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290 <br />RECORDS DISPOSITION DOCUMENT <br />NO. <br />PAGE 1 OF 1 PAGES <br />1. AGENCY NAME and ADDRESS <br />Indian River County Fire Rescue <br />4225 43rd Avenue <br />Vero Beach, FL 32967 <br />2. AGENCY CONTACT (Name and Telephone Number) <br />Ellen Salm <br />(772) 226 — 3865 Ext. <br />3. <br />NOTICE OF INTENTION: The <br />one) <br />►,1 a. Destruction <br />scheduled records listed in Item 5 are to be <br />IN b Microfilming and Destruction <br />disposed of in the manner checked below (specify only <br />■ 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 />the s have b ly justified, and that further retention is not required r any litigation pending or imminent. <br />VP' ILIAC 5-Ai tat II-IA-Cc StSTAt E- ( D- — -- <br />Sign re Name and/Title Date <br />iZ. 7. ice, <br />5. LIST OF RECORD SER •� <br />a. <br />Schedule <br />b. <br />Item <br />c. <br />Title <br />d <br />Retention <br />e. <br />Inclusive <br />f. <br />Volume <br />In <br />9- <br />Disposition <br />Action and <br />No. <br />No. <br />Dates <br />Cubic <br />Feet <br />Date <br />Completed <br />After <br />Authorization <br />GS4 <br />GS4 <br />GS4 <br />40 <br />127 <br />80 <br />Incident Records <br />Inventory Records Drugs <br />Patient Medical Records7 <br />7 CY <br />2 CY <br />CY <br />through to November 2007 <br />through to November 2012 <br />through to November 2007 <br />Totlal <br />5 <br />S►vre ddb <br />12-t�� 4 <br />6. DISPOSAL AUTHORIZATION: Disposal for the above listed <br />records is authorized. Any deletions or modifications are indicated. <br />0 <br />7. DISPOSAL CERTIFICATE: The above listed records have been <br />isposed of in the manner and on the date shown in column g. <br />�� ichwc4a /4 f1� jal� 6- q-t6. <br />/, t 4.L4., J !/ ' ,-'i,, _, /i. q JL- <br />/ <br />Si ature Date <br />�rNr \A C...)-Na <br />R t r CIS Cr}GL-FfAss+ <br />'Cu todian/Reco • u . . • :/ • Liais• n Officer ate <br />Name and Title <br />Witness <br />290 <br />