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2022 HR - Personnel Separated, Medical, & FMLA 2020div ofcf-a QuLnta RECORDS DESTRUCTION AUTHORIZATION In accordance with the City's Records Retention Schedule as adopted by Resolution 2-013935, it is requested that the records delineated below be destroyed. There is no known litigation or reasonably anticipated investigation or litigation that would require these records be held. The total retention period has expired or in accordance with GC34090.5, any original/permanent records herein are being destroyed because (1) these records have been scanned into a permanent electronic format, (2) the format produced an accurate, legible copy that does not permit edits, (3) it is accessible for public reference to the same degree as the original version, and (4) a rue econd ry tronic copy is kept in a safe and separate place. Carla Triplett Community Resources Si jhftfe Print Name Department ' William Ihrke ,Z.0 -.- City ttorney Signature Print Name Date RECORDS TO BE DESTROYED: UFFS# and TITLE or DESCRIPTION OF RECORD TYPE FORMAT RECORD DATES &IMAGE EXIST? REQUIRE© TOTAL RETENTION 502.05 AMBRIZ, ROBERT PERSONNEL RECORD C PS 6/17/2020 yes Separated + 6 508.01 AMBRIZ, ROBERT MEDICAL RECORD C PS 6/17/2020 yes Separated + 30 502.05 ESCATEL-CARRELLO, ELIZABETH PERSONNEL RECORD C PS 3/2/2020 yes Separated + 6 508.01 ESCATEL-CARRELLO, ELIZABETH MEDICAL RECORD C PS 3/2/2020 yes Separated + 30 502.05 HENSEL, KAREN PERSONNEL RECORD C PS 6/17/2020 yes Separated + 6 508.01 HENSEL, KAREN MEDICAL RECORD C PS 6/17/2020 yes Separated + 30 502.05 LINDSEY, JAMES PERSONNEL RECORD C PS 6/17/2020 yes Separated + 6 508.01 LINDSEY, JAMES MEDICAL RECORD C PS 6/17/2020 yes Separated + 30 502.05 MELAT-LISTON, ALICE PERSONNEL RECORD C PS 6/17/2020 yes Separated + 6 508.01 MELAT-LISTON, ALICE MEDICAL RECORD C PS 6/17/2020 yes Separated + 30 502.05 NIETO, PAMELA PERSONNEL RECORD C PS 6/17/2020 yes Separated + 6 508.01 NIETO, PAMELA PERSONNEL RECORD C PS 6/17/2020 yes Separated + 30 L I certify that the records described above and approved destruction were o recycledxshredded on as prescribed by law. 1 City Clerk City Clerk or Deputy CMCleignature Print Name Title -GkCA - U )-q dits of a Quinta RECORDS DESTRUCTION AUTHORIZATION In accordance with the City's Records Retention Schedule as adopted by Resolution 201-3-03-6, it is requested that the records delineated below be destroyed. There is no known litigation or reasonably anticipated investigation or litigation that would require these records be held. The total retention period has expired or in accordance with GC34090.5, any original/permanent records herein are being destroyed because (1) these records have been scanned into a permanent electronic format, (2) the format produced an accurate, legible copy that does not permit edits, (3) it is accessible for public reference to the same degree as the original version, and (4) a tru econdary el ronic copy is kept in a safe and separate place. Carla Triplett Community Resources Sign Print Name Department William Ihrke 0, x/f City Attorney Signature Print Name Date RECORDS TO BE DESTROYED: UFFS# and TITLE or DESCRIPTION OF RECORD TYPE FORMAT E -IMAGE REQUIRED RECORD DATES EXIST? TOTAL RETENTION 503.11 SCOTT, ANGELA 1997 STD C PS 6/17/2020 yes Separated+30 902.05 SCOTT, ANGELA 1999 WC C PS 6/17/2020 yes Separated+30 902.05 SCOTT, ANGELA 2000 WC C PS 6/17/2020 yes Separated+30 902.05 SCOTT, ANGELA 12/2000 WC C PS 6/17/2020 yes Separated+30 503.11 SCOTT, ANGELA 2013 STD C PS 6/17/2020 yes Separated+30 503.11 ST SALIVER, LEONARD 2012 STD C PS 5/18/2020 yes Separated+30 I certify that the records described above and approved for destruction were o recycled shredded on 401�Axz_ `g, as prescribed by law. City Clerk Clerk or Deputy City Clerk Signature Print Name Title Fty if%q of fa Quanta RECORDS DESTRUCTION AUTHORIZATION In accordance with the City's Records Retention Schedule as adopted by Resolution 2013=-036, it is requested that the records delineated below be destroyed. There is no known litigation or reasonably anticipated investigation or litigation that would require these records be held. i The total retention period has expired or in accordance with GC34090.5, any original/permanent records herein are being destroyed because (1) these records have been scanned into a permanent electronic format, (2) the format produced an accurate, legible copy that does not permit edits, (3) it is accessible for public reference to the same degree as the original version, and (4) a true, sqtW. dary ele r i copy is kept in a safe and separate place. Carla Triplett Community Resources Si natu Print Name I Department ` William Ihrke d Z_ City Attorney Signature Print Name Date RECORDS TO BE DESTROYED: REQUIRED UFFS# and TITLE or E-IMAGE TYPE FORMAT RECORD DATES TOTAL DESCRIPTION OF RECORD EXIST? RETENTION 502.05 ORTIZ, ANNA PERSONNEL RECORD C PS 7/15/2020 yes Separated + 6 508.01 ORTIZ, ANNA MEDICAL RECORD C PS 7/15/2020 yes Separated + 30 502.05 QUIROS,CARMEN PERSONNEL RECORD C PS 6/12/2020 Ves Separated + 6 508.01 QUIROS, CARMEN MEDICAL RECORD C PS 6/12/2020 yes Separated + 30 502.05 SCOTT, ANGELA PERSONNEL RECORD C PS 6/17/2020 yes Separated + 6 508.01 SCOTT, ANGELA MEDICAL RECORD C PS 6/17/2020 yes Separated + 30 502.05 STOIANOVICI, TOMA PERSONNEL RECORD C PS 6/17/2020 yes Separated + 6 508.01 STOIANOVICI, TOMA MEDICAL RECORD C PS 6/17/2020 yes Separated + 30 I certify that the records described above and approved for destruction_ were ❑ recycled Kshredded on "~ as prescribed by law. i N LA-1 City Clerk City Clerk or Deputy City CI eVk Sig rWtune Print Name ITitle dt# Of,& Qaurta RECORDS DESTRUCTION AUTHORIZATION In accordance with the City's Records Retention Schedule as adopted by Resolution 2&1 -3=036, -it is requested that the records delineated below be destroyed. There is no known litigation or reasonably anticipated investigation or litigation that would require these records be held. The total retention period has expired or in accordance with GC34090.5, any original/permanent records herein are being destroyed because (1) these records have been scanned into a permanent electronic format, (2) the format produced an accurate, legible Apy that does not permit edits, (3) it is accessible for public reference to the same degree as the original version, and (4onda t onic copy is kept in a safe and separate place. K1 Carla Triplett Communit Resources Signature Print Name IDepartment �~ William Ihrke U - City Attorney Signature Print Name Date RECORDS TO BE DESTROYED: UFFS# and TITLE or DESCRIPTION OF RECORD TYPE FORMAT RECORD DATES E -IMAGE REQUIRED EXIST? TOTAL RETENTION 502.05 ST SAUVER, LEONARD PERSONNEL RECORD C PS 5/18/2020 yes Separated + 6 508.01 ST SAUVER, LEONARD MEDICAL RECORD C PS 5/18/2020 yes Separated + 30 502.05 WISE-LATTA, WANDA PERSONNEL RECORD C PS 7/17/2020 yes Separated + 6 508.01 WISE-LATTA, WANDA MEDICAL RECORD C PS 7/17/2020 yes Separated + 30 I certify. that the records descri ed above and approved for destruction were o tecyClad i shredded on _ as prescribed by law. City Clerk rtyrk or Deputy City ClerkjrignatuW Print Name Title o,ta Quinta RECORDS DESTRUCTION AUTHORIZATION In accordance with the City's Records Retention Schedule as adopted by Resolution 2013-036, it is requested that the records delineated below be destroyed. There is no known litigation or reasonably anticipated investigation or litigation that would require these records be held. The total retention period has expired or in accordance with GC34090.5, any original/permanent records herein are being destroyed because (1) these records have been scanned into a permanent electronic format, (2) the format produced an accurate, legible copy that does not permit edits, (3) it is accessible for public reference to the same degree as the original version, and (4) a true, secpNary electronic copy is kept in a safe and separate place. Carla Triplett Community Resources Sign ur [Print Name Department William Ihrke — Z City Attorney Signature Print Name I Date RECORDS TO BE DESTROYED: UFFS# and TITLE or DESCRIPTION OF REQUIRED TOTAL TYPE FORMAT RECORD DATES IMAGE RECORD RETENTION EXIST? TERMINATED EMPLOYEES: 503.12 AMBRIZ, ROBERT JR 2008 FMLA C PS 6/17/2020 YES SEPARATED + 30 503.12 AMBRIZ, ROBERT JR 2005 FMLA C PS 6/17/2020 YES SEPARATED + 30 503.11 ESCATEL, ELIZABETH 2011 STD C PS 3/2/2020 YES SEPARATED + 30 503.12 ESCATEL, ELIZABETH 2008 FMLA C PS 3/2/2020 YES SEPARATED + 30 503.12 ESCATEL, ELIZABETH 2008 STD C PS 3/2/2020 YES SEPARATED + 30 '902.05 HENSEL, KAREN 2004 WORK COMP C PS 6/17/2020 YES SEPARATED + 30 503.12 LINDSEY, JAMES 2002 FMLA C PS 6/17/2020 YES SEPARATED + 30 503.11 LINDSEY, JAMES 2002 STD C PS 6/17/2020 YES SEPARATED + 30 503.12 NIETO, PAMELA 2010 FMLA C PS 6/17/2020 YES SEPARATED + 30 503.11 NIETO, PAMELA 2010 STD C PS 6/17/2020 YES SEPARATED + 30 902.05 NIETO, PAMELA 2004 WORK COMP C PS 6/17/2020 YES SEPARATED + 30 509.07 ORTIZ, ANNA 2003 GRIEVANCE C PS 7/15/2020 YES SEPARATED + 3 503.11 ORTIZ, ANNA 1995 STD C PS 7/15/2020 YES SEPARATED + 30 '902.05 SILVA, LAURA WC 2018 C PS 1/24/2022 YES SEPARATED + 30 '902.05 GARCIA, JUSTINE WC 2018 C PS 2/25/2021 YES SEPARATED + 30 I certify that the records:descr bed above and approved for destruction were o recycledcjshredded on W as prescribed by law. i ArC y Clerk City Clerk or Deputy City Clerk Signature Print Name Title