This is a Blue Amberol Edison Cylinder recording. The printed ID number is 4003. The performer is printed as Louise Terrell and C. Ballard. There is a small accretion stuck to the plastic cellulose. It is in its original case, however, the lid is coming apart.
This cylinder has been digitized by UC Santa Barbara and can be streamed here: http://cylinders.library.ucsb.edu/search.php?queryType=@attr%201=4&query=don%27t+you+remember+the+time&num=1&start=1&sortBy=&sortOrder=id