HomeMy WebLinkAboutMUNICIPAL COURT 04122022 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.) Re Meton examples below*)
Source Records— GS50-09-14 CORE 4.2 Verification of Successful DM52-06A-01 Various Dates 04-11-22 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 February 1—March 31, 04-01-22 Electronic Copy
Infraction,Court 01 Municipal Courts 2019 Deleted
Docket, &Case File Retention
(All Case Types) Schedule—V6
Uniform Notice of DM52-06A- District& 3 years Closed Februar 1—March 31, 04-01-22 Secure shred bin
Infraction,Court 01 Municipal Courts 2019 for outside
Docket,&Case File Retention contractor
(criminal) 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 foror inventorying the listed records must sign below prior to� the` Record's Manager approval: yam, Comployee Signature: �( Y1 W Printed Name: J3..A)fl w' l 1 i CUYri_s Division: i ► !u - I C) pc ) ` o
The Records Manager must sign
�th_e approval of this request prior to the destruction of the listed records: f�
Records Manager Signature: ['a ) jdilYruQ Printed Name: .DQWOn w 1 1 1 O.JYY)S Date Approved: . - I _ 0��
The person/people responsible for the destruction of records must sign upon destruction of the listed records:
Form Revised 05/06/2014
CERTIFICATE OF DESTRUCTION
' Name: CO OP MUNICIPAL COURT-BREMERTON
woR ,„„.Le cw� obile
Address: 550 PARK AVE
City: BREMERTON 98337 ���/ 74 fa v r - ii (CERTIFIED 51
Phone: 360-473-5242 % % ///%%%
Request: SCHEDULED ON CALL % q, "Fr
�y�c
Account : 2185-952778-705 Service Date: 4/12/2022 Route Id: SN92 Ticket#: 1573465
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 / 13.65
SHEXB 1.00 SHRED EXTRA BOX 3.78
Driver Signature: /(4 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