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