Sample Taken Date	04/13/2023	Sample Unique Key	33
Date that the sample was received by the laboratory/organization performing the testing	04/13/2023	Sample type	Quality Control
A brief description of the sample	Concrete	The quantity of what the sample constitutes	100 cy
From where was the sample collected	Job Site	First name of sampler or witnessed by	Dylan
Last name of sampler or witnessed by	Bishop	Title of sampler
Telephone number of sampler		Laboratory sample identification
Linked DIME Sample ID		The fabricator/manufacturer/facility name	Central Ready Mix
Transportation Laboratory (TL) Number		Inspector Lot Number from the Transportation Laboratory (TL) Form
Structure unique identifier		Structure name
Bid Item	Not set

Material Type	Concrete	The concrete mix design number	D101C5RS
The truck number from where the sample was collected	6239	The batch plant ticket number from where the sample was collected	316783
Concrete batch plant		The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collected	BRIDGE DECK	Where the material sample would have been placed if not sampled
From Lot No.		Bag Lot No.

DIME Test ID: 2023-04-13-33-1 ASTM C143-20 (Verified)
DIME Test ID: 2023-04-13-33-2 CTM 557-June 2020 (Verified)
DIME Test ID: 2023-04-13-33-3 CTM 504-June 2010 (Verified)
DIME Test ID: 2023-04-13-33-4 CTM 521-June 2020 (Verified)