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NO. <br /> RECORDS DISPOSITION DOCUMENT <br /> PAGE 1 OF 1 PAGES <br /> 1 . AGENCY NAME and ADDRESS 2 AGENCY CONTACT (Name and Telephone Number) <br /> Indian River County Rachel Ivey <br /> Department of Emergency Services <br /> Fire Rescue <br /> 4225 43rd Avenue , Vero Beach , FL 32967 ( 772 ) 226 - 3859 Ext . <br /> 3. NOTICE OF INTENTION: The scheduled records listed in Item 5 are to be disposed of in the manner checked below (specify only <br /> one). <br /> ® a. Destruction ❑ b. Microfilming and Destruction ❑ c. Other <br /> 4. SUBMITTED BY: I hereby certify that the records to be disposed of are correctly represented below, that any audit requirements for <br /> orris have been fully justified, and that further retention is not required for any litigation pending or imminent. <br /> Sig ture Name and T&94 L � , tz Date <br /> 5. LIST OF RECORD SER114 . <br /> I, go <br /> a, bo cm d. e. Volume Disposition <br /> Schedule Item Title Retention Inclusive In Action and <br /> No. No, Dates Cubic Date <br /> Feet Completed <br /> After <br /> Authorization <br /> GS4 480 Patient Medical Records 7 CY 2004 6 � <br /> 127 Inventory Records: Drugs 2 CY 2007-2009 4 <br /> N GSI - 195 Payroll Records: supporting documents 3 CY 2003 -2004 2 <br /> SL <br /> DNA l - �a <br /> Total <br /> 12 CF <br /> 6. DISPOSAL AUTHORIZATION: Disposal for the above listed 7. DISPOSAL CERTIFICATE: The above listed records have been <br /> records is authorized. Any deletions or modifications are indicated. ad of in the manner and on the date shown in column g. <br /> Moo <br /> 0< <br /> re Date <br /> todian/RReco anagemento n to ;Narmbd Title <br /> � J CUF <br />