HomeMy WebLinkAboutMUNI COURT - 07/26/2016 • 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
Descriptfon Date Method of
Records Series Records Retention Minimum
Reeords Series Title OAN Schedule Minimum Retention Period (Box/Item numbers, Dates Covered Retentlon Destruction(See
volume,etc.) Met examples below')
Source Records— G550-09-14 CORE 3.1 Verification of Successful DM52-066-01 Closed June 23, 2016—July 21, 07-21-16 Secure shred bin
Images(Non- Rev. 1 Conversion 2016 for outside
contractor
Archival) shredding
Uniform Notice of DM52-06B- District& 3 years Closed June 1—June 30, 2013 07-01-16 Electronic Copy
Infraction,Court 01 Municipal Courts Deleted
Docket,&Case File Retention
Schedule—V6
Uniform Citation, DM52-06A- District& 3 years Closed July 1,2010—May 31, 06-01-14 Secure shred bin
Complaint,Court 01 Municipal Courts 2011 for outside
Docket&Case File Retention contractor
(DV Files Schedule—V6 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: 1J��Yl Printed Name: �JQ.I..I�Y� 'v � �dn Division: I� 1J17 � C�QV Cb U�
The Records Manager must si e approval t is requ�st prior to the destruction of the listed records:
Records Manager Signatur • Printed Name: h� Date Approved: - ( "° I�
The person/people responsible for the destruction of records must sign upon destruction of the listed records:
Employee Signature: Printed Name: � " � 1 �l� �r`�1 SdYI Date Records Destroyed: �"' o��' ! �
Vendor Business Name(if used): Phone:
Form Revised OS/06/2014
� �C� �A Mobil� CERTIFICATE OF DESTRUCTION
i i � . / Y FOR U�(Fp �,
��• ���� � �� 2910 Hogum Bay Rd ,���a �,_
"',�fj/��j'��//,i������j��� Olympia Wa 98516 � ��i
%'��/��i�r/�i. �O/,�//i��//���ii//,%%//�i, %�i� E-Mail: Ims@wcnx.org � � o
%/////O%%////O//O//%//////%//%//%/%�////%///////////%/////%�'�///� Phone: 1-877-898-0112 � �
Name: CO OP MUNICIPAL COURT-BREMERTON Fax: 1-360-486-2467 �o �c�
Address: 550 PARK AVE '�eti:. �,o`
City: BREMERTON , 98337 ' • •
Phone: 360-473-5242 Account : 2185-952778-705 Route Id: SN92
Request: RWAUTO Invoice Date: 7/26/2016 Invoice#: 1226050
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 �
2.96
SHEXB 1.00 SHRED EXTRA BOX 3.33
Driver Signature: Date: Truck
Customer Signature: Date: Time