Sample Taken Date	08/07/2023	Sample Unique Key	50
Date that the sample was received by the laboratory/organization performing the testing	08/07/2023	Sample type	Quality Assurance
A brief description of the sample	1 x 4 PCC Aggregates	The quantity of what the sample constitutes	5cy
From where was the sample collected	Supplier	First name of sampler or witnessed by	Dorell
Last name of sampler or witnessed by	Harper	Title of sampler
Telephone number of sampler		Laboratory sample identification
Linked DIME Sample ID		The fabricator/manufacturer/facility name	CEMEX Santa Barbara
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)	91-19-0016
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	Converyor Belt
Where the material sample would have been placed if not sampled		Primary Aggregate Nominal Size	1 inch
The concrete mix design number	1614705	Lot number
Sublot number		Aggregate Mix Number

DIME Test ID: 2023-08-07-50-1 CTM 202-November 2011 (Verified)
DIME Test ID: 2023-08-07-50-2 CTM 202-November 2011 (Verified)
DIME Test ID: 2023-08-07-50-3 CTM 217-June 2011 (Verified)
DIME Test ID: 2023-08-07-50-4 CTM 227-December 2014 (Verified)