Sample Taken Date	03/14/2024	Sample Unique Key	64
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	03/19/2024
Sample type	Preliminary	A brief description of the sample	1 bag of Soil
The quantity of what the sample constitutes	Soil for use in Embankment	From where was the sample collected	Source
First name of sampler or witnessed by	Scott	Last name of sampler or witnessed by	Lewis
Title of sampler	Senior Engineering Geologist	Telephone number of sampler
Laboratory sample identification	D79447	Linked DIME Sample ID
The fabricator/manufacturer/facility name	In situ	Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form		Structure unique identifier
Structure name

Material Type	Soil	The fabricator's/manufacturer's product name for the sample
The fabricator/manufacturer designation for the sample		A detailed description of where the material sample was collected	Embankment near culvert outlet at south side, 02-Sha-299-41.17, 0 - 0.7 ft depth.
Where the material sample would have been placed if not sampled

DIME Test ID: 2024-03-14-64-1 CTM 202-November 2011 (Verified)
DIME Test ID: 2024-03-14-64-2 CTM 203-February 2008 (Verified)
DIME Test ID: 2024-03-14-64-3 CTM 204-June 2010 (Verified)
DIME Test ID: 2024-03-14-64-4 ASTM D2487-17 (Verified)