Sample Taken Date	09/30/2026	Sample Unique Key	3
Date that the sample was received by the laboratory/organization performing the testing	09/30/2026	Sample type	Acceptance
A brief description of the sample	CRCP Concrete	The quantity of what the sample constitutes	CRCP 1" , 3/8" and sand
From where was the sample collected	Job Site	First name of sampler or witnessed by	NEale
Last name of sampler or witnessed by	Brown	Title of sampler
Telephone number of sampler		Laboratory sample identification
Linked DIME Sample ID		The fabricator/manufacturer/facility name	SPCI onsite
Transportation Laboratory (TL) Number		Inspector Lot Number from the Transportation Laboratory (TL) Form
Structure unique identifier		Structure name
Bid Item	56 - CONTINUOUSLY REINFORCED CONCRETE PAVEMENT

Material Type	Aggregate	Source Identification (SMARA, name of Pit or Job Site)	91-54-0021
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	Conveyor Belt
Where the material sample would have been placed if not sampled		Primary Aggregate Nominal Size	1 inch
The concrete mix design number	G3-26-pCC-400	Lot number
Sublot number		Aggregate Mix Number

DIME Test ID: 2026-09-30-3-1 CTM 202-November 2011 (Verified)
DIME Test ID: 2026-09-30-3-2 CTM 202-November 2011 (Verified)
DIME Test ID: 2026-09-30-3-3 CTM 217-June 2011 (Verified)
DIME Test ID: 2026-09-30-3-4 CTM 227-December 2014 (Verified)