Sample Taken Date	05/08/2025	Sample Unique Key	7
Date that the sample was received by the laboratory/organization performing the testing	05/09/2025	Sample type	Quality Assurance
A brief description of the sample	TYPE II/V CEMENT	The quantity of what the sample constitutes	2 CY
From where was the sample collected	Job Site	First name of sampler or witnessed by	Laura
Last name of sampler or witnessed by	Cangas	Title of sampler	SR
Telephone number of sampler	7074964358	Laboratory sample identification
Linked DIME Sample ID		The fabricator/manufacturer/facility name	Eureka Ready Mix
Transportation Laboratory (TL) Number		Inspector Lot Number from the Transportation Laboratory (TL) Form
Structure unique identifier	12-04E0056	Structure name	RW C
Bid Item	Not set

Material Type	Concrete	The concrete mix design number	E400F
The truck number from where the sample was collected	98	The batch plant ticket number from where the sample was collected	42062
Concrete batch plant	Arcata Eureka Ready Mix	The fabricator/manufacturer designation for the sample	Batch
A detailed description of where the material sample was collected	CHUTE FROM TRUCK	Where the material sample would have been placed if not sampled	RW C CIP lagging
From Lot No.		Bag Lot No.

DIME Test ID: 2025-05-08-7-1 CTM 557-July 2012 (Verified)
DIME Test ID: 2025-05-08-7-2 CTM 556-January 2018 (Verified)
DIME Test ID: 2025-05-08-7-3 ASTM C39-21 (Verified)
DIME Test ID: 2025-05-08-7-5 CTM 521-June 2012 (Verified)