Schedule) Agency Retords
Date Method of
Records Series Records Retention Description Minimum
Records Series Title Minimum Retention Period (Box/Item numbers, Oates Covered Destruction(See
DAN Schedule volume,etc.) RetMe ion examples below•)
Authorizations/ GS50-01-42 CORE Retam for 6 years after authonzat�on Hydraulic Project June 1990 7/1/1996 In-house Shredding
Certifications— Rev.1 Version 3.2 superseded or termmated and conditions qPProval
AgenCy Management of authonzation satisfied and violations .
(if any)corrected then Destroy.
Authonzations/ G550-01-42 CORE Reta�n for 6 years after authonzation Hydraulic Pro�ect February—June 1995 7/1/2001 In-house Shredding
CertifiCations— Rev.1 Version 3.2 superseded or terminated and conditions qpproval
Agency Management of authorization satisfied and violations
(if any)corrected then Destroy.
Authorizations/ GS50-01-42 CORE Retain for 6 years after author�zat�on Hydraulic Pro�ect May—December 2000 1/1/07 In-house Shredding
Certifications— Rev.1 Version 3.2 superseded or terminated and conditions Approval
Agency Management of authorization satisfied and violations
(if any)corrected then Destroy.
*Examples of inethods of destruction:electron�c deletion,�n-house OR outside contractor shredding,secure recycling,other(describe)
Statemeni: The public records listed above have met iheir minimum retention period(sJ, are noi subject to ongoing or reasonab/y aniicipated litigation or
public records requests, are not needed for audit or other agency business, and shal/be destroyed.
The individual responsible for inventorying the listed re ords must sign below prior to the Record's Manager approval:
Employee Signature: Pnnted Name: I 1�I I��1� T"1 A��( IUI� Division:�l��C7I1 L �Ur�S Y ��l I�eS
The Records Manager must sign proval of request prior to the destruction of t listed records:
���.� �/� C�/.���, �� . ��./c��
Records Manager Signature: Printed Name: '" '� `� � Date Approved: r J
The person/people responsible for the destruction o records must sign upon destruction of the listed records:
Employee Signature: Printed Name: l � �1 IG��A r I��1 I I U n 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 Destrudion Log is"Retam for the life of the agency"pursuant to CORE series G550-09-06.
Form Revised OS/06/2014