HomeMy WebLinkAboutMUNI COURT - 11/21/2016 - 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 Retention Description Minimum
Records Series Title Minimum Retention Period (Box/Item numbers, Dates Covered Retention Destruction(See
DAN Schedule volume,etc.) Met examples below*)
Source Records— GS50-09-14 CORE 3.3 Verification of Successful DM52-06B-01 Closed October 22, 2016— 11-21-16 Secure shred bin
Images(Non- Rev. 3 Conversion November 21,2016 for outside
Archival) contractor
shredding
Uniform Notice of DM52-06B- District& 3 years Closed October 1—October 31, 11-01-16 Electronic Copy
Infraction,Court 01 Municipal Courts 2013 Deleted
Docket,&Case File Retention
Schedule—V6 _ _
Uniform Citation, DM52-06A- District& 3 years Closed October 1—October 31, 11-01-16 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 August 1—October 31, 11-01-16 Secure shred bin
Complaint,Court Municipal Courts 2013 for outside
Docket&Case File Retention contractor
(parking&photo Schedule—V6 shredding
enforced)
Uniform Citation, DM52-06A- District& 3 years Closed June 1—October 31, 11-01-14 Secure shred bin
Complaint,Court 01 Municipal Courts 2011 for outside
Docket&Case File Retention contractor
(DV Files) Schedule—V6 shredding
*Examples of methods 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 responsibleforinventorying the listed records must sign below prior to the Record's Manager approval: �1.�
Employee Signature: 7�L&I,QY! 'L.J(„Q l"
ute Y� _{Printed Name: n wi I I i cunt Division: mink.;)vnk. Coir
The Records Manager must sign t approval of this request prior to the destruction oft e isted records:
{I I�1 �n 1 ,- ;- I c
Records Manager Signature: C.11/ t� _` Printed Name: ►1;t LL� C_-,�I Y�. Date Approved: I I
Form Revised 05/06/2014
City of Bremerton Public Records Destruction Log
The person/people responsible for the destruction of records must sign upon destruction of the listedl/ records:
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Employee Signature:_! 1 T!'1 1 ( �(i_XY1n Printed Name: _� r7 W 1 ' i�-�' ' !J Date Records Destroyed: I I -a I-1 f W
Vendor Business Name(if used): Phone:
Vendor Signature: Printed Name: Date Records Destroyed:
The retention and disposition action for this Public Records Destruction Log is"Retain for the life of the agency"pursuant to CORE series G55O-09-06.
Form Revised 05/06/2014
Le May Mobile CERTIFICATE OF DESTRUCTION
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folk 2910 Ho umBa Rd
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E-Mail: Ims@wcnx.org
41 CERTIFIED el
Name: CO OP MUNICIPAL COURT-BREMERTON Phone: 1-877-898-0112 ' ��~
Address: 550 PARK AVE Fax: 1-360-486-2467
City: BREMERTON , 98337 %� ao\
Phone: 360-473-5242 Account#: 2185-952778-705 Route Id: SN92
Request: RWAUTO Invoice Date: 11/22/2016 Invoice #: 1244522
On the date shown, Designated Confidential Data was Shredded and Destroyed as per Customers Instructions.
Notes: Acct: 952778-705
fRILED
Service Description Qty Rate Amount
65SC 2.00 65 GAL SHRED CART Z 2.96
SHEXB 1.00 SHRED EXTRA BOX o" 0 2016 3.33
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UNICIPAL COURT
Driver Signature: - Date: Truck
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Customer Signatur-: -Y� ' Date: J(-.2 (K0 Time