Sample Taken Date	10/17/2025	Sample Unique Key	33
Date that the sample was received by the laboratory/organization performing the testing	10/28/2025	Sample type	Aggregate Prequalification Program
A brief description of the sample	coarse aggregate	The quantity of what the sample constitutes	12 Bags
From where was the sample collected	Source	First name of sampler or witnessed by	Bryan
Last name of sampler or witnessed by	Dorsch	Title of sampler
Telephone number of sampler		Laboratory sample identification
Linked DIME Sample ID		The fabricator/manufacturer/facility name	Big Rock Creek - LEBATA
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)	91-19-0054
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 @ Yard
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: 2025-10-17-33-1 CTM 202-November 2011 (Verified)
DIME Test ID: 2025-10-17-33-2 CTM 227-December 2014 (Verified)
DIME Test ID: 2025-10-17-33-3 CTM 211-May 2010 (Verified)
DIME Test ID: 2025-10-17-33-4 CTM 214-August 2010 (Verified)