Dangerous cargoes certificates

APPLICATION FORM

POSITION APPLIED FOR: Wiper

Personal data

Family Name: Kovalskyi	Name: Anton	Father's name: Nikolaevish
Date of birth: 10.01.1990	Place of birth: Lugansk region	Nationality: Ukrainian
Marital status: Married	Children (name & DOB): Eva 21.01.2010
Address: Odessa.Segedskaya street. 15 app. 5	E-Mail:[e-mail]	Mobile; [phone]
Next of kin and relationship: Nikolay .-father, Valentina .-mather
Next of kin’s address: Odessa. Segedskaya street. 15 app.5	Tel: [phone]
Inter. P’port No: ER 169459	Issued: 14.02.2014	Valid: 14.02.2024	Place of issue: Nikolaev
Seaman's book No: AB 527676 asdfAaAB527676	Issued: 13.05.2014	Valid: 13.05.2019	Place of issue: Odessa
Civil P’port No: EP 252742	Place of issue: Nikolaev	Date of issue: 08.09.2006
USA visa No:	Issued:	Valid:	Place of issue:

Medical information

Medical examination	Issued:	Valid:	Weight, kg: 90	Height, cm: 173
Drug & alcohol test	Issued:	Valid:	Eyes: Green	Hair: Black
Yellow fever	Issued: 14.06.2014	Valid: 14.06.2024	Overall size: 50	Safety shoes: 42

Name of marine school attended	Address of school	From	To	Degree of diploma
Training center of seafarers – «AVANT»	Odessa.Prospekt Shevshenko 16	29.08.2013	07.03.2014

National License

Certificate of competency hold	Number	Issued	Valid	Place of issue
Диплом	10117/2014/07	27.03.2014	27.03.2024	Nikolaev
Endorsement

IMO	STCW Certificates	Number	Issued	Valid	Place of issue
	GMDSS Endorsement
	Basic Training for Liquefied Gas Tanker Cargo Operations		28.02.2014	28.02.2019	Odessa
1.08	ARPA (A-I/12, A-II/1, A-II/2, B-I/12)
	Personal safety (A-VI/1) (IMO 1.13, 1.19, 1.20, 1.21)
2.03	Advanced fire fighting (A-VI/3)		11.03.2015	11.03.2020	Odessa
1.23	Prof. in survival craft (A-VI/2 p.1-4)
1.14	Medical first aid (A-VI/4-1)
1.15	Medical care (A-VI/4-2)
	Proficiency in survival craft and rescue boats other than fast rescue boats		11.03.2015	11.03.2020	Odessa
	Safety officer (ISM code)
	Crowd management (A-V/3)
	Basic Safety Training STCW-95		27.11.2013	27.11.2018	Odessa
	Security – Related Training and Instruction For All Seafarers		28.02.2014	28.02.2019	Odessa
	RoRo passenger (A-V/2-1,-2,)		28.02.2014	28.02.2019	Odessa
	Designated security duties of shipboard personnel		11.03.2015	11.03.2020	Odessa

Dangerous cargoes certificates

1.01	Oil tank. familiarization (A-V/1)
1.02	Oil tank.Specialized training (A-V/1,p.9-14)		28.02.2014	28.02.2019	Odessa
1.03	Chem. tank. familiarization (V/1)				.
1.04	Chem. tank. advanced (A-V/1,p.16-21)
1.05	LPG familiarization (V/1)

PREVIOUS SEA SERVICES (last 5 years)

Name of vessel	Year of built	Company	Flag	Type of vessel	DWT	Type of main engine	BHP	Rank	From Day,mont,year	To Day,month,year
MARS		Illichevsk port	Ukreine	Bunkering Vessel	1621t	8NVD36-14	450 kBt	Motorman	30.12.2013	01.03.2014
Fort Azov		Valdex Trade LTD	SAINT KITTS & NEVIS	GENERAL Cargo	3261t	515*2Kw	1030kBt	Motorman	19.05.2014	23.12.2014

Дата добавления: 2015-07-26