HomeMy WebLinkAboutMUNICIPAL COURT 01/07/2020 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
Description Date Method of
Records Series Title Records Series Records Retention Minimum Retention Period (Box/Item numbers, Dates Covered Minimum Destruction(See
DAN Schedule volume,etc.) Retention examples below*)
MeSource Records- GS50-09-14 CORE 4.0 Verification of Successful DMS2-06A-01 Various Dates 01-03-20 Secure shred bin
Images(Non- Rev. 3 Conversion for outside
Archival) contractor
(All Case Types) shredding
Uniform Notice of DM52-06B- District& 3 years Closed December 1-31,2016 01-01-20 Electronic Copy
Infraction, Court 01 Municipal Courts Deleted
Docket, &Case File Retention
(All Case Types) Schedule-V6
Uniform Notice of DM52-06B- District& 3 years Closed January 1,2014- 01-01-18 Secure shred bin
Infraction, Court 01 Municipal Courts December 31,2014 for outside
Docket,&Case File Retention contractor
(Closed DV Cases) 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 responsible for inventorying
CSthe�lliilsted records must sign below-pTriioor.,to the Record's Manager approval:
Employee Signature: I)l 1 LA r1 Up LSL_CLr)-LCl Printed Name: 1�l i L.0 n w I I ) I QX175 Division: r n u rl i C Cf:)I r-E
The Records Manager must sign t e approval of this request prior to the destruction of( r the lissttedd records:
Records Manager Signature: tl I Printed Name: I J ks_ V ICjV Date Approved: 0 /GI 349•40c9•0
The person/people responsible for the destruction of records must sign upon destruction of the listed records:
L O t rtrYl�� "DQ.A..i ( L)i ) l i CI FY)S Date Records Destroyed: I / an t O
Employee Signature: Printed Name:
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 GS50-09-06.
Form Revised 05/06/2014
Name: CO OP MUNICIPAL COURT-BREMER
RTIFICATE OF DESTRUCTION
Address: 550 PARK AVELe Mail \off �o.�,�
City: BREMERTC 98337 fvlobile �t soft � r
- i % jo o
Phone: 360 473 5242 %// � f � ,� ,
Request: RWAUTO / i2/0 A� % j%%� 4�CERTIFIED I
Account : 2185-952778-705 Service Date: 1/7/2020 Route Id: SN92 Ticket #: 1431389
On the date shown, Designated Confidential Data was Shredded and Destroyed as per Customers Instructions.
CUSTOMER COPY
Service Description ,Qty Rate Amount
65SC 1.00 65 GAL SHRED CART 12.88
SHEXB 1.00 SHRED EXTRA BOX 3.57
Driver Signature: .0j Date: Truck
Customer Signature: Date: Time
2910 Hogum Bay Rd Olympia Wa 98516 E-Mail: Ims@wcnx.org Phone: 1-877-898-0112 Fax: 1-360-486-2467