Sample Taken Date	10/28/2020	Sample Unique Key	13
Date that the sample was received by the laboratory/organization performing the testing	10/29/2020	Sample type	Quality Assurance
A brief description of the sample	Hydrolite-Trinity Lightweight	The quantity of what the sample constitutes	3-5 gallon bucket
From where was the sample collected	Job Site	First name of sampler or witnessed by	not available
Last name of sampler or witnessed by	not available	Title of sampler
Telephone number of sampler		Laboratory sample identification	20-PCCC-0217
Linked DIME Sample ID		The fabricator/manufacturer/facility name	na
Transportation Laboratory (TL) Number	na	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)	na
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	at job site
Where the material sample would have been placed if not sampled		Primary Aggregate Nominal Size	3/8 inch
The concrete mix design number		Lot number
Sublot number		Aggregate Mix Number	Not set

DIME Test ID: 2020-10-28-13-2 CTM 202-November 2011 (Verified)
DIME Test ID: 2020-10-28-13-3 AASHTO T104-99r16 (Verified)
DIME Test ID: 2020-10-28-13-4 CTM 214-August 2010 (Verified)
DIME Test ID: 2020-10-28-13-5 AASHTO T104-99r16 (Verified)