HomeMy WebLinkAboutDispositions Forms_61-19_1/17/2020_Utilities f�
NO.
RECORDS DISPOSITION DOCUMENT
PAGE 1 OF 1 PAGES
1. AGENCY NAME 2. AGENCY CONTACT(Name and Telephone
VILLAGE OF TEQUESTA Number)
Lori McWilliams, MMC
DEPARTMENT: Utilities- Production (561) 768-0443
3. NOTICE OF INTENTION: The scheduled records listed in Item 5 are to be disposed of in the manner checked
below(specify only one).
Qa. Shred Q b. Imaging and Destruction c. Recycle
d. Removed from Server Qe. Other
4. SUBMITTED BY:
I hereby certif that the records to be disposed of are correctly represented below, that any audit requirements for the
records h v b en full 'u nd that further retention is not r quired for any litigation pendin or imminent.
/ilii - , . 'r J). 141
Sig ature Name and Title Senior Staff only) Date
5. LIST OF RECORD SERIES
6.
a. b. C. d. e. f. g.
Schedule Item Title Retention Inclusive Volume Disposition
No. No. Dates in Action and
Cubic Date
Feet Completed
After
Authorization
GS14 131 Treatment Plant Reports 4 years 2006-2013
r.
Chemical Settings - Tank Levels _ 2�
TOTAL CUBIC FEET THIS PAGE:
7. DISPOSAL AUTHORIZATION:Disposal for 8. DISPOSAL CERTIFICATE: The above and below listed records have
the above listed records is authorized. Any been disposed of in the manner and on the date shown in column g.
deletions or modifications are indicated. (Witness to the records disposition)
811CIEV IVA"- 1A 0
`7 Signature Date
Custodian/Records Liaison Officer Date M L(
Name and Title
Form Updated: 1/3/17