HomeMy WebLinkAboutDisposition Forms_43-14_02/28/2014_Utilities RECORDS DISPOSITION DOCUMENT NO. —, 4
Revised: 12/20/11 PAGE 1 OF 1 PAGES
1. AGENCY 2. DEPARTMENT Utilities 3. BUREAU
Village of Tequesta N/A
4. ADDRESS (Street, City, and Zip Code) 5. CONTACT (Name and Telephone Number)
345 Tequesta Drive Lori McWilliams, MMC
Tequesta, FL 33469 561- 768 -0443
6. SUBMITTED BY: I hereby certify that the records to be disposed of are 7. NOTICE OF INTENTION
correctly represented below, that any audit requirements for the records
have been fully justified, and that further retention is not required for any The scheduled records listed in Item 8 are to be disposed of in the
litigati n pending or ' 'nen manner checked below (specify only one):
Sign ture Date V Destruction F7 b. Microfilming and Destruction
77 a.1 Shred LL] a.2 Recycle
Nathan Litteral, Water Plant Superintendent 0 c. Imaging and Destruction
Name and Title = d. Other
8. LIST OF RECORD SERIES
a. b. C. d. e. f. g.
Schedule Item Title Retention Inclusive Volume Disposition
Item No. Dates in Action and Date
Cubic Completed After
Feet Authorization /
GS14 89 Pumpage Reports: Monthly 10 years:
Water System Pumpage 1996-1999
Treated Water
Monthly Production Well Pumpage 1996-1999
Report
SFWMD Pumpage Report 1996-2001
9. DISPOSAL AUTHORIZATION: Disposal for the above listed records 10. DISPOSAL CERTIFICATE The above listed records have been
authorized. Any deletions or modifications are indicated disposed of in the manner and on the date shown in column g.
(Witness to the.2ecords Disposition)
v
Signature:�� � V w m" "Z Date: p� Signature: �) �� � / /„�� Date: r w q
Print Name: Lori McWilliams Print Name: �`�\ (�� t` I!
Print Title: Village Clerk Print Title:
NOTE: Upon disposition retain this form for your records