Sample Taken Date	12/18/2023	Sample Unique Key	35
Date that the sample was received by the laboratory/organization performing the testing	12/18/2023	Sample type	Aggregate Prequalification Program
A brief description of the sample	1" Palmdale	The quantity of what the sample constitutes	3 Buckets
From where was the sample collected	Manufacturer	First name of sampler or witnessed by	Jordan
Last name of sampler or witnessed by	Brucelas	Title of sampler
Telephone number of sampler		Laboratory sample identification
Linked DIME Sample ID		The fabricator/manufacturer/facility name	Holliday Rock Co. Inc.
Transportation Laboratory (TL) Number		Inspector Lot Number from the Transportation Laboratory (TL) Form
Structure unique identifier		Structure name
Bid Item	Not set

Material Type	Aggregate	Source Identification (SMARA, name of Pit or Job Site)	91-19-0001
The fabricator's/manufacturer's product name for the sample		The fabricator/manufacturer designation for the sample
The plant number		A detailed description of where the material sample was collected	Stockpile
Where the material sample would have been placed if not sampled		Primary Aggregate Nominal Size	1 inch
The concrete mix design number		Lot number
Sublot number		Aggregate Mix Number

DIME Test ID: 2023-12-18-35-1 CTM 202-November 2011 (Verified)
DIME Test ID: 2023-12-18-35-2 CTM 227-December 2014 (Verified)
DIME Test ID: 2023-12-18-35-3 CTM 211-May 2010 (Verified)
DIME Test ID: 2023-12-18-35-4 CTM 214-August 2010 (Verified)