HomeMy WebLinkAboutMUNICIPAL COURT 04/25/2017City 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)).
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Source: Records -
` GS50-0g-14 _
CORE 3:3
Verification of Successful
DM52-066-01
Closed March 24 —April 20,
04-21-17
Secure shred bin
Images (Novi-
Rev. 3
Conversion
2017
for outside
-Ar;hival):
contractor
shredding
Source Records —
(3550,90-14,
CORE 3.3
Verification of Successful
DM62-06A-01
Closed April 1— April 20, 2017
04?1-17
Vee"effk-Goi;-y
Images (Non-
Rev. 3
Conversion
Deleted
F'��rcrr�
Archival)
cSQ.CGei
(criminal files
broken down)
Uniform Notice of
DM52-066-
District &
3 years.
Closed March 1— March 31,
04-01-17
Electronic Copy
Infraction, Court
01
Municipal Courts
2014
Deleted
Docket, & Case File
Retention
Schedule — V6
Uniform Citation,
DM52'06A=
District &
3 years
Closed March 1— March 31,
04-01-17
Secure shred bin
Complaint, Court
01
Municipal Courts
2014
for outside
Docket&Case File
Retention
contractor
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 M� aAnager approval:
Employee Signature: /(Y � 7�„ A 321 o jo::1,6 Printed Name: T,P ! i L�� LJC Ll o�_..O Division:_ t . In I
The Records Manager must sign the approval of this request prior to the destruction of the listed records:
Form Revised 05/06/2014
Records Manager Signatu
City of Bremerton Public Records Destruction Log
Printed Name:
Date Approved:
The person/people responsible for the destructiio/n� of records must sign upon destruction of the listed records:
Employee Signature: Daum • ��cc�'� Printed Name: � � t j n lJV 1�� �'� la'Y��� Date Records Destroyed:
Vendor Business Name (if used):
Vendor Signature: Printed Name:
Form Revised 05/06/2014
Phone:
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 GS50-09-06.
Le May Mobile
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Name:
Address:
City:
Phone:
Request:
CERTIFICATE OF DESTRUCTION
CO OP MUNICIPAL COURT-BREMERTON
550 PARK AVE
BREMERTON , 98337
2910 Hogum Bay Rd
Olympia Wa 98516
E -Mail: Ims@wcnx.org
Phone: 1-877-898-0112
Fax: 1-360-486-2467
360-473-5242 Account #: 2185-952778-705
RWAUTO Invoice Date: 4/25/2017
Route Id: SN92
Invoice #: 1269113
On the date shown, Designated Confidential Data was Shredded and Destroyed as per Customers Instructions.
Notes: Acct: 952778-705
Service Description I&Qty Rate Amount
65SC 2.00 65 GAL SHRED CART 2.98
SHEXB 1.00 SHRED EXTRA BOX 3.36
Driver Signature: Date: Truck
Customer Signature: Date: Time