HomeMy WebLinkAboutHR - 05/03/2016 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
Description Date Method of
Records Series Records Retention Mlnlmum
Records Series Title DAN Schedule Minimum Retention Period (Box/Item numbers, Dates Covered Retention Destruction(See
volume,etc.) Met examples below•)
Employee GS50-04B-46 3 Years after 3 Years Written May 31, 2001 June 1, Shredded
Misconduct close reprimand 2004
Investigation File— Randy Olson
Sustained
*Examples of inethods of destruciion:electronic de/etion,in-house OR ou[side 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 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: Printed Name: Charlotte Belmore Division: Human Resources
The Records Manager must si e approval of this request prior to the destruction of the listed records:
Records Manager Signature: Printed Name: Shannon Corin Date Approved: � ` �' �`F�
The person/people responsi le r the destruction of records must sign upon destruction of the listed records:
Employee Signature• Printed Name: Charlotte Belmore Date Records Destroyed: � (�/
Vendor Business Name(if used): Phone:
Vendor Signature: Printed Name: Date Records Destroyed:
Form Revised OS/06/2014