HomeMy WebLinkAboutPOLICE - 05/11/2016 �' 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 Retords
� Descriptfon Date Method of
Records Series Title Records Serles Records Retention Minimum Retentfon Period Minimum
DAN Schedule (Box/�tem numbers, Dates Covered Destructlon�See
volume,etc.) Re MeY°� examples below'�
03/07/2016^' LE2010-064 20 Years 95-000001^' 01/01/1995^'12/31/1995 Ol/01/2016 Outside
03/10/2016 95-14870 Contractor
Shredding
*Examples of inethods 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 listed records must sign below prior to the Record's Manager approval:
Employee Signature: ���1/lJ��t/� Printed Name: Marie Hansen Division: Records
The Records Manager must sign the approval of this request prior to the destruction of the listed records:
Records Manager Signature: I �fU1'�+" IIAwY`� Printed Name: Rena Brown Date Approved: �� 6 ��b
The person/people responsible for the destruction of reco s must sign upon destruction of the listed records:
Employee Signature: Printed Name: �l/j.s K/� �i� Date Records Destroyed: J �����
Vendor Business Name(if used): Phone:
Vendor Signature: Printed Name: Date Records Destroyed:
The retention and disposition adion 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
� 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 Loca/Governmeni Records Retention Schedule(COREJ).
Legal Disposition Authority(taken from Records Retention Schedule) . Agenry Retords
Description . Date Method of
Records Serles Title Records Serfes Records Retention Mlnimum Retention Period (Box/Item numbers, Dates Covered Minimum Destructlon(See
DAN Schedule volume,etc.) Re Met�� examples below•)
3/29/16 Law 09-000001 01/01/09 to 04/13/09 01/Ol/16 Outside
To 4/13/16 LE2010-064 Enforcement 7 Years To 09-004300 To Contractor
Schedule 04/13/16 Shredding
*Examples of inethods 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 listed records must sign below prior to the Record's Manager approval:
Employee Signature:�1.,,,"5�d'W��w" Printed Name:� ��""'��V� Division: F�-��
The Records Manager must sign the approval of this request prior to the destruction of the listed records:
Records Manager Signature: � Printed Name:��/�� �r �� Date Approved: =J��I Ia
The person/people responsible for the destru io of records must sign upon destruction of the listed records:
Employee Signatur . Printed Name: �[i!/.5 �CJ �.C� Date Records Destroyed: `��D!!lv
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"Retoin for the life of the agency"pursuanf to CORE series G550-09-06.
Form Revised OS/06/2014
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Name: CO OP POLICE-BREIVIERTON Phone: 9-877-898-0112 �
Address: 1025 BURWELL ST Fax: 1-360-486-2467 °Qy.N� �,o�'� �
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City: BREMERTON , 98337 .
Phone: 360-473-5237 Account#: 2185-952778-700 Route Id: SIN92 I
Request: MSO-�U(S Invoice Date: 5/'10/2016 Invoice#: 1212814
On the date shown, Designated Confidential Data was Shredded and Destroyed as per Customers Instructions. '
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Notes: 5/10 SERVICE CONTAINERS
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Service Description /,Q�'
Rate Amount
65SC 5.00 65 GAL SHRED CART ��, _ 2•89 �
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Driver Signature: Date: Truck
Customer Signature: Date:
�� Time �
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