SCHEDULE NO (4)
Application for license for building a factory or extensions in a factory in accordance with section 80 of
the Labor Act. 1997.
1. Name of the factory owner…………………………..
2. Name and address of the Factory……………………
3. Economic and Industrial activity…………………….
4. Number of the Plot……………..Block…………….
Area…………………………………………………
Site………………………………………………….
5. Building materials used in:(a) Floors……………………………
(b) Walls……………………………..
(c) Roofs…………………………….
6. The types of machinery used in the factory:(a) Are they run by electricity?
(b) Are they run by diesel?
(c) Are they run by steam?
(d) Whether run manually?
7. Are steam boilers and pressure receptacles used; if so state their:(a) Number……………………………
(b) Serial No………………………….
(c) Pressure…………………………..
(d) Date of manufacture……………..
8. Storage:(a) Chemical substances;
(b) Organic substances;
(c) Other waste.
Workers employed.
Stages
1st
2nd
3rd
Men
Women
Infants
Date………………. Signature of Factory owner……………
34
Total