Sample Taken Date	08/27/2014	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	08/28/2014
Sample type	Acceptance	A brief description of the sample	Class 3 Aggregate Base
The quantity of what the sample constitutes	1 Bag	From where was the sample collected	Source
First name of sampler or witnessed by	Ramsey	Last name of sampler or witnessed by	Doumani
Title of sampler	Materials Tester	Telephone number of sampler
Laboratory sample identification	4240B	Linked DIME Sample ID	Not set
The fabricator/manufacturer/facility name	Stockpile at the contractors yard	Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form		Structure unique identifier	Not set
Structure name	Not set

Material Type	Aggregate	Source Identification (SMARA, name of Pit or Job Site)	Atlantic Blvd contractors yard
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	Atlantic Blvd contractors yard
Where the material sample would have been placed if not sampled		Primary Aggregate Nominal Size
The concrete mix design number		Lot number	Not set
Sublot number	Not set	Aggregate Mix Number	Not set

DIME Test ID: 2014-08-27-7-1 CTM 202-November 2011 (Verified)
DIME Test ID: 2014-08-27-7-2 CTM 217-June 2011 (Verified)
DIME Test ID: 2014-08-27-7-3 CTM 229-June 2011 (Verified)
DIME Test ID: 2014-08-27-7-4 CTM 301-March 2000 (Verified)