HomeMy WebLinkAboutMUNI COURT - 01/27/2016 4 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) Agenry Retords
Date
Description Method of
Records Serles Title Records Series Records Retention Minimum Retention Period (Box/Item numbers, Dates Covered Minimum Destrudlon(See
DAN Schedule volume,etc.) RetMe Ion examples below')
Source Records— GS50-09-14 CORE 3.1 Verification of Successful DM52-06B-01 Closed December 20,2015— O1-22-16 Secure shred bin
Images(Non- Rev. 1 Conversion January 22,2016 for outside
Archival) contractor
shredding
Uniform Notice of DM52-066- District& 3 years Closed December 1-31, 2012 01-01-16 Electronic Copy
Infraction,Court Ol Municipal Courts Deleted
Docket,&Case File Retention
Schedule—V6
Uniform Citation, DM52-06A- District& 3 years Closed November 1-30,2012 12-01-15 Secure shred bin
Complaint,Court 01 Municipal Courts for outside
Docket&Case File Retention contractor
Schedule—V6 shredding
Uniform Citation, DM52-06J-01 District& 3 years Closed January 1—April 30, OS-01-15 Secure shred bin
Complaint,Court Municipal Courts 2012 for outside
Docket&Case File Retention contractor
(photo enforced) Schedule—V6 shredding
"Examples of inethods of destruction:electronic de/etion,in-house OR ouiside 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 reasonab/y 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:�l!�?� / L_Y �1Printed Name: � 1 ve��J' �� Division:1 / I U17I GC�KI COV IrT
The Records Manager must si ie appro of this request prior to the destruction of listed records:
\ � (�
Records Manager Signature Printed Name: �✓L� � wr��- Date Approved: J ��� `
The person/people responsible for the destruction of records must sign upon destruction of the listed records:
Employee Signature: . Printed Name: _Jl�.l.��Yl �Qi�S�� Date Records Destroyed: I��� '"'
Vendor eusiness Name(if used): Phone:
Form Revised OS/06/2014
� City of Bremerton Public Records Destruction Log
` Vendor Signature: Printed Name: Date Records Destroyed:
The retention and disposition action for this Public Records Destrudion Log is'Retain for the life of the agency"pursuant to CORE series G550-09-06.
Form Revised OS/06/2014
� LC� MA Mobil� CERTIFICATE OF DESTRUCTION
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Name: CO OP MUNICIPAL COURT-BREMERTON Fax: 1-360-486 2467 0 , �
Address: 550 PARK AVE �'�"ti� a°�
City: BREMERTON , 98337 - '
Phone: 360-473-5242 Account : 2185-952778-705 Route Id: SN92
Request: RWAUTO Invoice Date: 1/26/2016 Invoice#: 1197833
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
�� Date: Truck
Driver Signature:
Customer Signature: Date: Time