Sample Taken Date	11/16/2020	Sample Unique Key	37
Date that the sample was received by the laboratory/organization performing the testing	12/14/2020	Sample type	Aggregate Prequalification Program
A brief description of the sample	Washed Concrete Sand	The quantity of what the sample constitutes	production stockpile.
From where was the sample collected	Manufacturer	First name of sampler or witnessed by	Jon
Last name of sampler or witnessed by	Blumer	Title of sampler	QA Technician
Telephone number of sampler	530-749-1182	Laboratory sample identification	20-APPF-0232
Linked DIME Sample ID	2020-11-16-24	The fabricator/manufacturer/facility name	Teichert Materials Hallwood
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)	91-58-0006::HALLWOOD PLANT
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 at the Plant
Where the material sample would have been placed if not sampled		Primary Aggregate Nominal Size	fine
The concrete mix design number		Lot number
Sublot number		Aggregate Mix Number	Not set

DIME Test ID: 2020-11-16-37-1 CTM 202-November 2011 (Verified)
DIME Test ID: 2020-11-16-37-2 CTM 213-December 2012 (Verified)
DIME Test ID: 2020-11-16-37-4 CTM 217-June 2011 (Verified)
DIME Test ID: 2020-11-16-37-5 CTM 229-June 2011 (Verified)