HomeMy WebLinkAboutLEGAL 010323 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 Title Records Series Records Retention Minimum Retention Period Description(Box/Item Dates Covered Minimum Destruction(See
DAN Schedule numbers,volume,etc.) Retention
Met examples below*)
4.4 Employee Health GS2017-016 Local Retain for 3 years after 12 packets 2019 Safety& Health 12/31/20 Secure recycling
and Safety Rev.0 Government end of calendar year Committee Agendas 1/3/22.
CORE Version and no longer needed
4.2 for agency business
then destroy.
1.14 Risk GS2010-081 Local Retain for 3 years after 2 redwells 2019 Accidents/Incidents 12/31/22 Secure recycling
Management/Insurance Rev. 2 Government date of incident then 1/3/23.
CORE Version destroy.
4.2
3.5 Payroll GS50-03E-15 Local Retain for 4 years after 1 large binder clip 2018 Volunteer Timesheets 12/31/22 Secure recycling
Rev. 1 Government end of fiscal year and 1/3/23.
CORE Version no longer needed for
4.2 agency business then
destroy.
4.2 Employee Benefits GS2017-007 Local Retain for 3 years after 2 redwells 2019 WC Loss Runs 12/31/22 Secure recycling
Rev. 0 Government end of calendar year 1/3/23.
CORE Version and no longer needed
4.2 for agency business
then destroy.
GS50-02-04 Local Retain until no longer 1 large binder clip 2019 Accident& Injuries 12/31/22 Secure recycling
Rev. 2 Government needed for agency 1/3/23.
CORE Version business then destroy.
4.2
*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 res onsible for inventorying the listed records must sign below prior to the Record's Manager approval:
Employee Signat re: / kPrintied Name: Melisa Vaal Folmer Division: City Attorney's Office —
The Records Manager must sign the approval of this request prior to the destruction of the listed records:
Form Revised 05/06/2014
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