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Login at business. wa.gov/BLS. You ll need a Secure Access Washington user ID for My DOR. Visit bls. Wa.gov/BLS UBI Owner name Local Authority Inspection This form may only be submitted as an attachment to the renewal. If you are unable to obtain a signature from your local authority please call Department of Licensing at 360 664-6466. A Business Site Identification Business Firm Name Business Telephone Number Business physical location address Street or rural route City B County Inspecting Officer approval Do not use PO box number Hulker Hauler State Vehicle Wrecker Zip Code Motor Vehicle Salvage Processor Signature required of a Washington State Patrol Official if the city population is under 5 000 or signature of Chief of Police if population is more than 5 000. This business complies with Chapter 46. 79 RCW or 46. 80 RCW. Name of Officer Signature of inspecting officer C Badge Phone number Scrap Metal Processor Title Date signed Scrap Metal Recycle and/or Scrap Metal Supplier only Name of Local Authority Signature of local authority D Other Information Optional For Local Authority Use You may send this information by My DOR the fastest and easiest way to send documents. State of Washington Business Licensing Service PO Box 9034 Olympia WA 98507-9034 Telephone 1-800-451-7985 business. wa*gov/BLS UBI Owner name Local Authority Inspection This form may only be submitted as an attachment to the renewal* If you are unable to obtain a signature from your local authority please call Department of Licensing at 360 664-6466. A Business Site Identification Business Firm Name Business Telephone Number Business physical location address Street or rural route City B County Inspecting Officer approval Do not use PO box number Hulker Hauler State Vehicle Wrecker Zip Code Motor Vehicle Salvage Processor Signature required of a Washington State Patrol Official if the city population is under 5 000 or signature of Chief of Police if population is more than 5 000. This business complies with Chapter 46. 79 RCW or 46. 80 RCW* Name of Officer Signature of inspecting officer C Badge Phone number Scrap Metal Processor Title Date signed Scrap Metal Recycle and/or Scrap Metal Supplier only Name of Local Authority Signature of local authority D Other Information Optional For Local Authority Use You may send this information by My DOR the fastest and easiest way to send documents. dor. wa/MyDOR for more information* Fax to 360 705-6699 Mail this form to the address above. For tax assistance or to request this document in an alternate format please call 1-800-647-7706. State of Washington Business Licensing Service PO Box 9034 Olympia WA 98507-9034 Telephone 1-800-451-7985 business. wa*gov/BLS UBI Owner name Local Authority Inspection This form may only be submitted as an attachment to the renewal* If you are unable to obtain a signature from your local authority please call Department of Licensing at 360 664-6466. wa*gov/BLS UBI Owner name Local Authority Inspection This form may only be submitted as an attachment to the renewal* If you are unable to obtain a signature from your local authority please call Department of Licensing at 360 664-6466. A Business Site Identification Business Firm Name Business Telephone Number Business physical location address Street or rural route City B County Inspecting Officer approval Do not use PO box number Hulker Hauler State Vehicle Wrecker Zip Code Motor Vehicle Salvage Processor Signature required of a Washington State Patrol Official if the city population is under 5 000 or signature of Chief of Police if population is more than 5 000.

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