Sample Taken Date	09/13/2018	Sample Unique Key	7
Will the laboratory/organization for which you are a member perform testing on this material sample?	Yes	Date that the sample was received by the laboratory/organization performing the testing	09/14/2018
Sample type	Informational	A brief description of the sample	Sand, Rock, Silt, Clay, DG
The quantity of what the sample constitutes	N/A	From where was the sample collected	Job Site
First name of sampler or witnessed by	Dan	Last name of sampler or witnessed by	Curran
Title of sampler		Telephone number of sampler
Laboratory sample identification	D77636	Linked DIME Sample ID
The fabricator/manufacturer/facility name	Not applicable	Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form		Structure unique identifier
Structure name

Material Type	Aggregate	Source Identification (SMARA, name of Pit or Job Site)	N/A
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	Plu 70 PM 67.85
Where the material sample would have been placed if not sampled		Primary Aggregate Nominal Size	1-1/2 inch
The concrete mix design number		Lot number
Sublot number		Aggregate Mix Number	Not set

DIME Test ID: 2018-09-13-7-1 CTM 301-March 2000 (Verified)
DIME Test ID: 2018-09-13-7-2 CTM 217-June 2011 (Verified)
DIME Test ID: 2018-09-13-7-3 CTM 202-November 2011 (Verified)
DIME Test ID: 2018-09-13-7-4 CTM 643-April 2020 (Verified)