Sample Taken Date	07/08/2016	Sample Unique Key	20
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	07/08/2016
Sample type	Department Acceptance	A brief description of the sample	Class 2 Aggregate Base
The quantity of what the sample constitutes	Unknown	From where was the sample collected	Job Site
First name of sampler or witnessed by	Larry	Last name of sampler or witnessed by	Francisco
Title of sampler	TE	Telephone number of sampler	Unknown
Laboratory sample identification	6281B	Linked DIME Sample ID	Unknown
The fabricator/manufacturer/facility name	Robertsons Barstow	Transportation Laboratory (TL) Number	Unknown
Inspector Lot Number from the Transportation Laboratory (TL) Form	Unknown	Structure unique identifier	Not set
Structure name	Not set

Material Type	Aggregate	Source Identification (SMARA, name of Pit or Job Site)	Unknown
The fabricator's/manufacturer's product name for the sample	Unknown	The fabricator/manufacturer designation for the sample	Unknown
The plant number	Unknown	A detailed description of where the material sample was collected	Sta 92 00 Pioneer Blvd
Where the material sample would have been placed if not sampled	Unknown	Primary Aggregate Nominal Size	1 inch
The concrete mix design number		Lot number	Not set
Sublot number	Not set	Aggregate Mix Number	Not set

DIME Test ID: 2016-07-08-20-1 CTM 202-November 2011 (Verified)
DIME Test ID: 2016-07-08-20-2 CTM 217-June 2011 (Verified)
DIME Test ID: 2016-07-08-20-3 CTM 229-June 2011 (Verified)
DIME Test ID: 2016-07-08-20-4 CTM 301-March 2000 (Verified)