HomeMy WebLinkAboutPWU ADMIN 011823 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
Method of
Records Series Records Retention (Box/Item Date Minimum
Records Series Title DAN Schedule Minimum Retention Period numbers,volume, Dates Covered Retention Met Destruction(See
etc.) examples below*)
Inspection and UT55-06A-17 Utility Services Retain for 3 years then 2017—43 pages 2017,2018,and 2019 1/1/2023 In-house shredding
Monitoring Rev.0 Records Retention Destroy. 2018—47 pages
Reports—Sewer Schedule Version 2019—25 pages
and Water System 1.5(June 2021)
Documentation
*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 t e listed records must sign below prior to the Record's Manager approval:
1
Employee Signature:0V ,(LLB, Printed Name: N l 1(&( H I c4m( ( n Division: f, \ I6/
The Records Manager must sign the a proval of this equest/ for to the destruction of
the listed records:/ ,n� I �/� ¢ 2
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Records Manager Signature: at Printed Name: I I ) ( I�M (�ll t I(l i �.v \ Date Approved: \I I U ZUZ J
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The person/people respon ible rrI
the de tr ction of ecords must sign upon destruction
�off the listed records: '7
Employee Signature: �j Printed Name: I ► II I�l� vl �l�li f �I I I U� Date Records Destroyed: I I� (U��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