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2013 HR - Medical Records 1999-20020 dt,q of fa QgWa RECORDS DESTRUCTION AUTHORIZATION In accordance with the City's Records Retention Schedule as adopted by Resolution 2010 -016, 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 p (4) a trye, secondary electirgoecopy is kept in a safe and separate place. Frank Spevacek City Manager Print Name Department �— M. Katherine Jenson Print Name Date RECORDS TO BE DESTROYED: UFFS# and TITLE or E -IMAGE . REQUIRED DESCRIPTION OF RECORD TYPE FORMAT RECORD DATES EXIST? TOTAL RETENTION .508.01 Medical Records 0 P/S N Anderson, Richard rS/QO 11999 Benford, Carol 3/10/2000 Bocanegra, Sergio 5h31 ago Bouma, Fred 3/22/2 00 Corrigan, Valerie 5/25/2001 Coyle, Linda 4/7/2000 Croft, Geniene 9/13/2000 De Terrible, Teresa 1/1/2002 Derenard, Deborah 1/1012001 Di lorio, Christine 8/1/2002 Diaz, Carey 4/20/2001 Downs, Brian 5/17/2001 Fabini, Renee 9/21/2001 Fuller, Marcus 1/1/1999 Gormley, Nicolette 10/9/2001 Haes, Tito Z /,141 I i R Harold, Mark 3/21/2000 7 I certify that the records described above and approved for destruction were o recycled� l shredded on i t-15- 0/ 3 es prescribed by law. Susan Maysels JWerinrCity Clerk City Clerk or Deputy City Clerk Sonature Print Name Title Type: Original Documents - O Format: Paper records to be shreded = PIS Copies - C Paper records to be recycled = P/R j Electronic document to be deleted = E CD, DVD, Tape to be destroyed = CDT Ow Of a Qgbda RECORDS DESTRUCTION AUTHORIZATION In accordance with the City's Records Retention Schedule as adopted by Resolution 2010 -016, 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 14) a ua, secondaryo arrcc copy is kept in a safe and separate place. Frank Spevacek City Manager j; 7e t ead re Print Name De artm 2 �L M. Katherine Jenson City Attorney Signature7 Print Name Date RECORDS TO BE DESTROYED: UFFS# and TITLE or E -IMAGE REQUIRED TYPE FORMAT RECORD DATES TOTAL DESCRIPTION OF RECORD EXIST? ----------- Herrera, Juan 1/1/1999 Johnson, Danny 3/9/2001 Juhola, Saundra 1/1/1999 Kortman, Cheryle 1/9/2001 Love, Robert 6 /1%1Qaol Miranda, Robert 8/1/2000 Negrinelli, Debbie 7/aI /)I q7 Olives, Jeffrey 8/25/2000 Post, Monte 1/11/2002 Rambo, Michelle 5/3 / J-60 I Shepherd, Eleanor 1/20/2000 Smith, Bruce 3/x81 ado I Spidell, Cristal 10/6/2000 Steiner, Edward 2/18/2000 Stone, Carrie 111/11/2002 Stull, Pamela 1/1/1999 Verdugo, Ruben 7/2/2001 Verlenoia, Romano 61.10goo I 1 I certify that the records described above and approved for destruction were o recycledArshredded on K • $ • 2613 as prescribed by law. � Susan Maysels JMwin►City Clerk City Clerk or Deputy City Clerk SVnature Print Name Title Type: Original Documents = O Format: Paper records to be shreded = PIS Copies = C Paper records to be recycled = PRi Electronic document to be deleted = E CD, DVD, Tape to be destroyed = CDT TLD RECORDS DESTRUCTION AUTHORIZATION In accordance with the City's Records Retention Schedule as adopted by Resolution 2010 -016, 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 trip, secondary elects y is kept in a safe and separate place. Frank Spevacek City Manager Print Name Department M. Katherine Jenson Print Name RECORDS TO BE DESTROYED: UFFS# and TITLE or E -IMAGE REQUIRED DESCRIPTION OF RECORD TYPE FORMAT RECORD DATES EXIST? TOTAL RETENTION 508.01 Medical Records O P/S N Vogt, Chris 11/7/2001 Vreeken, John 1/1/1999 Wilson, Britt 7/9/2001 Barnes, Joanne 11/1/2002 Campbell, Susan 1/6/2004 Craven, Robert 7/1/2002 Dean, Artemisa 2/1/2002 De Tamble, Teresa 1/1/2002 Glowitz, Joseph 2/18/2004 Hardcastle, John 1/21/2004 Kunsman, Marni 3/1/2004 Matthew, Susan 6/1/2002 Monz, Victor 5/1/2003 Mouriquand, Leslie 10/4/2000 Paisley, Elsa 1/1/2003 Ramirez, Martha 7/1/2003 Savio, Belinda 2/3/2004 Stone, Carrie 11/1/2002 I certify that the records described above and approved for destruction were o recycled XX shredded on 4• 18 • 2013 as prescribed by law. Susan Maysels City Clerk City Clerk or Deputy City Clerk Sign re Print Name Title Type: Original Documents = O Format: Paper records to be shreded = PIS Copies - C Paper records to be recycled = P/R Electronic document to be deleted = E CD, DVD, Tape to be destroyed = CDT Dk- e4 ofata Qainta . RECORDS DESTRUCTION AUTHORIZATION In accordance with the City's Records Retention Schedule as adopted by Resolution 2010 -016, 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 a and separate place. Frank Spevacek City Manager Print Name Department RECORDS TO BE DESTROYED: M. Katherine Jenson Print Name Date , <.al UFFS# and TITLE or E -IMAGE REQUIRED DESCRIPTION OF RECORD TYPE FORMAT RECORD DATES EXIST? TOTAL RETENTION 508.01 Medical Records O P/S 2000 -2005 N Swan - Draper, Amy 4/ 4/ 000 Thomas, Cathy W 1 14 12.00A ANGULO, JULIO 9/12/2003 BRANCHINI, JULIE 4/29/2005 CALHOUN, DEBORAH Eblbgpos CHRISTIANSEN, SHARON 3/18/2005 CLOMA, JAMIE 10/11/2004 FERNANDEZ, HECTOR 5/6/2004 FESKE, MATTHEW 6hIQ405 GATES, WILLIAM 10/9/2004 HERMAN, JEROLD 9/30/2004 MAGANA, MARTIN 3/11/2005 MC ELROY, GINA 5/27/2005 MOYA, ORALIA 7/1/2003 NAYLOR, LORI 3/7/2005 NELSON, STEVEN (GUS) If Iq 1 100 ORCI, OSCAR 11/26/2004 I certify that the records described above and approved for destruction were a recycled ,*( shredded on 7 •19 • 26 13 as prescribed by law. City Clerk or Deputy City Cle ignature Type: Original Documents = 0 Copies = C Susan Maysels 10frsity City Clerk Print Name Title Format: Paper records to be shreded = P/S Paper records to be recycled = P/R Electronic document to be deleted - E CD, DVD, Tape to be destroyed = CDT oft Of a Qgwa RECORDS DESTRUCTION AUTHORIZATION In accordance with the City's Records Retention Schedule as adopted by Resolution 2010 -016, 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 14) a tru , secondary electr opy is kept in a safe and separate place. rb Frank Spevacek City Manager rt t Head Ig ure Print Name Department M. Katherine Jenson A'a City Attorney Signature Print Name Date RECORDS TO BE DESTROYED: UFFS/1 and TITLE or E -IMAGE REQUIRED TYPE FORMAT RECORD DATES TOTAL DESCRIPTION OF RECORD EXIST? SMITH, BARBARA w / ) q/Qoo -t N SMITH, MARILYN 3/18/2005 N SMITH, ROXANNE 7/16/2004 N TROUSDELL, GREG 8/13/2004. N VALADEZ, PHILIP 3/14/2005 N WHELCHEL, DONALD 10/12/2004 N WISE, MELISSA 7/9/2004 N I certify that the records described above and approved for destruction were o recycled)'shredded on K • l S • ) 0 13 as prescribed by law. Susan Maysels Uoeaist City Clerk City Clerk or Deputy City Clerl gnature Print Name Title Type: Original Documents = O Format: Paper records to be shreded = PIS Copies - C Paper records to be recycled - P/R Electronic document to be deleted = E CD, DVD, Tape to be destroyed = CDT