BOX 19506 SPRINGFIELD, ILLINOIS 627949506 Revision #: Date: Page of Source Designation: FOR AGENCY U 2026

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3. In the 'Source Information' section, provide details such as 'Source Name', 'Date Form Prepared', and 'Source ID No.' if known.
4. Fill out the 'General Information' fields, including the name of the emission unit and a description of the process involved.
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