Department of Labour and Employment FORM 31 (Prescribed under sub rule (3) of rule 111) ANNUAL Return shelters, Rest rooms and lunch Rooms Year ending 31st December 200 1. Industry 2. Name of the factory and address 3. Number of workers normally employed 4. Average daily attendance of workers at the shelter, rest room or lunchroom 5. Details of facilities provided with regards to drinking water 6. Details of accommodation, furniture and other equipment provided 7. General remarks - Certified that the information furnished above is to the best of my knowledge and belief correct. Date: Signature of Manager
