Sample Taken Date	01/07/2022	Sample Unique Key	3
Date that the sample was received by the laboratory/organization performing the testing	01/07/2022	Sample type	Per Request
A brief description of the sample	A set of 6 LCB RS cylinders	The quantity of what the sample constitutes	Trail Batch
From where was the sample collected	Source	First name of sampler or witnessed by	Marcus
Last name of sampler or witnessed by	Molina	Title of sampler	Field Materials Tester
Telephone number of sampler	9095343477	Laboratory sample identification	220026
Linked DIME Sample ID		The fabricator/manufacturer/facility name	Security Paving Burbank Batch Plant
Transportation Laboratory (TL) Number		Inspector Lot Number from the Transportation Laboratory (TL) Form
Structure unique identifier		Structure name	Trial Batch
Bid Item	Not set

Material Type	Concrete	The concrete mix design number	G322LRS271
The truck number from where the sample was collected	Load 1	The batch plant ticket number from where the sample was collected	224686
Concrete batch plant	Security Paving Burbank Batch Plant	The fabricator/manufacturer designation for the sample	Trial Batch
A detailed description of where the material sample was collected	Concrete from wheelbarrow	Where the material sample would have been placed if not sampled	Trial slab
From Lot No.		Bag Lot No.

DIME Test ID: 2022-01-07-3-1 ASTM C39-21 (Verified)
DIME Test ID: 2022-01-07-3-2 CTM 521-June 2020 (Verified)
DIME Test ID: 2022-01-07-3-3 CTM 521-June 2020 (Verified)
DIME Test ID: 2022-01-07-3-4 CTM 521-June 2020 (Verified)