HomeMy WebLinkAboutMUNICIPAL COURT 04/24/2018City 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
Records Series Title
Records Series
Records Retention
Minimum Retention Period
Description
(Box/Item numbers,
Dates Covered
Date
Minimum
Retention
Method of
Destruction (See
DAN
Schedule
volume, etc.)
examples below )
Met
Source Records -
GS50-09-14
Core 4.0
Verification of Successful
DM52-06E-05
Closed 2015
4-21-18
Secure shred bin
Images (Non-
Rev.3
Conversion
for outside
Archival)
contractor
(Civil Protection
shredding
Order Files)
Source Records -
GS50-09-14
CORE 4.0
Verification of Successful
DM52-06A-01
Various Closure Dates 2018
04-21-18
Secure shred bin
Images (Non-
Rev. 3
Conversion
for outside
Archival)
contractor
(Closed Criminal)
shredding
Uniform Notice of
DM52-066-
District &
3 years
Closed March 1- March 31,
04-01-18
Electronic Copy
Infraction, Court
01
Municipal Courts
2015
Deleted
Docket, & Case File
Retention
(infraction)
Schedule - V6
*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 responsible for inventorying the listed records must sign below prior to the Record's Manager approval: /� ]
L( �j 1 I 1 Gt;Y3 )S Division: f—nL)
Employee Signature: DLL Q`n (X1'��l 12240 Printed Name: n
The Records Manager must sign the approval of this request pr{or to the destruction of the listed records:
Records Manager Signature: Printed Name: l/� `-�' v� Date Approved:
The person/people responsible for the destruction of records must sign upon :t destruction of the listed records: �/ Q
Employee SignatureEn Z.i 1t 0�� Printed Name: _[)ftLQ }) L'O 1 I I 1 a 1 y� � Date Records Destroyed: 7 , Q `LJ —' V
Form Revised 05/06/2014
City of Bremerton Public Records Destruction Log
Vendor Business Name (if used): Phone:
Vendor Signature:
Form Revised 05/06/2014
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 Gs50-09-06.
to MoMobile CERTIFICATE OF DESTRUCTION
2910 Hogum Bay Rd
Cool
js�Olympia Wa 98516 JAE-Mail: Ims@wcnx.orga a„
W,�'0�' wo'��1 '� ,/"ff/, ��y �"N Phone: 1-877-898-0112
Name: COOP MUNICIPAL COURT-BREMERTON Fax: 1-360-486-2467
Address: 550 PARK AVE
City: BREMERTON 98337
Phone: 360-473-5242 Account: 2185-952778-705 Route Id: SN92
Request: RWAUTO Invoice Date: 4/24/2018 Invoice #: 1328296
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
3.13
SHEXB 1.00 SHRED EXTRA BOX 3.47
Driver Signature:
Date: Truck
Customer Signature: Date: Time