Sample Taken Date	03/04/2025	Sample Unique Key	58
Date that the sample was received by the laboratory/organization performing the testing	03/05/2025	Sample type	Aggregate Prequalification Program
A brief description of the sample	Washed Concrete Sand	The quantity of what the sample constitutes	100 pounds
From where was the sample collected	Manufacturer	First name of sampler or witnessed by	Ron
Last name of sampler or witnessed by	Novak	Title of sampler	Quality Control Representative
Telephone number of sampler		Laboratory sample identification
Linked DIME Sample ID	2025-03-04-51	The fabricator/manufacturer/facility name	CEMEX Eliot Aggregates Quarry
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)	91-01-0009
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 @ Plant
Where the material sample would have been placed if not sampled		Primary Aggregate Nominal Size	fine
The concrete mix design number		Lot number
Sublot number		Aggregate Mix Number

DIME Test ID: 2025-03-04-58-2 CTM 217-June 2011 (Verified)
DIME Test ID: 2025-03-04-58-3 CTM 213-December 2012 (Verified)
DIME Test ID: 2025-03-04-58-5 CTM 229-June 2011 (Verified)
DIME Test ID: 2025-03-04-58-6 CTM 202-November 2011 (Verified)