HomeMy WebLinkAboutMUNI COURT - 09/27/2016 _ 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
Date Method of
Records Series Records Retentlon Descrtption Minimum
Records Series Title DAN Schedule Minimum Retention Period (Box/Item numbers, Dates Covered Retentlon Destruccfon(See
volume,etc.) Met examptes below')
Source Records— GS50-09-14 CORE 3.1 Verification of Successful DM52-06B-01 Closed August 23 2016— 09-23-16 Secure shred bin
Images(Non- Rev. 1 Conversion September 23, 2016 for outside
contractor
Archival) shredding
Uniform Notice of DM52-06B= District& 3 years Closed August 1—August 31, 09-01-16 Electronic Copy
Infraction,Court 01 Municipal Courts 2013 Deleted
Docket,&Case File Retention
Schedule—V6
Uniform Citation, DM52-06A- District& 3 years Ctosed August 1—August 31, 08-01-16 Secure shred bin
Complaint,Court 01 Municipal Courts 2013 for outside
Docket&Case File Retention contractor
Schedule—V6 shredding
Uniform Citation, DM52-06J-01 District& 3 years Closed April 1—July 31,2013 08-01-16 Secure shred bin
Complaint,Court Municipal Courts for outside
Docket&Case File Retention contractor
(photo enforced) Schedule—V6 shredding
*Examples of inethods of destruction:electronic dele[ion,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 t S'Y� w�xX�Q-1'Y'�J� Frinted Name: . � ��1 � 1 1 Ct�)'�")S Division: � U17 1 Cl.nQ ��U IrT
The Records Manager must sign t approval of is request prior to the destruction of t e listed records:
� ` - 9� �.�,�
Records Manager Signature: Printed Name: V� v` Date Approved:
The person/people responsible for the destruction of records must sign upon destruction of the listed records:
Employee Signature: '� Q A �� "(.l� f sl�,1 C�P rY�S Printed Name: �(�' l.(�h �.��l 1 � ! GZ,I'Y�S Date Records Destroyed: �"��� � �
Vendor Business Name(if used): Phone:
Form Revised 05/06/2014
. City of Bremerton Public Records Destruction Log
Vendor Signature: Printed Name: Date Records Destroyed.
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The retention and disposition action for this Public Records Destruction Log is'lietain for the life of the agency"pursuant to CORE series G550-09-06.
Form Revised 05/06/2014 .
- lC �� ����jC► CERTIFICATE OF DESTRUCTION
40R INF� ..
' %�� � �� 2910 Hogum Bay Rd .���a �
- ����f/ j�/��%j/j///�/�,, ��%�% Olympia Wa 98516 oP °z
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%//%///%///////%////%/%%//%///////%%%%/%////%/%////'%%%/�///G Phone: 1-877-898-0112 � ��
Name: CO OP MUNICIPAL COURT-BREMERTON Fax: 1-360-486-2467 �o c
Address: 550 PARK AVE �
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City: BREMERTON , 98337 - '
Phone: 360-473-5242 Account : 2185-g52778-705 Route Id: SN92
Request: RWAUTO Invoice Date: 9/27/2016 Invoice#: 1235973
On the date shown, Designated Confidential Data was Shredded and Destroyed as per Customers Instructions.
Notes: Acct: 952778-705
Service Description � Qh' Rate Amount
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SEP 7 2016
� � I I AL C URT
Driver Signature: Date: Truck
Customer Signature: Date: ���'�� Time