HomeMy WebLinkAboutPOLICE - 06/28/2016 City of Bremerton Public Records Destruction Log
The purpose of this form is to document compliance and reasonable accountability by verifying that specific pubiic 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 thon "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/Government Records Retention Schedule(CORE)).
Legal Disposition Authority(taken from Records Retention Schedule) Agenty Retords
Records Serles Records RetenUon DestNption ��e Method of
Records Serles Tltle DAN Schedule Mlnlmum Retentbn Perlod (Box/Item numbers, Oates Covered Minlmum Destructlon(See
Retentlon
volume,etc.) Met examples below•)
��/16/2016 to 5 Years 10-000001"' Ol/01/2010 to Outside
06/24/2016 L07-01-07 10-008699 08/13/2010 Contractor
Shredding
*Examples of inethods of destruction:electronic deletion,in-house OR outside contractor shredding,secure recycling,other(describeJ
Statement: The public records listed above have met their minimum retention period(s), are no!subjed to onqoing 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:
Employee5ignature:�����"�'�"y� PrintedName: �V`�« �Q-�'L-S �� Division: ���'��� C�
The Records Manager must sign the approval of this request prior to the destruction of the listed records:
Records Manager Signature:�� /W"'"'`� Printed Name: �• �`l d vv^' Date Approved: CV��V �!/O
The person/people responsible for the destruction of records must sign upon destruction of the listed records:
Employee Signature: Printed Name:�tfi.� � ' �� Date Records Destroyed:
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 GS50-09-06.
Form Revised 05/06/2014
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 Local Government Records Retention Schedule(COREJ).
legal Disposition Authority(taken from Records Retention Schedule) Agency Records
Descriptlon Date Method of
Records Serles Records Retention Mlnlmum
Records Serles Title DAN Schedule Mlnimum Retentlon Period (Box/Item numbers, Dates Covered Retentfon Destrudlon(See
volume,etc.) Met examples below•)
5/13/16 Law 09-004301 to 4/15/09 to 10/29/09 4/15/14 Outside
To 6/16/16 LE2010-064 Enforcement 5 Years 09-12299 to Contractor
Schedule 10/29/14 Shredding
*Examples of inethods of destruction:electronic deletion,in-house OR outside contractor shredding,secure recycling,other(describef
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 si�al/be destroyed.
The individual responsible for inventorying the listed records must sign below prior to the Record's Manager approval:
�
Employee Signature:� I�.1llri ��—' Printed Name: l��1��`' �����✓� _Division: �1ZL l�(�S �IV ,
The Records Manager must sign the approval of this request prior to the destruction of the listed records:
Records Manager Signature: � �/C�`�"' ' Printed Name: �,• �/���1�N _Date Approved: l9_ �� �C
The person/people responsible for the destruction of records must sign upon destruction of the listed records:
I e Si natur Printed Name: � �� Date Records Destroyed: �/'2�l��
Emp oye g �
Vendor eusiness Name(if used): Phone:
Vendor Signature: Printed Name: Date Records Destroyed:
The retention and disposition action for this Public Records Destruction Log is"Retoin for the life of the agency"pursuant to CORE series G550-09-06.
Form Revised 05/06/2014
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Name: CO OP POLICE-BREMERTON Fax: 1-360-486-2467 ti � ��
Address: 1025 BURWELLST �'�bN� �o`
City: BREMERTON , 98337 • '
Phone: 360-473-5237 Account : 2185-g52778-700 Route Id: SN92
Request: LUIS-ST invoice Date: 6/28/2016 Invoice#: �221643
On the date shown, Designated Confidential Data was Shredded and Destroyed as per Customers Instructions.
Notes: 06/28 SERVICE CONTAINERS CALL 15 MIN BEFORE ARRIVAL360-473-5221
Service Description Qty Rate Amount
SHEXB 1.00 SHRED EXTRA BOX � 3.26
65SC 5.00 65 GAL SHRED CART �_ 2 89
Driver Signature: f Date: Truck
Customer Signature: Date: — p`� � Time --