HomeMy WebLinkAboutRISK MANAGEMENT 04052022 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(Box/Item Minimum
Records Series Title DAN Schedule Minimum Retention Period numbers,volume,etc.) Dates Covered Retention Destruction(See
Met examples below*)
4.4 Employee Health GS2017-016 Local Retain for 3 years after 12 packets 2018 Safety& Health 12/31/21 Secure recycling
and Safety Rev.0 Government end of calendar year Committee Agendas 4/5/22.
CORE Version and no longer needed
4.1 for agency business
then destroy.
1.14 Risk GS2010-081 Local Retain for 3 years after 1 Redwell of 2018 2018 Accidents/Incidents 12/31/21 Secure recycling
Management/Insurance Rev. 2 Government date of incident then accidents/incidents 4/5/22.
CORE Version destroy.
4.1
3.5 Payroll GS50-03E-15 Local Retain for 4 years after Binder of 2017 2017 Volunteer Timesheets 12/31/21 Secure recycling
Rev. 1 Government end of fiscal year and Volunteer 4/5/22.
CORE Version no longer needed for timesheets
4.0 agency business then
destroy.
4.2 Employee Benefits GS2017-007 Local Retain for 3 years after Redwell of 2018 WC 2018 WC Loss Runs 12/31/21 Secure recycling
Rev.0 Government end of calendar year Loss Runs 4/5/22.
CORE Version and no longer needed
4.0 for agency business
then destroy.
3.1 Accounting GS2011-184 Local Retain for 6 years after 1 Redwell of 2015 2015 WC Check Registers 12/31/21 Secure recycling
Rev. 3 Government end of fiscal year then WC Check Registers 4/5/22.
CORE Version destroy.
4.0
4.4 Employee Health GS2017-016 Local Retain for 3 years after 1 Redwell 2018 Job Hazard Analysis for 12/31/21 Secure recycling
and Safety Rev.0 Government end of calendar year Personal Protective 4/5/22.
CORE Version and no longer needed Equipment(PPE)Assessments
4.0 for agency business
then destroy
*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.
Form Revised 05/06/2014
City of Bremerton Public Records Destruction Log
r
• The individual es onsible for i ventoryin the listed records must sign below prior to the Record's Manager approval:
I /
Employee Si natu e: in ed e:) Melisa Vaal Folmer Division: City Attorney's Office
The Records Manager must sign the approval of thi re t prio to e destruction of the listed records:
Records Manager Sig ture int d Ielisa Vaal Folmer Date Approved: 4/5/22
The person/people responsible f r the de uctio of records must sign upon destruction of the listed records:
\i )/ I
Employee ii#atur : in ed Na . Melisa Vaal Folmer Date Records Destroyed:4/5/22
The retention and disposition action for this Public Records Destruction Log is"Retain for the bite of the agency"pursuant to CORE series GS50-09-06.
RECEIVED
APR 11 2022
OFFICE OF THE
CITY CLERK
Form Revised 05/06/2014