HomeMy WebLinkAboutMUNICIPAL COURT 04/13/2021 R' 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 Records Retention Minimum
Records Series Title DAN Schedule Minimum Retention Period (Box/Item numbers, Dates Covered Retention Destruction(See
volume,etc.) Met examples below•)
Source Records— GS50-09-14 CORE 4.0 Verification of Successful DM52-06A-01 Various Dates 4-08-21 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 January 1— March 31, 4-01-21 Electronic Copy
Infraction,Court 01 Municipal Courts 2018 Deleted
Docket,&Case File Retention
(All Case Types) Schedule—V6
Uniform Notice of DM52-06A- District& 3 years Closed January 1—March 31, 4-01-21 Secure shred bin
Infraction,Court 01 Municipal Courts 2018 for outside
Docket,&Case File Retention contractor
(criminal) Schedule—V6 shredding
Uniform Notice of DM52-06B- District& 3 years Closed January 1—March 31, 4-01-21 Secure shred bin
Infraction,Court 01 Municipal Courts 2018 for outside
Docket,&Case File Retention contractor
(parking&photo) 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 the listed records must sign below prior to the Record's Manager approval:
Employee Signature: - L L)l�1 �l L� lCt !.y L Printed Name: J JCLLQ l LO i ) 1 I CA MS Division: I )C r)IC i_p-L I C C-'C,'i
The Records Manager must sign the approval of this,request prior to the destruction of tke listed records: 1
Records Manager Signature: • \, t j t`�'l �l ' Printed Name: ) ; , �• IE 0 v(� / Date Approved: G / ' 2.-)ps i
The person/people responsible for the destruction of records must sign upon destruction of the isted records:
Form Revised 05/06/2014
City of Bremerton Public Records Destruction Log
Employee Signature:. (LLOY) h i i P.+c1 6 Printed Name: T,t.)r) Lt.); ) I i 6tj) r f Date Records Destroyed: LI• 1-s .7
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
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gRTIFICATE OF DESTRUCTION
Name: CO OP MUNICIPAL COURT BREMERT
Address: 550 PARK AVE Boa Ike
City: BREMERTC 98337 y' Mobile �o� N,
Phone: 360-473-5242
Request: RWAUTO / iV %OOJfig,
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Account : 2185-952778-705 Service Date: 4/13/2021 Route Id: SN92 Ticket#:M 1504310
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
APR 13 2021
e BY NIUNICIPAI
Date: COURT
Driver Signature: 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