Sample Taken Date	08/07/2025	Sample Unique Key	51
Will the laboratory/organization for which you are a member perform testing on this material sample?	Yes	Date that the sample was received by the laboratory/organization performing the testing	08/08/2025
Sample type	Quality Control	A brief description of the sample	rsc
The quantity of what the sample constitutes	cy	From where was the sample collected	Source
First name of sampler or witnessed by	Dennis	Last name of sampler or witnessed by	Rodriguez
Title of sampler	QC Technician	Telephone number of sampler
Laboratory sample identification		Linked DIME Sample ID
The fabricator/manufacturer/facility name	GL Throop Co.	Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form		Structure unique identifier
Structure name		Bid Item	Not set

Material Type	Concrete	The concrete mix design number	2007-007
The truck number from where the sample was collected	113	The batch plant ticket number from where the sample was collected	1
Concrete batch plant		The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collected	NB Rte805 at 47th Street at Lane 3 South Side	Where the material sample would have been placed if not sampled
From Lot No.		Bag Lot No.

DIME Test ID: 2025-08-07-51-1 CTM 521-June 2020 (Verified)
DIME Test ID: 2025-08-07-51-2 CTM 521-June 2020 (Verified)
DIME Test ID: 2025-08-07-51-3 CTM 521-June 2020 (Verified)
DIME Test ID: 2025-08-07-51-4 CTM 521-June 2020 (Verified)