HomeMy WebLinkAboutMUNI COURT - 02/22/2016 - 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 destro�' (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) Agenty ReCords
Oescription Date Method of
Records Series Records Retention Minimum
Records Serles Tltle DAN Schedule Minimum Retention Period (Box/Item numbers, Dates Covered Retentlon Destrudlon(See
volume,etc.) Met examples below•)
Source Records— GS50-09-14 CORE 3.1 Verification of Successful DM52-06B-01 Closed January 23, 2016— 03-19-16 Secure shred bin
Images(Non- Rev. 1 � Conversion March 18, 2016 for outside
Archival) contractor
shredding
Uniform Notice of DM52-066- District& 3 years Closed January 1—February 28, 03-01-16 Electronic Copy
Infraction,Court 01 IVlunicipal Courts 2013 Deleted
Docket,&Case File Retention
Schedule—V6
Uniform Citation, DM52-06A- District& 3 years Closed December 1-31,2012 03-01-16 Secure shred bin
Complaint,Court 01 Municipal Courts &January 1-February 28, for outside
Docket&Case File Retention 2013 contractor
Schedule—V6 shredding
Uniform Citation, DM52-06J-01 District& 3 years Closed June 1—December 31, 01-01-14 Secure shred bin
Complaint,Court Municipal Courts 2010 for outside
Docket&Case File Retention contractor
(photo enforced) Schedule—V6
shredding
*Examples of inethods of destruction:electronic deletion,in-house OR outside contrador 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:� �--� )'Yl %Yl Printed Name: �Q..l.L9 1�1 �1�5�7� Division: l�dV r�
The Records Manager must sign the approval of this request prior to the destruction of the listed records:
Records Manager Signature: � Printed Name: ��w�� �C/r�+� Date Approved: � ���• � �
The person/people responsible for the destruction of records must sign upon destruction of the listed records:
Employee Signature: -+ J .�..t--m Printed Name: I l�'.� .�.L��'-2 I v� 5�� Date Records Destroyed: �'�a— � �
Vendor Business Name(if used): Phone:
Form Revised OS/06/2014
- City of Bremerton Public Records Destruction log
• The purpose of this form is to document compliance and reasonable accountability by venfying that speafic public records have met current, approved mirnmum 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) Agenty Records
Date Method of
Description Minimum
RecoMs Serles Title Records Series Records Retentlon Minimum Retention Period (Box/Item numbers, Dates Covered Destruction(See
DAN Schedule Ret�Lion examples below•)
volume,etc.)
Domestic Violence DM52-06E-02 District& 3 years Closed January 1 2010— 03-01-14 Secure shred bin
and Anti- Municipal Courts February 28,2011 for outside
Harassment Case Retention contractor
Files(Civil) Schedule—V6 shredding
*Examples of inerhods of destruction:electronic deletion,in-house OR outside coniractor shredding,secure recycling,other(describe)
Statement: The public records listed above have met iheir 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: � I�� 1�Y'�1 '/ !X IC�i�;_Printed Name: _J�a�(�Yl r v'�'�I ��}� Division: ��.r� _
The Records Manager must sign approval of this request prior to the destruction of the listed records: ,
Records Manager Signature: ` Printed Name: 1'�Q�.�- `�� ""�� _Date Approved: ✓ ���" I�
The person/people responsible for the destruction of records must sign upon destruction of the listed records:
Employee Signature: "IJl l.l�_TYl ��� Printed Name: 1 .(1 .1.1 � I �-'�Ls�� _Oate Records Destroyed: � ��r� �
Vendor Business Name(if used): Phone:
Vendor Signature: Printed Name: Date Records Destroyed:
Form Revised 05/06/2014
� �� M� Mobil� CERTIFICATE OF DESTRUCTION
. � � �, �fOR �NF� a
, ��% � �� 2910 Hogum Bay Rd ,�.�
��/�j�����/�'i�����'�/���/����� Olympia Wa 98516 �� �
//�� ���d�/�// �Y//,c 6�`'�/.G.� E-Mail: Ims@wcnx.org � o
�///////////O//00////////J7/%///////////////'O//%///,O%/////,0/'%/i'�//// Phone: 1-877-898-0112 � ��
Name: CO OP MUNICIPAL COURT-BREMERTON Fax: 1-360-486-2467 � , �� �
Address: 550 PARK AVE ���'��,� •��
City. BREMERTON , 98337 - •
Phone: 360-473-5242 Account : 2185-g52778-705 Route Id: SN92
Request: RWAUTO Invoice Date: 3/22/2016• Invoice#: 1206883
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 2 89
Driver Signature: � Date: Truck
Customer Signature: Date: Time