HomeMy WebLinkAboutMUNI COURT - 12/22/2016 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
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 examples below')
volume,etc.) Met
Source Records– GS50-09-14 CORE 3.1 Verification of Successful DM52-0613-01 Closed November 24– 12-20-15 Secure shred bin
Images(Non- Rev. 1 Conversion December 20,2015 for outside
contractor
Archival) shredding
Uniform Notice of DM52-066- District& 3 years Closed August 1–September 12-01-15 Electronic Copy
Infraction,Court 01 Municipal Courts 30,2012&November 1-30, Deleted
Docket, &Case File Retention 2012
Schedule–V6
Uniform Citation, DM52-06A- District& 3 years Closed October 1-31, 2012 11-01-15 Secure shred bin
for outside
Complaint,Court 01 Municipal Courts
contractor
Docket&Case File Retention
shredding
Schedule–V6
Uniform Citation, DM52-06J-01 District& 3 years Closed September 1–30, 2012 10-01-15 Secure shred bin
Complaint,Court Municipal Courts
for outside
Docket&Case File Retention contractor
(photo enforced) Schedule–V6 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 list/ed records must sign below prior to the Record's,Manager approval:
Employee Signature: "►f!��N? _x —Printed Name: J ) t�Y meA s on Division:n-2(11')1('1 (-0,
The Records Manager must sign the approval o his request prior to the destruction of the listed records:
Records Manager Signature: Printed Name: ��� 1\/L �?IO�, Date Approved:
The person/people responsible for the destruction of records must sign upon destruction of the listed records:
Employee Signature: r '1 1?'t"7 �D�� 1 Printed Name: S Nn Date Records Destroyed: 1 9--o - 15
Vendor Business Name(if used): Phone:
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
Minimum
Records Series Title Records Series Records Retention Minimum Retention Period (Box/item numbers, Dates Covered Destruction(See
DAN ScheduleRetienn ion examples below*)
volume,etc.)
et
Search Warrants DM-52-06A- District& 2 years March 21, 2003—March 31, 04-01- Secure shred bin
02 Municipal Courts 2011 2013 for outside
Retention contractor
Schedule—V6 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.
r inventorying the listed records must sign below prior to the Record's Manager approval:
The individual responsible fo ry g g
Employee Signature:_`d.l 1 1777) `n Qje�� Printed Name: JDQ 1A��QAJC' n r1 Division:rel
The Records Manager must sign a approval of this request prior to the destruction of the listed records:
Records Manager Signature: ' Printed Name: nk (�FJYi�- Date Approved: ' 01 a
The person/people responsible for the destruction of records must sign upon destruction of the listerd records:
Employee Signature: —/ )Q11m D�� Printed Name: ] `A 1 is�'QJA5on Date Records Destroyed:
Vendor Business Name(if used): Phone:
Vendor Signature: Printed Name: Date Records Destroyed:
Form Revised 05/06/2014
Lei MoV Mobile CERTIFICATE OF DESTRUCTION
orel;
� 2910 Hogum Bay Rd ��oA
aOF���0.I'll,
Olympia Wa 98516
E-Mail: lms@wcnx.org
Name: COOP MUNICIPAL COURT-BREMERTON Phone: 1-877-898-0112 ,
Address: 550 PARK AVE Fax: 1-360-486-2467
BREMERTON 98337 •'!i.��
City: . .
Phone: 360-473-5242 Account#: 2185-952778-705 Route Id: SN92
Request: RWAUTO Invoice Date: 12/22/2015 Invoice #: 1192686
On the date shown, Designated Confidential Data was Shredded and Destroyed as per Customers Instructions.
Notes: Acct: 952778-705
Service Description Qty Rate Amount
65SC 2.00 65 GAL SHRED CART Z- 2.89
Driver Signature: Date: Truck
Customer Signature: Date: Time