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This Form to be filled up

and sent to the Inspector
of the District on Jan. 1
1874 and every following
year.

COAL MINES REGULATION ACT, 1872. 35. & 36 VICT. CAP. 76. SECT. 69. AND SCHEDULE 4.

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Diameter and Depth of downcast and

upcast Shafts.

Average Number of Persons

employed daily.

Mode of Ventilation

Furnace or Fan, with

Description.

Number of Splits and

Quantity.

Average
Length of
Airways.

Sectional
Area of
Airways.

Average Total

Quantity of fresh Air in

cubic feet per minute.

Downcast.

Upcast.

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This Form to be filled up and sent to the Inspector of the District

on or before 1st February every year.

COAL MINES REGULATION Act.

35 & 36 Vict. c. 76. s. 38.

Name of the Mine or Colliery,

Situation of Mine

County

Name of Owner (Company)
Return of Persons ordinarily employed during the Year ending

31 December 187

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Quantity of Mineral wrought during the Year ending. 31 December

187

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NOTE.—The dates printed in the column
headed “Memorandum of Certificates of School
Attendance" are the dates of the successive
Saturdays in the year 1873.

Upon a FORTNIGHTLY Certificate being
received certifying that during the fortnight
ending on any one of the printed dates the
school attendance of a boy has been such as to
satisfy the provisions of the Act, a mark
thus is to be placed in the space allotted
to such date.

Also if during any such fortnight a boy has
been employed, but for some cause sanctioned
by the Act has not attended school, the cause
should be inserted in the space, as “ Sick,"
“ School closed," or “ No school," as the case
may be.

Mine.

Manager.

Boys of the age of 10 and under the age of 12 employed below ground.

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Memorandum of Certificates of School Attendance.

Remarks.

Jan.

Feb.

March

April

May

June

July

August

Sept.

Oct.

Nov.

Dec.

4 11 18 25 1 8 15 22 1 8 15 22 29 5 12 19 26 3 10 17 24 31 7 14 21 28 5 12 19 26 2 9 16 23 30 6 13 20 27 4 11 18 25 1 8 15 22 29 6 13 20 27

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Boys of the age of 12 and under the age of 13 employed below ground.

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Male young persons of the age of 13 and under the age of 16 employed below ground.

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