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DE,,TAILED REVIEW CHECK LIST <br /> Page 3 <br /> Claim No: 61G Claimant Name: ��� TQii1 SOS. <br /> COMPLIANCE DOCUMENTATION <br /> DATE ACTION/RESPONSE <br /> "6./ <br /> j <br /> s o �rz /o <br /> ;1 <br /> (o iv 7 <br /> ya �7 S GGP I <br /> _. 7 <br /> if <br /> �c <br /> 21A LrG77 P01 S ? <br /> T S mss ' i. <br /> i <br /> it <br /> lI <br /> i <br /> i <br /> 'J <br /> t, <br /> Continued on Reverse if <br /> CONFIRMATION OF CORRECT7VE ACTION COMPLIANCE <br /> Claimant in Corrective Action Compliancei� <br /> Claimant NOT in Corrective Action Compliance at the Time of this Review - 90 Day Letter Required I, <br /> Claimant NOT in Corrective Action Compliance - Recommend Rejection <br /> f U :6Q- 31 a6 <br /> LEAD AGENCY SIGNATURE DATE �I <br /> CLAIMS REVIEWER SIGNATURE DATE <br /> q <br /> USTCF025.DET (Rev 1195) <br />