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3NO.: 17 CLAIMANT NAME: 1�P <br /> SPTE ADDRESS: C.1� .L -Ave -34 C 6 �4 0 <br /> •r rc�l. :r.SS,i;!.i:hlrYr`�x:h:.:....-. �..... ..f//.:... <br /> —7[7Continued on reverse <br /> COI+FFIRMATION OF CORREC'TIVE'ACTION C0IVIPLiAI�ICE <br /> ❑ Claimant in corrective action compliance <br /> 4lailaimant not in corrective action compliance(90 day letter required) <br /> manntt not in ccorr action compliance- rejection recommended <br /> LEAD AGENCY SIGNATURE DATE <br /> CLAIMS REVIEWER SIGNATURE DATE <br /> USTCF025.COM(New 11/97) Page 3 <br />